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CLINICAL PLACEMENT RESOURCE MANUAL CLINICAL FACILITATORS Bachelor of Nursing School of Nursing and Midwifery Deakin University March 2015 Deakin University CRICOS Provider Code: 00113B

Table of Contents

School of Nursing and Midwifery – Clinical team contact list ................... 4

SONM Clinical placement communications ................................................... 5

Overview of Bachelor of Nursing (BN) ............................................................ 6

BN course outline .............................................................................................................. 6

Assessment of Clinical Practicum ....................................................................................... 7

Pre-requisites for clinical placement (pre-placement requirements) ...... 7

Clinical placement rules and responsibilities – Requirements 2015 ........................................................................................ 8

Clinical placement rules and responsibilities – Academic Progress 2015 .............................................................................. 14

Supervision of placement ............................................................................... 19

Clinical Learning Activities ............................................................................. 19

Attendance ........................................................................................................ 19

Uniform .......................................................................................................................... 19

Rosters ............................................................................................................................ 19

Absences ......................................................................................................................... 19

Clinical Assessment Tool submission ............................................................ 20

Clinical Assessment Tool (CAT) ...................................................................... 21

CAT Checklist .................................................................................................... 21

Clinical Assessment Tool 2015 ....................................................................... 22

Bachelor of Nursing: Professional Learning Portfolios .............................. 27

HNN112: Quality and Safety: Nursing Practice 1 ............................................................... 27


HNN217: Community Nursing Practice ............................................................................. 36

HNN222: Mental Health and Illness ................................................................................. 40


HNN318: The Older Person and Supportive Care .............................................................. 48

HNN319: Chronic Illness and Supportive Care .................................................................. 52

Deakin University CRICOS Provider Code: 00113B

School of Nursing and Midwifery Faculty of Health

Geelong Waterfront Campus, Melbourne Burwood Campus, Warrnambool Campus www.deakin.edu.au

HNN325: Comprehensive Nursing Practice ....................................................................... 55

ISBAR Handover Tool - Introduction ................................................................................. 59

ISBAR Handover Tool ....................................................................................................... 60




School of Nursing and Midwifery – Clinical team contact list

Director of Clinical Studies Dr. Lauren McTier [email protected]

(03) 9244 6490

Burwood Campus

Clinical Coordinator Ms. Michele McGrath [email protected]

(03) 9244 6932

Clinical Administrative Officer Ms. Alison Kenny [email protected]

(03) 9244 6521

Clinical Administrative Assistant Ms. Michelle Doney [email protected]

(03) 9244 6113

Waterfront Campus

Clinical Coordinator Ms. Jennifer Hosking [email protected]

(03) 5227 8438

Clinical Administrative Officer Ms. Geeta Jaswal [email protected]

(03) 5227 8403

Warrnambool Campus

Clinical Coordinator Ms. Erin Guiney [email protected]

(03) 5563 3264

Clinical Administrative Officer Ms. Simone Russell [email protected]

(03) 5563 3325




mailto:[email protected]








SONM Clinical placement communications

Clinical Facilitator

Administration Staff:

(B) Alison Kenny 3 9244 6521

(S) Geeta Jaswal 3 5227 8403

(W) Simone Russell 3 5563 3325

Clinical Coordinators:

(B) Michele McGrath 3 9244 6932 or 0410518197

(S) Jennifer Hosking 3 5227 8438 or 0429383176

(W) Erin Guiney 3 5563 3264 or 0499491979

Unit/Campus Chair

Director of Clinical Studies:

Lauren McTier

3 9244 6490 or 0413616314

Key

(B) Burwood

(S) Waterfront

(W) Warrnambool




Overview of Bachelor of Nursing (BN)

BN course outline The tenets of quality and safety and clinical risk management provide the conceptual framework that underpins the curricula of the Bachelor of Nursing and combined courses, and the Bachelor of Nursing (Clinical Leadership). The key themes of the quality and safety framework are; patient-centred care, working within multidisciplinary teams, evidence-based practice, effective communication, ethical practice, and clinical decision-making. To facilitate development of knowledge and skills in the area of quality and safety students are provided with a range of teaching and learning activities that address the key themes. Knowledge within these core competency domains will be developed through the major themes of symptom, risk, and management of functional status. These themes will be examined from the perspectives of professional studies, clinical studies and supportive units of study across the curriculum.

This conceptual framework is further supported by Deakin University’s strategic plan, ‘LIVE the Future 2020’. Deakin’s strategic agenda provides a bold and exciting plan for the future, defining and distinguishing the university through to the end of 2020. The LIVE the future Agenda 2020 responds to challenges and opportunities, and to changes in national policy and market conditions, while holding true to Deakin's character and founding goals. Deakin plans to drive the digital frontier and transform the student learning experience by redesigning online, cloud delivery, to ensure resources are engaging and personalised. Deakin will use located and cloud learning to provide accessible, media-rich, interactive and active educational experiences designed for excellent learning outcomes and optimum employability. They will incorporate the best that Deakin has to offer together with excellent external resources available from around the world. The “Deakin Promise” comprises four important and interconnecting elements, with the initial letters spelling the acronym of LIVE; Learning, Ideas, Value and Experience. Deakin promises to advance:

Learning – offering brilliant education where you are and where you want to go;

Ideas – making a difference through world class innovation and research;

Value – strengthening our communities, enabling our partners and enhancing our enterprise; and

Experience – delighting our students, our alumni, our staff and our friends.

The Bachelor of Nursing and combined courses, and the Bachelor of Nursing (Clinical Leadership) clearly reflect each of these elements, and will develop in students the awareness and skills to adapt to an ever changing work place and world, preparing them for the jobs and skills of the future. The Bachelor of Nursing suite of courses will provide opportunities for students to develop the ability to reflect on learning, engage with others, with the community, with the health care industry and as a global citizen. As such it is pertinent to ensure students have a holistic view of their course and a clear future view of their career and employability. This will be achieved through use of ePortfolio, a recently introduced innovative technology to Deakin University that will enable students to evidence their learning and achievement of the Bachelor of Nursing course learning outcomes.

The “Deakin Promise” provides impetus for developing student-staff partnerships, fostering learning environments that focus on student outcomes, acknowledging student diversity, and encouraging course design which is relevant, flexible, and informed by high quality contemporary research. In addition, the National Competency Standards for the Registered Nurse (ANMAC, 2012), The Global Standards for the Initial Education of Professional Nurses and Midwives (WHO, 2009) and The Health Professions Education report (Institute of Medicine of the National Academies, 2003) have informed the overall pedagogy of this




course. The approaches to teaching and learning are based on the scholarship of John Biggs (2011) and Paul Ramsden (2003) who assert that alignment of intended learning outcomes, teaching approaches and assessment are fundamental to the achievement of quality learning outcomes.

The curriculum has a learner-centred pedagogy where students gain knowledge through inquiry, problem solving and experience. The curriculum goals are to ensure graduates develop the necessary knowledge and competencies to meet registration requirements, are safe competent clinicians with quality clinical risk management skills, and have the ability to apply new technology safely and appropriately. The curriculum is designed to help students develop flexible knowledge, effective problem solving skills, self-directed approaches to learning, and effective collaboration skills.

Development of the necessary inquiry skills requires a curriculum with strong purpose and clear articulation between professional standards, course outcomes, unit learning outcomes and the overall Deakin Graduate Learning Outcomes. Teaching and learning approaches and assessment tasks are constructively aligned with unit leaning outcomes. Supported workplace experiences give students the opportunity to care for people from diverse cultural backgrounds in a range of health care settings, allowing application of knowledge and further development of technical and non-technical skills.

Assessment of Clinical Practicum Students’ clinical experience for nursing units is assessed using the Clinical Assessment Tool (CAT) based on the Nursing and Midwifery Board of Australia (NMBA) Competency Standards for Registered Nurses. These competencies reflect the knowledge, skills, and attitudes required of a beginning level Registered Nurse. Assessment of clinical competencies is linked to theoretical content and the achievement of the appropriate standard to meet unit outcomes, clinical outcomes, and course content. Each clinical unit identifies specific Clinical Placement Activities that describe the objectives of the unit’s clinical placement. This document comprises part of the student’s Professional Learning Portfolio.

Pre-requisites for clinical placement (pre-placement requirements)

In order to be allocated to and attend clinical placement in 2015 students must have:

1. a 2015 National Police Check (NPC);

2. a current Working with Children (WWC) Check card (including 2015);

3. submitted the Vaccination and Blood Test Checklist;

4. submitted the 2015 Influenza Vaccination Form; and

5. signed and submitted a Consent for Information Collection and Release Form.

Failure to meet any of these pre-requisites will result in an inability to attend clinical placement and an overall fail grade for clinical units. This will impede student’s course progression.

Students can be asked by a clinical agency to confirm their NPC, WWC Check Card and Immunisation status during clinical placements. As per the Clinical rules and responsibilities – requirements 2015, failure to do so may result in the Clinical Agency refusing permission for the student to continue their placement and affect the student’s ability to complete the clinical requirements for the unit.




Clinical placement rules and responsibilities – Requirements 2015

Bachelor of Nursing courses* and non-award courses 1 These Clinical Placement Rules and Responsibilities apply to the following:

a) H326 Bachelor of Nursing;

b) H329 Bachelor of Nursing (Clinical Leadership);

c) D355 Bachelor of Nursing/Bachelor of Midwifery;

d) D381 Bachelor of Nursing/Bachelor of Public Health and Health Promotion;

e) D387 Bachelor of Nursing/Bachelor of Psychological Science; and

f) Non-award course H011 Return to Practice and Initial Registration (Overseas Qualified Nurses) (collectively “the Courses”).

2 The learning experience undertaken on clinical placements is designed to provide students with opportunities to develop knowledge and skill in the cognitive, psychomotor and affective nursing domains. The development of these attributes are essential for students to meet the overall requirements of the accredited course and to be eligible to register with the Nursing and Midwifery Board of Australia.

3 Students on clinical placements are undertaking a University activity and remain subject to the University’s statutes, regulations, policies and procedures, including in relation to student misconduct.

All students undertaking clinical placement must abide by all relevant legislation and in particular the principles of the Privacy and Data Protection Act 2014 (Vic)1 the Health Records Act 2001 (Vic)2 and the Health Professions Registration Act 2005 (Vic)3.

4 The emphasis of all clinical learning experiences will be on providing opportunities for students to:

• integrate theory and practice;

• develop an appropriate level of competence; and

• achieve clinical outcomes associated with the unit learning outcomes.

5 The academic progress of students undertaking clinical placement is governed by:

a) Regulation 5.3(1) – Assessment and Academic Progress in Higher Education Award Courses;

b) Academic Progress Procedure; and

* Bachelor of Nursing courses includes H326, H329, D355, D381, D387 1 Privacy and Data Protection Act 2014 (No.60, 20014) accessed 05/01/15 from www.legislation.vic.gov.au 2 Health Records Act 2001 (No.2, 2001) accessed 05/01/15 from www.legislation.vic.gov.au 3 Health Professions Registration Act 2005 (No.97, 2005) accessed 05/01/15 from www.legislation.vic.gov.au




c) The School of Nursing and Midwifery “Clinical Placement Rules and Responsibilities – Academic Progress”.

National Police Check 6 The Department of Human Services (DHS), Police Record Check Policy (4.6) requires all students to

complete a National Police Check (NPC) prior to the first clinical placement and in each subsequent year of study.4

7 International students are also required to obtain a police records check from their country of residence prior to commencement of the course, as well as meet the obligations detailed in clause 5 above.

8 Where it is not possible for the International Student to complete a Police Record Check from their home country, they must provide at least two (2) references from persons they personally knew whilst residing in their home country. The references must include any knowledge or information concerning the student which would adversely affect the student undertaking clinical placement, including relevant criminal offences.4

Note: The credentials of persons acting as referees must be verified and can include previous employers, government officials, and family members.4

9 The School of Nursing and Midwifery has contracted the services of Mercury Search and Selection Pty Ltd trading as Fit2Work, to undertake the NPC for the University and students. On instructions from the School of Nursing and Midwifery Fit2Work will send students instructions and a consent form via email detailing how to complete their application form for the NPC for each calendar year of study. Students must supply their application for a NPC by the date specified by the School of Nursing and Midwifery and Fit2Work. The date will be communicated to students via Deakin email address and on Cloud Deakin.

10 If a student has not completed their NPC by the designated due date, the student CANNOT participate in any clinical placements for that Trimester of study.

Note: This will result in a Fail grade for each clinical unit and will impede progress in the course.

11 If a student has a disclosable offence on their NPC, clinical agencies have the right to refuse to provide a placement. The School of Nursing and Midwifery will attempt to secure an alternative placement. If an alternative placement cannot be obtained by the School, the student will be unable to meet the requirements for the unit and completion of the course will not be possible.

Working with Children Check 12 As a requirement of the Working with Children Act, 2005 as administered by the Victorian

Department of Justice, all students must undergo a Working with Children (WWC) Check at the commencement of their course.

4 Department of Health (2014) Service agreement information kit for funded organisations accessed 05/01/15 from http://www.dhs.vic.gov.au/facs/bdb/fmu/service-agreement

4 Department of Health (2014) Service agreement information kit for funded organisations accessed 05/01/15 from http://www.dhs.vic.gov.au/facs/bdb/fmu/service-agreement




13 The WWC Check is valid for five (5) years, unless revoked by the Department of Justice5. Hence, students will normally only be required to complete the WWC Check at the commencement of their course.

14 Students must present, in person, their WWC Check card by the date specified by the School of Nursing and Midwifery. The date will be communicated to students via their Deakin email address, on CloudDeakin and at each Orientation Session.

15 If a student does not present their WWC Check card to the School of Nursing and Midwifery by the designated due date, the student CANNOT participate in any clinical placements for that Trimester of study.

Note: This will result in a Fail grade for each clinical unit and will impede progress in the course.

16 If the student is unsuccessful in obtaining a WWCC the student will be unable to meet the requirements for the unit and completion of the course will not be possible.

Immunisations 17 Deakin University enters into agreements with agencies for health science related student

placements. These agreements include the Clinical Agencies’ requirements for immunisation (vaccinations) and provide that an agency may refuse to accept a student for placement if the student’s immunisation status is not satisfactory to the agency.

18 Deakin University provides students with information regarding immunisations when they enrol in the course. This specifies vaccinations for students undertaking relevant health science related courses and reflects the Clinical Agencies’ requirements.

19 Students are required to submit to the School of Nursing and Midwifery the “School of Nursing and Midwifery Vaccination and Blood Checklist” form as evidence of their immunisation status by the designated due date. The date will be communicated to students via Deakin email address and on Cloud Deakin. It is the responsibility of students to ensure that they have obtained all necessary immunisations prior to placement.

20 If a student does not present the School of Nursing and Midwifery Vaccination and Blood Checklist form by the designated due date, the student CANNOT participate in any clinical placements for that Trimester of study. Note: this will result in a Fail grade for each clinical unit and will impede progress in the course.

21 A student with a conscientious objection to meeting Immunisation requirements may be refused clinical placements by Clinical Agencies. As a result the student may be unable to meet the clinical requirements for the unit and this will affect the student’s ability to complete the course.

Provision of the NPC, WWC Check Card and immunisation status to the Clinical Agency 22 If a student is unable to provide documentary evidence of their NPC, WWCC card and Immunisation

status to the Clinical Agency as requested during the clinical placement, the agency may refuse permission for the student to undertake the clinical placement. This will affect the student’s ability to complete the clinical requirements for the unit.

5 Working with Children Act 2005 (No.57, 2005) accessed 05/01/15 from www.legislation.vic.gov.au




23 Clinical Agencies may require students to sign a privacy, confidentiality, and security agreement either prior to, or at commencement of a clinical placement.

Acknowledgment of (i) “Clinical Placement Rules and Responsibilities – Requirements”, and (ii) “Clinical Placement Rules and Responsibilities – Academic Progress” 24 The School of Nursing and Midwifery requires all students to acknowledge receipt of and

confirmation that they have read this document and the following document prior to being allocated to clinical placements:

Faculty of Health, School of Nursing and Midwifery “Clinical Placement Rules and Responsibilities – Academic Progress”

Students will receive an email via their Deakin email address directing them to the online website to view the documents and confirm their acknowledgement. Students will be unable to allocate to any clinical placements until their acknowledgement is received. Note: Acknowledgment indicates the student has read the rules and responsibilities as outlined,

and understands them.

Note: If a student has provided false or misleading information to the School of Nursing and Midwifery the student will be withdrawn from placement and will be liable for all Clinical Agency and administrative costs relating to the clinical placement/s. Please note that providing false information to the University may also result in disciplinary action being taken against a student pursuant to Regulations 4.1(1) or 4.1(2).

Lines of responsibility and incident reporting 25 The student engaged in clinical learning is responsible to both the Nurse Unit Manager/team leader

and the Clinical Facilitator as these individuals have responsibility for safe patient care.

26 Should an 'incident' occur which involves a student or a person for whom the student is providing care, the Clinical Facilitator and Nurse Unit Manager/team leader should be immediately notified by the student. Failure by the student to provide such immediate notification may be grounds for withdrawal from the clinical learning experience.

27 An 'incident' is any event or circumstance that could have resulted, or did result, in unnecessary harm to a patient.6 The Clinical Facilitator and student involved will together complete the appropriate Clinical Agency documentation such as RiskMan or an Incident report. A copy of the report or summary of incident if RiskMan is completed must be attached to the Clinical Assessment Tool (CAT). The Clinical Facilitator should verbally notify the Unit/Campus Chair that an incident has occurred. The student and Clinical Facilitator must be familiar with the Clinical Agency's policy regarding an incident and ensure that the requirements outlined in the Clinical Agency's policy are duly followed.

28 If a student is unsure of whether an incident has occurred, they should consult with their Clinical Facilitator and the nurse unit manager/team leader.

Dress code and religious observance during clinical placement 29 Students must wear Deakin University, School of Nursing and Midwifery uniforms and display the

appropriate Deakin University identification. In line with relevant industry Occupational Health and Safety policies and the relevant Clinical Agency policies, short sleeves must be worn, hair is to be




tied back, no jewellery is to be worn, except for small studs and a plain banded ring, finger nails are to be short, clean and free from nail polish consistent with the relevant Clinical Agency policy.

30 Any student not adhering to the expectations outlined in 29 will be placed on clinical review.7

31 If a particular placement requires alterations to dress, students will be notified prior to the commencement of that clinical placement. All students must maintain a professional appearance while on clinical placement.

32 Students who require consideration for religious observance requests in relation to clinical placement rosters must notify the clinical co-ordinator on their campus by the end of week 1 of each Trimester. Students will be required to provide supporting documentation in the form of a letter from their religious leader or group to confirm they are a member and list the religious dates/days requested not to be allocated.

Clinical placement allocation 33 To meet the course requirements of the accredited Courses and requirements to be eligible to

register with the Nursing and Midwifery Board of Australia, students are required to attend clinical placement as per the dates and times for which they are allocated.

34 Student clinical placement may include gaining experience from all shift cycles, that is; morning, evening and night shift, including some weekend shifts. A shift is normally for eight (8) hours.

35 Clinical placements are arranged by the School of Nursing and Midwifery. Students must make themselves available to undertake their clinical placement at the designated time. If clinical placement is not successfully completed at the arranged time, a fail grade for the unit will be recorded. This will impede the student’s course progression and the student will be required to re-enrol into the unit.

Students should not make specific arrangements regarding employment or holidays that may impact on their ability to undertake the allocated clinical placement, until clinical placement allocation has been confirmed.

Students may submit preferences via self-allocation for the clinical placements available for each Unit provided the required clinical pre-requisites are met by the published due date. Clinical pre-requisites include NPC, WWC Check, immunisations and Consent for Information Collection and Release Form.

Once final allocations have been released by the School of Nursing and Midwifery no changes will be made to student allocations. If a student experiences extenuating circumstances beyond their control the School may consider an allocation change at its sole discretion. Students must notify the Clinical Co-ordinator of such circumstances at least 6 weeks prior to clinical. However, any application lodged for a Change of Placement due to Exceptional Circumstances may result in the student being required to cover the Clinical Agency and School administrative costs for the organisation of the new clinical placement.

6 Runciman, W., Hibbert, P., Thomson, R., Van Der Schaaf, T., Sherman, P. & Lewalle, P. (2009). Towards an International Classification for Patient Safety:Key Concepts and Terms. International Journal for Quality in Health Care, volume. 21, No. 1, pp. 18-26.

7 Refer to Clinical Placement Rules and Responsibilities - Academic Progress 2015 clause 15




Missed clinical hours 36 In the case of illness a medical certificate must be obtained to cover any uncompleted clinical

hours. Missed clinical hours that are accounted for by a medical certificate will result in the re-allocation of missed clinical hours. The student must be available to undertake the make-up clinical time as allocated (refer 35 above and refer Clinical Placement – Academic Progress clause 68).

Students who miss clinical hours for reasons other than illness must provide appropriate documentation to support their absence. As soon as reasonably practicable, the student must advise the Clinical Co-ordinator of the reason for the absence. The Clinical Co-ordinator will then advise the student of the appropriate supporting documentation to be provided in those circumstances. Appropriate supporting documentation will be determined by the Clinical Co-ordinator in their sole discretion.

Completion of clinical placement 37 Students are required to submit their Clinical Assessment Tool (CAT) within 10 working days of the

completion of their clinical placement. Please note: the unit result cannot be processed until the CAT has been submitted. When submitting the CAT students need to ensure they have complied with the CAT checklist.

Insurance for university students involved in practical placements or work experience 38 Students, whilst on clinical placements, are not considered employees of either the clinical agency

or of Deakin University. They are therefore not covered by WorkCover insurance.

39 The University has a Public Liability Insurance policy which provides insurance cover in respect of the University’s legal liability to pay compensation to a third party for physical injury and/or property damage caused by a student while on practical placements or work experience in hospitals or with other host organisations. (A third party is someone other than the University or the student concerned).

40 The University maintains a Personal Accident Insurance policy for the benefit of currently enrolled University students who suffer injury while either on campus or off campus for University or course related activities. This policy provides a variety of capped benefits (for permanent disability, weekly benefits for income earners, home tutorial, injury assistance, overseas medical expenses, non-Medicare expenses and some other benefits).

41 The national health care system, Medicare, provides medical, optical and hospital cover for eligible Australians.

42 In Victoria, third party motor vehicle accident (for personal injury) insurance is mandatory and benefits are provided by the Transport Accident Commission to persons who sustain personal injury in motor vehicle accidents.

43 There is no insurance for loss or damage to a student’s belongings.

44 The onus is on each student to assess their own insurance needs and to ensure that they have appropriate insurance cover in place in addition to that provided by the University.

8 Refer to Clinical Placement Rules and Responsibilities - Academic Progress 2015 clause 6




45 If a student sustains a physical injury during a clinical placement, an incident report should be generated in accordance with the procedures used by the clinical agency. A copy should be retained by the clinical facilitator and the student (as well as by the clinical agency). The onus is on the student to ensure that the reporting obligations set out in clause 25 are complied with.

Clinical placement rules and responsibilities – Academic Progress 2015

Bachelor of Nursing courses* and non-award courses 1 These Clinical Placement Rules and Responsibilities apply to the following:

a) H326 Bachelor of Nursing;

b) H329 Bachelor of Nursing (Clinical Leadership);

c) D355 Bachelor of Nursing/Bachelor of Midwifery;

d) D381 Bachelor of Nursing/Bachelor of Public Health and Health Promotion;

e) D387 Bachelor of Nursing/Bachelor of Psychological Science; and

f) Non-award course H011 Return to Practice and Initial Registration (Overseas Qualified Nurses) (collectively “the Courses”).

2 All nursing and midwifery units are designed to integrate theory and practice. Where a unit comprises both theoretical and clinical practice components, a student must pass both components in the enrolled trimester in order to successfully complete the unit.

3 Assessment and academic progress of all students is determined under:

a) Regulation 5.3 (1) Assessment and Academic Progress in Higher Education Award Courses; and

b) the Academic Progress Procedure.5

These rules outline the standards that will be applied by the School in respect of students undertaking clinical placements and in particular identify the grounds for exclusion, restriction, or issuing a warning to students.

3.1 Assessment of Clinical Performance is the process whereby students' achievement of learning outcomes and clinical competence is assessed.

Under section 8.1 of Regulation 5.3 (1) Assessment and Academic Progress in Higher Education Award Courses:

8.1 The Faculty Committee will:

(a) Identify students whose academic performance it judges to be unsatisfactory according to the policies, procedures and Course rules governing Academic Progress and published officially by the University.

* Bachelor of Nursing courses includes H326, H329, D355, D381, D387 5 www.theguide.deakin.edu.au




http://www.theguide.deakin.edu.au/

3.2 Failure of either the clinical component of a unit or academic component, or both may result in the Faculty Committee considering the academic progress of a student unsatisfactory, even where the student withdraws from the unit before results are released.

Unsatisfactory progress that results in a clinical fail within a nursing or midwifery unit will normally lead to exclusion.

4 Assessment of students whilst completing clinical experience is based on the Nursing and Midwifery Board of Australia (NMBA) Competency Standards for the Registered Nurse2. These competencies reflect the knowledge, skills, and attitudes required of a beginning level Registered Nurse. Assessment of clinical competencies is linked to theoretical content and the achievement of the appropriate standard to meet unit outcomes, clinical outcomes, and course content.

Attendance 5 Attendance for all clinical experience is integral to the achievement of the unit objectives and to

obtaining the NMBA competencies. Attendance is required to meet the overall requirements of the course and to be eligible to register with the Nursing and Midwifery Board of Australia. Therefore, if a student is absent from clinical, the student must:

5.1 Notify their Clinical Facilitator/ the agency AND the School of Nursing and Midwifery immediately if they are unable to attend for any reason. Failure to do so will result in the student being placed on Clinical Review.

5.2 Upon resumption of clinical experience, the student must provide a medical certificate for sick leave or appropriate supporting documentation to explain the absence to the Clinical Facilitator (See the Clinical Placement Rules and Responsibilities – Requirements 2015 for details). The medical certificate must be attached to the Clinical Assessment Tool (CAT) and submitted to the School of Nursing and Midwifery. Failure by the student to provide supporting documentation explaining the absence from clinical may impede satisfactory completion of the clinical placement. It is a matter for the School of Nursing and Midwifery, at its sole discretion, to determine whether the supporting documentation is acceptable to explain the absence.

Missed clinical placement days 6 Any student who is absent for one or more days from a scheduled clinical placement for a

particular unit, will be required to attend a Clinical Agency for missed placement days for that unit. This will occur either during the trimester in which the absence occurred, at the end of the trimester, or when a clinical venue can be secured. These placement days may be provided by any agency that allows the student to meet the unit outcomes and clinical assessment requirements of the unit. The student must be available to undertake these missed placement days as allocated.

7 In all instances, missed clinical hours will be arranged by the School of Nursing and Midwifery and the student must make themselves available to undertake the clinical placement at the time arranged. If clinical is not completed at the arranged time, the student will receive a fail grade for their clinical learning experience.

8 All expenses associated with clinical practicum such as parking, transport, travelling, immunisations, Working with Children Check (WWC) Check, National Police Check and accommodation must be met by the student.

____________________________ 2 http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-Guidelines.aspx#competencystandards




http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-Guidelines.aspx%23competencystandards

Additional clinical learning experience 9 The School of Nursing and Midwifery reserves the right to require students who are unable to

demonstrate the appropriate level of competence to attend additional clinical learning experience. Progress within the course may be delayed in instances where the student is required to attend additional clinical learning experience.

10 A student may be required to attend additional days of clinical learning experience if it is considered that the student’s performance is unable to be assessed by the scheduled time of evaluation. In the event a student is required to attend additional clinical learning experiences, they will be automatically placed on Clinical Review. (See below)

An example in which it may be necessary for a student to attend additional days of clinical experience is when a student’s performance at or before the time of assessment on clinical indicates the student is at risk of failing but the student has demonstrated enough improvement to indicate potential for success.

11 Normally, the maximum amount of additional clinical learning experience which can be awarded to any student is five (5) days. Should the situation which necessitated the award of additional days not be resolved by the end of the trimester the student will receive a fail grade for their clinical learning experience.

Deferral of placement 12 The School of Nursing and Midwifery may elect to defer a student’s clinical placement in the Clinical

Learning Program. A student’s clinical placement may be deferred if:

12.1 The student is medically unfit to undertake the clinical learning experience at that particular time. The student must provide the School of Nursing and Midwifery with a medical certificate to support deferral. In the case of medical illness, the student may be required by the School to provide a medical clearance certificate indicating that they are medically fit to undertake and complete all requirements of the clinical placement.

or

12.2 The Clinical Agency cannot fulfil its contractual obligation with respect to booked clinical placements.

Preparation for placement 13 If a student is unable to demonstrate the necessary knowledge or skills required for clinical

placement, they may be required to complete additional learning activities to assist development of the required knowledge and skills prior to being permitted to complete the clinical placement. The learning activities will be formally assessed via a hurdle assessment task and if the student is deemed competent to complete clinical placement following the completion of the additional learning activities, the School will arrange for the clinical placement to be completed.

14 If a student is unable to demonstrate the necessary knowledge and skills following the completion of the recommended additional learning activities, the student will not be permitted to attend clinical placement and a fail grade will be recorded for the unit.

(See the Faculty of Health’s “Assessment (Higher Education Courses) – Procedure Hurdle Requirements”).




Clinical Review 15 Clinical Review is the process whereby a student who is at risk of failing the clinical component of a

unit is formally notified in writing by the Unit/Campus Chair of the need to improve.

16 A student who is unable to meet the NMBA competencies to the appropriate level, shall be placed on Clinical Review. The student will be formally notified, in writing, by the Unit/Campus Chair of the unit. The notification to the student will outline the details of the Clinical Review. The format, length of the clinical review, and clinical objectives to be achieved will be determined by the Unit/Campus Chair, in consultation with the clinical facilitator, based on the individual learning needs of the student.

17 Clinical Review may occur at any time during placement in any clinical setting.

18 The time frame for Clinical Review will normally be three (3) days.

19 A copy of the notification will be issued to the Clinical Facilitator involved.

20 If the student achieves the outcomes and competencies stated in the Clinical Review, the student will have successfully completed the Clinical Review and this process is referred to as having the clinical review ‘redeemed’. However, if at any time during the remainder of that clinical experience the student is again identified as not meeting the objectives of the unit and/or NMBA competencies they will immediately enter the Clinical Challenge process.

Clinical Challenge 21 If the student does not achieve the clinical outcomes and/or NMBA competencies stated in the

Clinical Review letter, they will be notified of such in writing by the Unit/Campus Chair.

22 The student will then enter the Clinical Challenge process. The student's performance will be assessed by a second facilitator during the student’s next available rostered day at the placement. The student will be formally notified, in writing, of this process by the Unit /Campus Chair of the unit. The notification to the student will outline the details of the Clinical Challenge. The format of Clinical Challenge and clinical outcomes to be achieved will be determined by the Unit/Campus Chair, in consultation with the Clinical Facilitator.

23 A copy of the notification will be issued to the Clinical Facilitator involved.

24 If the student achieves the outcomes stated in the Clinical Challenge, the student will have successfully completed the Clinical Challenge and thus the challenge is redeemed (see above). However, the student will remain on Clinical Review until the completion of the clinical placement. No alteration to the student's progress will occur.

25 All parties involved will be notified of redemption by the Unit Chair/Campus Chair of the unit.

26 If at any time during the remainder of that clinical placement the student is again identified as not meeting the objectives of the unit and/or the NMBA competencies at the appropriate level, they will not be given any further opportunities to redeem the challenge. The student will be immediately removed from the clinical placement which will result in a fail grade being recorded for the clinical placement. See Academic Progress in Higher Education Award Courses Procedure and Regulation 5.3(1) Assessment and Academic Progress in Higher Education Award Courses.

27 If, following the Clinical Challenge, the student's performance is not at the level required, this will result in a fail grade being recorded for the clinical placement. In this instance, the student will be withdrawn immediately from the clinical placement. See Academic Progress in Higher Education




Award Courses Procedure and Regulation 5.3(1) Assessment and Academic Progress in Higher Education Award Courses.

28 All parties involved will be formally notified of the failure by the Unit Chair/Campus Chair of the unit.

Misconduct and withdrawal from placement 29 Students remain subject to the University’s statutes, regulations, policies and procedures while on

placements, including in relation to student misconduct. Students may be withdrawn from a clinical placement prior to completion of the clinical experience if they display unprofessional conduct (see AHPRA’s website for examples of unprofessional conduct

http://www.ahpra.gov.au/Notifications/What-is-a-notification/Common-types-of-notification.aspx) or it is considered that their performance could possibly be detrimental to safe client care in the clinical setting.

29.1 Some examples of situations in which it may be necessary to withdraw a student from clinical learning situations are:

• when a student cannot provide adequate rationale for nursing actions because of inadequate knowledge base;

• when a student demonstrates inadequate performance of any nursing action which may or does result in physical harm, unreasonable emotional distress or neglect of the client;

• when, after guidance, a student consistently demonstrates they are unable to perform without an inappropriate or unattainable amount of supervision;

• when a student consistently demonstrates that they are unable to practice within ethical guidelines;

• when the student consistently demonstrates unprofessional behaviour such as being late for clinical shifts, not notifying ward/facilitator/university of their absence from clinical shifts or displaying unprofessional communication to staff/patients including using derogatory language, being disrespectful or rude; or

• when a Bachelor of Nursing/Bachelor of Midwifery student leaves clinical placement to undertake a Continuity of Care experience without permission of the relevant unit/campus chair.

30 Withdrawal of a student from clinical placement may be initiated by either a University representative or a representative of the Clinical Agency following consultation with the University. If a student is withdrawn, formal notification will be issued and the action taken will be specified. Because of the diversity of factors that are involved in withdrawal, each case will be resolved on an individual basis. Refer to Clinical Review section of this document.

31 Withdrawal of a student from clinical placement may be initiated by either a University representative or a representative of the Clinical Agency if documentary evidence of clinical pre-requisites including immunisation status, WWCC card and NPC are not provided upon request.

32 A student who has failed the theoretical component of the unit is unable to complete/commence the clinical component of that unit.




http://www.ahpra.gov.au/Notifications/What-is-a-notification/Common-types-of-notification.aspx

Supervision of placement

There are several models of student supervision and clinical support used in the Bachelor of Nursing program. These models vary according to the clinical agency. In all models, a clinical facilitator/preceptor will be available to provide students with guidance and support.

Clinical Learning Activities

During clinical placement students must seek opportunities to achieve clinical outcomes associated with the Unit learning outcomes. Clinical outcomes for each Unit are clearly articulated in the Professional Learning Portfolio of each Unit as Clinical Learning Activities. The Clinical Learning Activities are skills that students are able to perform under the supervision of a registered nurse in the clinical setting and as such are a guide for student’s scope of practice whilst on placement. As the students complete clinical units the ability to increase skill development and scope of practice increases. The Clinical Learning Activities for each Unit are outlined below.

Attendance

Uniform All students are required to wear the Deakin nursing uniform whilst on clinical placements. Students are required to wear navy pants or skirt and shirt with Deakin logo affixed.

Students are required to wear navy or black shoes with their uniform. Shoes must have covered toe and be a supportive type with a non-slip sole.

Rosters Clinical Placement Information and Rosters are displayed on the Bachelor of Nursing Courses site – Clinical Placements, CloudDeakin. The Clinical Team aim to have clinical rosters uploaded at least 2 weeks prior to clinical placements.

Students are responsible for viewing Clinical Placement Information to ensure they complete all pre-placement requirements specified by the clinical facility they will be attending. This may include orientation, learning packages or submission of annual hand hygiene certificates.

Absences If a student is unable to attend clinical placement due to illness, they must notify the School of Nursing and Midwifery Clinical team (via phone or email) and their clinical facilitator prior to the commencement of the shift. Failing to do so will result in the student being placed on clinical review (as per the Clinical Rules and Responsibilities where it is all clearly explained in full detail).

When the student returns the Clinical Assessment Tool (CAT) to the School of Nursing and Midwifery following placement they must attach their medical certificate/s, identifying all absent days, to their CAT.

Please refer to the School of Nursing and Midwifery - Clinical Placement Rules and Responsibilities - Requirements 2015, item 36 – Missed Clinical Hours for detailed information.




https://d2l.deakin.edu.au/d2l/le/content/97916/Home

https://d2l.deakin.edu.au/d2l/le/content/97916/viewContent/2465480/View


Clinical Assessment Tool submission

It is the student’s responsibility to submit the Clinical Assessment Tool (CAT) to the School of Nursing and Midwifery within 10 days of completion of their placement.

Before clinical placement

Students must ensure the full CAT is printed off (including Checklist) and complete page 1 prior to placement starting.

At the commencement of clinical placement

Students should discuss with their clinical facilitator/preceptor that they are responsible for submitting their CAT to the School of Nursing and Midwifery clinical administration team on the completion of placement.

At the end of clinical placement

Students and their Clinical Facilitator must sign page 3 of the CAT once they have reviewed the completed CAT and discussed the appraisal with their clinical facilitator/preceptor.

It is the student’s responsibility to ensure the checklist is completed by their Clinical Facilitator at the end of placement.

Following clinical placement

It is the student’s responsibility to submit the CAT to the School of Nursing and Midwifery clinical administration team on their home campus. This needs to occur normally within 10 days of completion of the placement. Please note: student’s unit result cannot be processed until the CAT has been submitted.

When submitting the CAT students must bring a copy of the original CAT. The copy of the CAT will be stamped and signed by a School representative and handed straight back to the student to keep and to use in future job applications. The original CAT will be reviewed by the Unit Chair and placed on your file held in the School.

The Clinical Assessment Tool 2015 is below.





Clinical Assessment Tool (CAT)

CAT Checklist

Clinical Facilitator/Preceptor/Coach

Unit Code:

Please tick

Completed and discussed formative assessment with student

Completed and discussed summative assessment with student

Completed and discussed overall result with student

Printed name, signed and dated Clinical Assessment Tool

Name: ______________________________________

Signature: ______________________________________

Date: ______________________________________

Student Please tick

Completed details on the front page of the Clinical Assessment Tool

Signed and dated Clinical Assessment Tool

Photocopied original Clinical Assessment Tool

Submitted Clinical Assessment Tool to School of Nursing and Midwifery Clinical Team

Name: ______________________________________

Student ID Number: _____________________________

Signature: ______________________________________

Date: ______________________________________

Students must return completed CAT to their Campus -School of Nursing and Midwifery office within 10 working days of completing clinical placement.




Faculty of Health School of Nursing and Midwifery

Clinical Assessment Tool 2015

Student Name: Student No:

Campus of Study: Burwood Waterfront Warrnambool Year of study: 1 2 3 4

Clinical Venue and Ward/Unit:

Unit Code: HNN112 HNN122 HNN217 HNN222 HNN227 HNN318 HNN319 HNN325

Dates of Attendance: / / to / /

Hours absent: Medical Certificate attached? Yes / No

Has the Supplementary Form for Critical Incidents and Clinical Review/Challenge (i.e. page 4) been filled out? Yes No N/A

Due to the nature of the clinical experience offered in HNN217 the opportunity to demonstrate all practice domains may not be available.

Student to complete: Each unit has a Clinical Placement Activities Record that identifies the main student learning activities and outcomes which should be achieved for each placement. However, you may have additional individual activities or outcomes that you would like to achieve during this placement. Identify and record any of these below and discuss with your Clinical Facilitator at the commencement of your clinical placement. (NOTE: this must be completed prior to commencement of clinical placement)

Areas that need to be undertaken or improved on for future clinical placements (Complete at the end of your placement)

*Please refer to the student’s Professional Learning Portfolio for assistance with meeting the competencies




Formative Assessment & Feedback Completed midway during clinical placement (Not applicable for HNN112 and HNN217)

Summative Assessment & Feedback Completed at end of clinical placement

Has the student demonstrated the following competencies to the expected level of practice and within the context of the practice setting?

(Initial in ONE square per question ONLY)

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Professional Practice

1. Practices in accordance with legislation affecting nursing practice and health care.

2. Practices within a professional and ethical nursing framework.

Comments: Critical Thinking and Analysis

3. Practices within an evidence-based framework.

4. Participates in ongoing professional development of self and others.

Comments: Provision and Coordination of Care

5. Conducts a comprehensive and systematic nursing assessment.

6. Plans nursing care in consultation with individuals/ groups, significant others and the interdisciplinary health care team.

7. Provides comprehensive, safe and effective evidence-based nursing care to achieve identified individual/group health outcomes.

8. Evaluates progress towards expected individual/ group health outcomes in consultation with individuals/groups, significant others and interdisciplinary health care team.

Comments: Collaborative and Therapeutic Practice

9. Establishes, maintains and appropriately concludes therapeutic relationships.

10. Collaborates with the interdisciplinary health care team to provide comprehensive nursing care.

Comments:




Clinical Facilitator/ Preceptor comments:

Discussion of student’s strengths

Formative feedback provided to student at mid-point of placement (not applicable HNN122 or HNN217):

Summative feedback:

Discussion of student’s areas for improvement (including strategies to assist improvement)

Formative feedback provided to student at mid-point of placement (not applicable HNN122 or HNN217):

Summative feedback:

New or complex actions/activities completed by the student during clinical learning situations (i.e. skills and or demonstration of professional qualities)

Student demonstrated successful completion of expected clinical activities relative to opportunity as outlined in the Units Professional Learning Portfolio*

Yes No

Overall Student Result for this clinical placement: PASS FAIL INCOMPLETE Date:

Clinical Facilitator/Preceptor name (printed) and signature

I have reviewed and discussed this appraisal with the Clinical Facilitator/Preceptor

Student’s signature: Date:




Supplementary information for Critical Incidents and Clinical Review / Clinical Challenge:

(Only needs to be completed for critical incidents, unsafe practice or when the student has been placed on Clinical Review).

Critical Incident / Clinical Review Process (Please circle whether this refers to an incident or review).

Please give details of any critical incidents. Attach signed copy of incident report or summary report if Risk Man is used, to this clinical report.

If a student is placed on Clinical Review, details of the reasons (with examples) why the student was placed on review are required, together with a brief description of student progress whilst on review

Consultation with Deakin Academic Nursing staff required: YES / NO Date: / / Consultation with Academics is mandatory prior to any student being placed on Clinical Review/Clinical Challenge)

Name of Academic with whom the issue was discussed:

Clinical Review Initiated? YES / NO If ‘yes’ then date started / /

Clinical Challenge Initiated? YES / NO If ‘yes’ then date of challenge / /

Name of Second facilitator/academic who assessed the Clinical Challenge:

Outcome of Clinical Review/Challenge:

Clinical Facilitator/Preceptor name, title (both printed) and signature




Instructions

This Clinical Assessment Tool (CAT) is an assessment tool based on the observations undertaken by the clinical facilitator or preceptor during the student’s placement. The NMBA National Standards for the Registered Nurse are used to frame the clinical learning experience and assess the student according to their level of study and the nature of the clinical placement.

The clinical facilitator or preceptor is required to make an assessment of whether or not the standard has been demonstrated and record it on this form. Students record their own clinical objectives according to the NMBA competencies on the first page. They then evaluate their own progress against the competencies and their objectives. The students then need to record their areas for improvement in the appropriate section on page one.

Students are assessed using five performance standards: Independent, Supervised, Assisted, Marginal and Dependent (adapted from Bondy, 1983). It is important to remember that these standards apply equally to the student’s level of knowledge, skill performance and professional behaviour, and communication. In order for a student to pass the clinical placement they need a minimum rating of ‘assisted’ in all competencies, except students completing HNN318, HNN319 and HNN325. These students must gain an overall rating of supervised or above.

Professional Standard Quality of Performance Support Required

Independent The student always achieves appropriate and accurate action safely.

Proficient, coordinated, confident and works within safe time frames.

No support or cues needed.

Supervised The student always achieves appropriate and accurate action safely.

Efficient, coordinated, confident.

Occasional supportive cues given.

Assisted The student mostly achieves appropriate and accurate action safely.

Skillful in most parts of skills or knowledge. Inefficient and can be uncoordinated in other parts.

Frequent verbal and occasional physical cues. Student also needs supportive cues.

Marginal The student is not always accurate. Only safe when supervised.

Unskilled and inefficient, excess use of energy and prolonged times.

Continuous verbal and frequent physical cues required.

Dependent Unsafe – unable to demonstrate skills and knowledge.

Unable to demonstrate behaviour/procedure. Lacking in confidence, coordination and efficiency.

Continuous verbal and physical cues required.

If a student is performing poorly in any NMBA competency then this should be recognised and documented at the formal mid-way feedback period and discussed with the student. Students who are scoring Marginal or Dependent in any area need to be discussed with the Unit Chair of the unit prior to the completion of clinical and usually within the first week of the clinical placement. This will usually result in the student being placed on clinical review so that strategies to aid the student can be formally introduced.

The Supplementary Information for Critical Incidents and Clinical Review / Clinical Challenge section needs to be completed by the Clinical Facilitator or Preceptor when a student is involved in an Incident, are unsafe or are placed on Clinical Review. Please ensure this section is completed in these instances and attach a copy of the agency incident form where one has been filled out (involving the student).

*Students must demonstrate successful completion of expected clinical activities relative to opportunity as outlined in the Units Professional Learning Portfolio in order to pass the clinical placement.




Bachelor of Nursing: Professional Learning Portfolios

HNN112: Quality and Safety: Nursing Practice 1

Clinical Placement Activities

Clinical placement This unit has a one week clinical placement in an inpatient health care facility. The clinical placement timetable is be displayed on CloudDeakin – Bachelor of Nursing Courses site – Clinical placement information – Clinical calendar and Clinical self-allocation timetable.

There are several models of student supervision and clinical support used in the Bachelor of Nursing program. These models vary according to the clinical agency. In all models, a clinical facilitator/preceptor will be available to provide you with guidance and support. At the start of your clinical placement, you will be informed of the name and contact details of your facilitator/preceptor.

Aim of the placement The overall aim of this clinical experience is to introduce you to the clinical nursing environment. Firstly, you will have an opportunity to observe the clinical environment where you can develop an understanding and appreciation of the complex roles and responsibilities of a professional nurse.

Secondly, the experience will provide you with the opportunity to apply your knowledge and beginning nursing skills in providing care to patients. You will be expected to undertake as many of the skills that you learned in the nursing Clinical Simulation Centre as are appropriate when assisting the RN caring for patients.

Thirdly, the clinical experience will contribute to your development as a professional nurse by assisting you to meet some of the Nursing and Midwifery Board of Australia Competency Standards for the Registered Nurse. The School of Nursing and Midwifery uses these competencies to assess you during your clinical placements.

Clinical Placement Activities list The Clinical Placement Activities list should be used with the guidance of your clinical facilitator/preceptor in establishing your objectives, carrying out your activities and evaluating your placement. In all cases, the care of the patient is paramount, and your activities must be appropriate to the needs of the patient and the clinical facility in which you are placed.




CORE clinical activities The following activity list contains numbers in parentheses which indicate the related Nursing and Midwifery Board of Australia Competency Standards and provides the link to the Clinical Assessment Tool. These activities are core competencies that will be undertaken in every clinical placement throughout the course. They are essential professional nursing activities that are performed in every clinical setting.

Core activities

Communication

• Establish, maintain and conclude therapeutic relationships with patients appropriate to the clinical setting (9)

Documentation

• Document appropriate and accurate information in the patient record (1,10)

Collaboration and teamwork

• Communicate and collaborate appropriately with nursing and other health team members (9,10)

Professional practice

• Demonstrate accountability and responsibility for own actions and behaviour through activities such as being punctual, dressing professionally, maintaining confidentiality and accepting constructive feedback (1,2,4)

Person – centred care

• Demonstrate physical and psychological comfort of patients whilst providing nursing care (2,9)

Provision of care

• Demonstrate comprehensive, safe, evidence-based nursing care within the context of the expected outcomes of the unit (7)




REQUIRED clinical activities and discussions These activities will enable you to develop insight into the role of the professional nurse working in a health care environment. They will assist you to meet the objectives of this unit, HNN112: Quality and Safety: Nursing Practice 1.

Required clinical activities /discussions

Communication and collaboration

• Observe a nursing handover and discuss the nature of the communication with an RN (10)

Problem solving process

• Observe a nurse implementing care and discuss the rationale for patient care (3,5,6,7,8,9)

Ethical practice

• Discuss an ethical/moral dilemma with an experienced nurse (2)

Communication

• Observe a nurse providing information to a patient who must make an informed decision about treatment or care and discuss the interaction with the nurse (1,2,9)

REQUIRED clinical activities These activities are required to be undertaken during this clinical placement to help you achieve the objectives of this unit, HNN112: Quality and Safety: Nursing Practice 1. These activities will contribute to the development of your overall professional nursing competencies.

Required clinical activities

Risk management: infection control

• Demonstrate an understanding of infection control principles e.g. hand washing and appropriate use of gloves (1,7)

Risk management: manual handling

• Identify the manual handling policies of the clinical facility

• Assist a patient in moving, positioning, transferring or walking (1,7)

• Make a patient’s bed, occupied or unoccupied (7)

Risk management: falls/pressure ulcer prevention

• Use and explain validated Falls Risk Assessment tools/pressure ulcer prevention

• Identify appropriate risk management strategies to reduce the risks (1, 5,7)

Risk management: safe medication administration

• Observe a nurse administering medications, and identify the safety measures implemented (1,2)

Assessment of vital signs

• Measure, interpret and document a patient’s temperature, pulse, respiration and blood pressure and pulse oximetry (5,8,10)





Providing essential care: hygiene

• Assess a patient’s hygiene needs and assist in implementing this care, which may include any of the following: shower, bath, bed bath, shaving, oral or eye and hair care (5,6,7,8)

Providing essential care: nutrition and hydration

• Identify patients who may be at risk of nutritional or hydration imbalance

• Explain the planned nursing care (5,6,7,8,10)

Providing essential care: elimination

• Assist a patient to meet their elimination needs by and explain why this assistance is required e.g. walk to the toilet, transfer to a commode, or use a bedpan/urinal (7)

ADDITIONAL clinical activities These additional activities may be undertaken during this clinical placement if they are appropriate for the patients for whom you will be caring. If you are unable to undertake these activities during this placement, they must become part of your individual objectives for future placements.

Additional clinical activities

Basic Life Support

• Observe the health care team performing BLS and discuss the experience with buddy nurse/facilitator (1,2,7,10)

Assessment and communication

• Obtain a basic health history from a patient, using therapeutic communication skills (5, 9)

Providing essential care: elimination

• Assess a patient’s elimination patterns and document using a fluid balance and/or bowel chart

• Undertake urinalysis and document results (5,10)

Providing essential care: sleep and rest

• Assess and document a patient’s sleep and rest patterns (5,10)

Providing essential care: activity and exercise

• Select and use appropriate bed appliances in positioning a patient (5,6,7,8)

Providing essential care: activity and exercise

• Assist a patient with range of motion (ROM) exercises where appropriate (5,6,7,8)






Clinical placement This unit has a two-week clinical placement. The clinical placement timetable will be displayed on CloudDeakin – Bachelor of Nursing Courses site – Clinical placement information – Clinical calendar and Clinical self-allocation timetable.

Each new placement is designed to build on the knowledge and skills developed in previous placements. Therefore, when caring for your patients, you are expected to continue utilising the nursing competencies previously learned, as well as adding the new skills acquired in this unit.


Aim of the placement The main aim of this clinical experience is to introduce you to providing care for patients who are experiencing an acute episode of illness. These patients may be hospitalised for surgery, for management of symptoms, investigation, surgery, procedures and other treatment, requiring skilled nursing care. In addition to providing care you have previously learned, you will be expected to undertake patient assessment, administration of medications, managing IV fluids, and providing acute care for patients including oxygen therapy, wound management and pain management.

This clinical experience will also contribute to your development as a professional nurse by assisting you to meet some of the Nursing and Midwifery Board of Australia (NMBA) Competency Standards for the Registered Nurse. The School of Nursing uses the NMBA competencies to assess you during your clinical placements. The following activity list contains numbers in parentheses which indicate the related NMBA Competency Standards and links to the Clinical Assessment Tool.





CORE clinical activities These activities are core competencies that will be undertaken in every clinical placement throughout the course. They are essential professional nursing activities that are performed in every clinical setting.

Core activity

Communication


Documentation







• Demonstrate physical and psychological comfort of patient’s whilst providing nursing care (2,9)

Provision of care


REQUIRED clinical activities These activities are required to be undertaken during this clinical placement to help you achieve the objectives of this unit, HNN122: Quality and Safety: Nursing Practice 2.

These activities will contribute to the development of your overall professional nursing competencies.


Assessment: undertake and document the following tests for at least one patient

• Blood glucose level (BGL)

Safety and risk management of medications

• Review medication administration policies of your clinical agency

• Locate an appropriate medication resource

• Review medication records and documentation requirements of your clinical agency

• Maintain the principles of safe medication administration

• Participate in patient medication administration (1,2)





Medication administration: oral medications

• Administer and document oral medications as ordered for your patients under the supervision of your facilitator/preceptor (1,7,10)

• Use principles of safe medication administration

Medication administration: parenteral medications

• Administer and document subcutaneous (SC) or intramuscular (IM) injections as ordered for your patients under the supervision of your facilitator/preceptor/buddy nurse (1,7,10)


Medication administration: intravenous (IV) infusion medications

• Administer and document IV medications as ordered for your patients under the supervision of your facilitator/preceptor (1,7,10)


Assessment and management of at least one patient in pain and /or discomfort

• Assess and document pain experienced by patient using a validated symptom assessment tool

• Identify and administer pain medication as ordered

• Plan appropriate non-pharmacological pain relief

• Evaluate and document pain relief experienced by patient using a validated symptom assessment tool (5,6,7,8,10)

Administration of oxygen to at least one patient

• Assess patient’s respiratory function, including oxygen saturation (SpO2)

• Connect oxygen to wall outlet or oxygen tank

• Administer oxygen via nasal cannula or face mask as appropriate

• Evaluate patient’s response to oxygen

• Document in relation to oxygen administration using a validated symptom assessment tool (5,6,7,8,10)

Wound management using the wound field concept for at least one patient

• Assess patient’s wound and document accurately using a validated symptom assessment tool

• Clean wound as required

• Select and apply an appropriate dressing

• Document wound care provided using a validated symptom assessment tool (5,6,7,8,10)





Managing intravenous (IV) therapy for at least one patient

• Assess hydration status using a Fluid Balance Chart

• Manage and assess IV fluids and IVT lines, ensuring correct rate of fluid administration

• Manage IV insertion site, checking for signs of infusion or infection

• Monitor patient’s condition while receiving IV fluids

• Assess hydration status using a Fluid Balance Chart (5,6,7,8,10)



Medication administration: topical

• Administer and document topical, transdermal, optic or otic medications as ordered for your patients under the supervision of your facilitator/preceptor (1,7,10)


Medication administration: inhaled medications

• Administer and document inhaled medications via metered dose inhaler (MDI) or nebuliser as ordered for your patients under the supervision of your facilitator/preceptor (1,7,10)


Airway suctioning for at least one patient

• Assess for airway obstruction

• Undertake oropharyngeal suctioning under the supervision of your facilitator/preceptor

• Evaluate patient’s response to suctioning

• Document in relation to suctioning (5,6,7,8,10)





Pre-Procedure/Pre-operative (pre-op) care for at least one patient

• Assess patient’s understanding and concerns about procedure/surgery

• Undertake pre-precedure/pre-op teaching on deep breathing/ coughing, leg exercises, and resuming activity

• Measure and apply anti-embolic stockings if ordered

• Complete pre-prosendure/pre-op routine e.g. patient identification, fasting status, need for elimination, consent forms signed, valuables accounted for

• Identify and administer any prescribed pre medications

• Assist in transferring patient to Operating Room (OR)

• Document appropriately (5,6,7,8,10)

Post-procedure/ Post-operative (post-op) care for at least one patient

• Prepare environment to receive patient

• Assemble and test oxygen and suctioning equipment

• Position patient for safety and comfort and attach equipment

• Monitor and document conscious state, vital signs and other patient parameters according to validated symptom assessment tools

• Encourage patient to undertake deep breathing/ coughing and leg exercises to prevent complications

• Identify and administer any prescribed post-op medications, including for pain relief

• Monitor hydration status, wound site and level of discomfort/pain

• Document appropriately using validated tools (5,6,7,8,10)

Wound care and suture removal for at least one patient

• Assess patient’s wound and document accurately using validated symptom assessment tools

• Remove sutures/clips/staples safely


• Document wound care provided using validated symptom assessment tools (5,6,7,8,10)

Basic Life Support (BLS)

• Assist the health care team during an episode of BLS by providing ventilation and/or chest compression as directed

• Debrief as required (1,2,7,10)

Managing grief and loss

• Communicate appropriately with patient’s and family members experiencing grief and loss

• Observe the completion of legally required documentation (1,7,9,10)




HNN217: Community Nursing Practice


Clinical placement This unit has a one week clinical placement in a community health setting. The clinical placement timetable will be displayed on Cloud Deakin – Bachelor of Nursing Courses site – Clinical placement information – Clinical calendar and Clinical self-allocation timetable.

Each new placement is designed to build on the knowledge and skills developed in previous placements. Therefore, when caring for your patients, you are expected to continue utilising the nursing skills previously learned, as well as adding the new skills acquired in this unit.

There are several models of student supervision and clinical support used in the Bachelor of Nursing program. These models vary according to the clinical agency. In all models, a clinical facilitator/preceptor will be available to provide you with guidance, support and feedback. At the start of your clinical placement, you will be informed of the name and contact details of your facilitator/preceptor.

Aim of the placement The main aim of this clinical experience is to provide an introduction to nursing practice in the community. A wide range of community health centres, clinics, schools, and community nursing services are used for this clinical placement. Consequently, the types of nursing activities you may participate in will vary from one setting to another. However, all placements will enable you to experience the essential principles of nursing in community-based settings.

This clinical experience will also contribute to your development as a professional nurse by assisting you to meet some of the Nursing and Midwifery Board of Australia Competency Standards for the Registered Nurse. The School of Nursing and Midwifery uses the competencies to assess you during your clinical placements. The following activity list contains numbers in parentheses which indicate the related Nursing and Midwifery Board of Australia Competency Standards and links to the Clinical Assessment Tool.

Clinical placement activities list The Clinical Placement Activities list should be used with the guidance of your clinical facilitator/preceptor in establishing your objectives, carrying out your activities and evaluating your placement. In all cases, the care of the patient is paramount, and your activities must be appropriate to the needs of the patient and the clinical facility in which you are placed.





Core activity

Communication


Documentation








Provision of care


REQUIRED clinical observations and discussions These observations and discussions are to be undertaken during this clinical placement to help you achieve the objectives of the unit HNN217: Community Nursing Practice. These activities will contribute to the development of your overall professional nursing competencies.

Required clinical observations /discussions

Nurses role in the community: Observe a nurse working in the community and discuss the following with your facilitator/preceptor

• What are the significant differences between nursing in a hospital setting and the community?

• How does the nurse carry out prevention and health promotion activities?

• How does the nurse work with patients and families in the management of health problems?

• How does the nurse collaborate with other health professionals and services?

• What knowledge and skills are required to work in the community?




Required clinical observations /discussions

Patients and families: Observe at least one episode of patient care and discuss with your facilitator/preceptor

• How was patient referred to the community nurse?

• What are the patient’s health problems?

• What is the nursing plan of care?

• What is the patient’s home, family and community environment like?

• What cultural issues must the nurse consider in the patient’s care?

• What other health and community services are involved in the patient’s care?

Health care agency: Identify the following for your placement and discuss with your facilitator/preceptor

• Agency name, location and services provided

• Clients served – ages, cultural background, health and social problems addressed

• Role of the nurse in the agency and interaction with multi-disciplinary team

• Referral networks – other health and social services used

• Organisation – funding, costs to clients, number and types of employees

ADDITIONAL clinical activities These additional activities may be undertaken during this clinical placement if they are appropriate for the patients for whom you will be caring.


Home visit

• Participate in a home visit to provide nursing care under the supervision of your facilitator/preceptor

Home nursing: For at least one patient in the community, provide one or more of the following types of nursing care under the supervision of your facilitator/preceptor

• Patient and/or family assessment

• Medication administration

• Pain management

• Wound management

• Venipuncture

• Patient education

• Referral to health or social services





Community nursing centre: For at least one patient who attends a community-based clinic, provide one or more of the following types of nursing care under the supervision of your facilitator/preceptor

• Patient and/or family assessment

• Health screening

• Medication administration

• Wound management

• Venipuncture

• Patient education

• Referral to health or social services

Health screening: Undertake and document patient education on cancer prevention for at least one patient

• Breast awareness and mammograms

• Pap smears for cervical cancer

• Testicular cancer




HNN222: Mental Health and Illness


Clinical placement This unit has a three (3) week clinical placement in a mental health setting. The clinical placement timetable will be available in the Unit Guide and on CloudDeakin – Bachelor of Nursing Courses site – Clinical placement information – Clinical calendar and Clinical self-allocation timetable.



Aim of the clinical placement The main aim of this clinical experience is to extend your competencies in providing care for patients experiencing mental illness. In addition to providing care, you will be expected to demonstrate understanding of issues affecting carers and families of people with mental illness. A key emphasis for this unit is risk assessment and appropriate intervention.

This clinical experience will also contribute to your development as a professional nurse by assisting you to meet some of the Nursing and Midwifery Board of Australia (NMBA) Competency Standards for the Registered Nurse. The School of Nursing uses the NMBA competencies to assess you during your clinical placements. The following activity list contains numbers in parentheses which indicate the related NMBA Competency Standards and links to the Clinical Assessment Tool.

Clinical Placement Activities list The Clinical Placement Activities list should be used with the guidance of your clinical facilitator/preceptor in establishing your objectives, carrying out your activities and evaluating your placement. In all cases, the care of the patient is paramount, and your activities must be appropriate to the needs of the patient and the clinical setting in which you are placed. Regardless of the setting that you will be based, you will come across patient information that is very personal; confidentiality must be maintained at all times during and after your clinical placement.





Core activity

Communication

• Establishes, maintains and appropriately concludes therapeutic relationships with patients appropriate to the clinical setting (9)

Documentation

• Documents a plan of care to achieve expected outcomes (6,10)






• Evaluates progress towards expected individual/group health outcomes in consultation with individuals/groups, significant others and interdisciplinary health care team (8)

Provision of care


REQUIRED clinical activities These activities are required to be undertaken during this clinical placement to help you achieve the objectives of this unit, HNN222: Mental Health and Illness. These activities will contribute to the development of your overall professional nursing competencies.


Admission (1,2,3)

• Participate in interviewing a newly admitted patient to a mental health service or in-patient unit under supervision

• Complete appropriate documentation for a newly admitted patient

• Identify appropriate sections of the Mental Health Act that apply for the newly admitted patient

• Develop understanding of compulsory and voluntary status in the care environment





Assessment (3,5,6,7,8,10)

• Participate in assessment of patients in mental health setting

• Perform mental state examination under supervision

• Perform risk assessment and develop appropriate interventions

• Document assessment findings in patient progress notes and notify appropriate clinicians

Medication administration (5,6,7,8,10)

• Familiarise yourself with organisational policy

• Assess patient and ensure medication compliance

• Administer prescribed medication using correct technique under the supervision of your facilitator/preceptor

• Monitor patient and report any side effects immediately

• Administer PRN medication under supervision if required

• Document according to agency protocols

Discharge planning (5,8,10)

• Familiarise yourself with organisation policy regarding discharge

• Participate in discharge planning with patient and family

• Participate in identifying appropriate support networks for patient post discharge

• Document discharge plan under supervision



Electro-Convulsive Therapy (ECT)

• Assist to prepare patients undergoing ECT

• Perform post ECT care

• Document procedure and outcome of ECT on patient progress notes





Nutrition

• Participate in supervising meals if appropriate for setting

• Identify patients at risk of under nutrition due to their mental illness e.g eating disorders, Bipolar, depression

• Undertake routine checking of cutlery as a risk measure in acute in-patient settings

• Document feeding patterns and amounts for all patients at risk of under nutrition

Group activities


• Participate in forming groups

• Participate in facilitating group activities

• Document observations during group activities

Home visiting and follow-up care


• Accompany staff during home visits

• Document relevant information on home visit

Multidisciplinary team meetings and case conferences

• Attend and participate in multidisciplinary team meetings and case conferences

• Make notes under supervision on outcome of meeting or case conference

Basic Life Support (BLS)


• Assist the health care team during an episode of BLS by providing ventilation and/or chest compression as directed






Clinical Placement This unit has a four week clinical placement in an acute care hospital. The clinical placement timetable will be available in the Unit Guide on CloudDeakin – Bachelor of Nursing Courses site – Clinical placement information – Clinical calendar and Clinical self-allocation timetable.



Aim of the placement The main aim of this clinical experience is to extend your competencies in providing care for hospitalised patients. In addition to providing care you have previously learned, you will be expected to undertake care of the medical or surgical adult patient. The unit emphasises care for patients experiencing an acute episodic illness.

This clinical experience will also contribute to your development as a professional nurse by assisting you to meet some of the Nursing and Midwifery Board of Australia Competency Standards for the Registered Nurse. The School of Nursing and Midwifery uses the Nursing and Midwifery Board of Australia Competency Standards for the Registered Nurse to assess you during your clinical placements. The following activity list contains numbers in parentheses which indicate the related Nursing and Midwifery Board of Australia Competency Standards for the Registered Nurse and links to the Clinical Assessment Tool.






Core activities

Communication


Documentation








Provision of care


REQUIRED clinical activities These activities are required to be undertaken during this clinical placement to help you achieve the objectives of this unit, HNN227: Quality and Safety: Nursing Practice 3. These activities will contribute to the development of your overall professional nursing competencies.

Required clinical activity

Complex wound management

• Assess patient’s wound and plan appropriate treatment

o Irrigate wound as appropriate and/or

o Pack an open/deep wound and/or

o Remove wound drain tube


• Document wound care provided






Assessment: 3/5 lead cardiac monitoring

• Undertake cardiac monitoring using correct technique

• Assess rhythm strip to identify normal sinus rhythm and report any abnormalities immediately

• Document appropriately

Assessment: 12 lead electrocardiogram (ECG)

• Undertake ECG using correct technique

• Assess ECG to identify normal sinus rhythm and report any abnormalities immediately


Medication administration: patient controlled analgesia (PCA)


• Assess patient and explain use of PCA

• Administer prescribed medication using correct technique under the supervision of your facilitator/preceptor

• Monitor patient and report any abnormalities immediately

• Document according to protocol

Blood transfusion


• Assess patient and explain procedure

• Administer blood transfusion using correct technique under the supervision of your facilitator/preceptor

• Monitor patient for signs of reaction according to protocols, reporting any abnormality immediately

• Document transfusion and patient response appropriately

Nasogastric (NG) tube insertion



• Insert NG tube using correct technique under supervision of your facilitator/preceptor

• Ascertain correct placement of tube

• Tape tube in position and connect to apparatus






Changing a colostomy/ileostomy bag


• Assess patient, including stoma site and surrounding skin, and explain procedure

• Change bag using correct technique, cleaning stoma and skin as required

• Document observations and care

Insertion of indwelling urinary catheter (IDC)



• Insert catheter using aseptic technique under the supervision of your facilitator/preceptor

• Attach and secure to appropriate drainage bag

• Document relevant information




HNN318: The Older Person and Supportive Care


Clinical placement This unit has a two week clinical placement in rehabilitation, aged care, or other inpatient facility. The clinical placement timetable will be displayed on CloudDeakin– Bachelor of Nursing Courses site – Clinical placement information – Clinical calendar and Clinical self-allocation timetable.

Each new placement is designed to build on the knowledge and skills developed in previous placements. Therefore, you are expected to use the nursing competencies learned previously. There are several models of student supervision and clinical support used in the Bachelor of Nursing program. At the start of your clinical placement, you will be informed of the name and contact details of your facilitator/preceptor.

Aim of the placement The main aim of this clinical experience is to apply an understanding of important issues in caring for older clients/patients to your nursing practice, and to use a problem-solving approach in providing holistic and individualised nursing care. You will be expected to demonstrate knowledge of the ageing process, and to plan care that focuses on protecting, promoting or optimising client/patient functional status while addressing common health problems and challenges in old age.

Second, an objective of the clinical experience is to introduce you to the role of the registered nurse as the leader of a nursing team that may include enrolled nurses, Personal Care Attendants (PCA) or others.

Third, the clinical experience will also contribute to your development as a professional nurse by assisting you to meet some of the Nursing and Midwifery Board of Australia Competency Standards for the Registered Nurse. The School of Nursing and Midwifery uses the competencies to assess you during your clinical placements. The following activity list contains numbers in parentheses that indicate the related Nursing and Midwifery Board of Australia Competency Standards and links to the Clinical Assessment Tool.

Clinical Placement Activities list The Clinical Placement Activities list should be used with the guidance of your clinical facilitator/preceptor to establish your objectives, carry out your activities and evaluate your placement. In all cases, the care of the patient is paramount, and your activities must be appropriate to the needs of the patient and the clinical facility in which you are placed.





Core activity

Communication


Documentation








Provision of care





REQUIRED clinical activities and discussions These activities are required to be undertaken during this clinical placement to help you achieve the objectives of this unit, HNN318: The Older Person and Supportive Care. These are the activities that will contribute to the development of your overall professional nursing competencies.

Required clinical activities and discussions

Provision and coordination of care

• Comprehensive care for one older (65+) client/patient with for example:

- Cognitive impairment

- Altered sensory function

- Decreased mobility

- Altered nutrition

- Incontinence or constipation

- Acute or chronic pain

• Comprehensively assess and manage the care of patients demonstrating behaviours of concern, such as:

- Patients with dementia

- Patients experiencing delirium

- Patients with aggression

- Patients experiencing confusion (5,6,7,8,10)

Medication safety: reducing risks of polypharmacy

• For at least one client/patient, identify all medications used, both prescribed and self-medicated

• Identify and report any potential medication interactions

• Identify factors that may affect the person’s ability to follow the medication regime (1,7,10)

Psycho-social health challenges: undertake nursing care for at least one older client/patient experiencing for example:

• Loss or bereavement

• Loneliness or isolation

• Role or relationship transitions

• Accommodation problems or relocation stress

• Economic or legal issues (5,6,7,8,10)






Assessment: Aged Care Funding Instrument (ACFI)

• Participate in the assessment of a client/patient using the ACFI under the supervision of your facilitator/preceptor (1,2,5,6,10)

Medication administration: safety and risk management in rehabilitation/aged-care facilities

• Review medication administration policies of the clinical agency

• Locate medication resources

• Identify any administration aids used (Webster-pak or other dose administration systems)

• Review policies on alternate forms of oral medications (liquids, crushing tablets, etc)

• Review medication records and documentation requirements of your clinical agency (1,2)

Case conference

• Participate in a multidisciplinary case conference under the supervision of your facilitator/preceptor (6,10)

Discharge planning

• Participate in the discharge planning process for at least one client/patient under the supervision of your facilitator/preceptor (6,10)

Provide end of life care: understanding grief, loss, and care of the body

• Communicate appropriately with dying client/patient and family members

• Participate in care of the body after death under the supervision of your facilitator/preceptor

• Observe the completion of legally required documentation (1,7,9,10)




HNN319: Chronic Illness and Supportive Care


Clinical placement This unit has a two week clinical placement in an in-patient health care facility. Each placement is designed to build on the knowledge and skills developed in previous placements. Therefore, you are expected to continue utilising the nursing competencies previously learned. There are several models of student supervision and clinical support used in the Bachelor of Nursing program. At the start of your clinical placement, you will be informed of the name and contact details of your facilitator/preceptor. The clinical placement timetable will be displayed on Cloud Deakin – Bachelor of Nursing Courses site – Clinical placement information – Clinical calendar and Clinical self-allocation timetable.

Aim of the placement The main aim of this clinical experience is to further develop your professional nursing skills and competencies through providing comprehensive care to patients with chronic health problems. These patients may be experiencing an acute exacerbation of their chronic condition. Or, they may have new health problems that are complicated by the presence of the chronic disease. You are expected to integrate theoretical and technical skills necessary for providing complex care whilst responding to the person with chronic illness in a broader social context. The focus is on the collaboration between the nurse and the chronically ill person to promote wellness, and restore and maintain health in acute care and after discharge. You need to be informed about not only the disease processes, but also the adaptation required to achieve optimal quality of life while coping with an enduring disabling condition. Providing education and counseling that encourages patients to undertake chronic disease self-management is a high priority.

This clinical experience will also contribute to your development as a professional nurse by assisting you to meet some of the Nursing and Midwifery Board of Australia Competency Standards for the Registered Nurse. The School of Nursing and Midwifery uses the NMBA competencies to assess you during your clinical placements. The following activity list contains numbers in parentheses which indicate the related NMBA Competency Standards and links to the Clinical Assessment Tool.

Activities list The Clinical Placement Activities list should be used with the guidance of your clinical facilitator/preceptor in establishing your objectives, carrying out your activities and evaluating your placement. In all cases, the care of the patient is paramount, and your activities must be appropriate to the needs of the patient and the clinical facility in which you are placed.





Core activity

Communication


Documentation








Provision of care


REQUIRED clinical activities These activities are required to be undertaken during this clinical placement to help you achieve the objectives of this unit, HNN319: Chronic Illness and Supportive Care. These activities will contribute to the development of your overall professional nursing competencies.



• Undertake and document comprehensive care for three (3) patients with a chronic illness


• Undertake and document comprehensive care for all patients in the students’ care; as far as possible, this should be patients who have a chronic illness so that emphasis on the psychosocial aspects of care can be explored


• Undertake and document comprehensive care for all your patients, with an emphasis on health education





Medication administration: medications administered by any route

• Administer and document medications as ordered for your patients under the supervision of your facilitator/preceptor



Skills and competencies: undertake as many of the following nursing care activities as possible:

• Cardiac assessment

• Administration of IV fluids and medications (+/- secondary line)

• Diabetes management (BSL/Insulin) and promotion of self-management

• Advanced wound management

• IDC insertion

• Management of chronic pain (including infusions)

• Nasogastric tube insertion

• Enteral feeding

• Neurological assessment (GCS)

• Pain Assessment and nursing management of chronic pain

• Insertion of butterfly for fluids or pain relief

• Use of Niki infusion pump

Health education

• Undertake a structured patient and/or family health education session on self-care for a chronic illness under the supervision of your facilitator/preceptor

Case conference

• Participate in a multidisciplinary team case conference/meeting under the supervision of your facilitator/preceptor

Discharge planning

• Participate in the discharge planning process for at least one patient with a chronic illness under the supervision of your facilitator/preceptor

• Ensure referral to appropriate community services on discharge under supervision of the R.N.




HNN325: Comprehensive Nursing Practice


Clinical placement HNN325: Comprehensive Nursing Practice has a five week clinical placement. The clinical placement timetable will be displayed on CloudDeakin – Bachelor of Nursing Courses site – Clinical placement information – Clinical calendar and Clinical self-allocation timetable. At the start of your clinical placement, you will be informed of the name and contact details of your facilitator/preceptor who will be available to provide you with guidance and support. Typically, you will be rostered for a forty (40) hour week or equivalent and undertake the same shifts as your preceptor.

Each placement in the Bachelor of Nursing is designed to build on the knowledge and skills developed in previous units. Therefore, you are expected to continue utilising the nursing skills and knowledge learned previously, as well as adding the new skills and knowledge acquired in this unit. You will be expected to take responsibility for the planning and delivery of nursing care to a group of allocated patients under the close supervision of your preceptor. In all situations, the care of the patient is paramount, and your activities must be appropriate to the needs of the patients and the clinical facility in which you are placed.

Your clinical placement will be assessed using the School of Nursing and Midwifery Clinical Assessment Tool, which is based on the Nursing and Midwifery Board of Australia Competency Standards for the Registered Nurse. Students are required to achieve the minimum standard on the Clinical Assessment Tool and the Core and Required Clinical Activities as outlined in this Professional Learning Portfolio. Students will be assessed using the Bondy Scale, and must achieve a minimum level of Supervised to pass the clinical placement.

The clinical placement will be conducted according to the School of Nursing and Midwifery Clinical Placement Rules and Responsibilities – Requirements 2015 and the School of Nursing and Midwifery Clinical Placement Rules and Responsibilities – Academic Progress 2015. A combined copy of these rules is contained in your Portfolio, or is available on the Bachelor of Nursing Courses site - Clinical Placements.

Aim of the placement

The main aims of this clinical placement are for you to be able to demonstrate your ability to:

• Comprehensively assess, manage and evaluate care for patients with complexity of illness and/or co-morbidities;

• Predict and manage areas of risk in complex patient situations; • Apply clinical decision-making skills to select evidence-based interventions for patients presenting with

symptoms and altered function as a consequence of the complexity of illness and/or co-morbidities; • Integrate knowledge and skills by providing safe, effective care for a group of individuals from diverse

cultural backgrounds • Successfully undertake the clinical activities outlined in the Professional Learning Portfolio and Clinical

Assessment Tool

Identifying clinical learning objectives This clinical placement has core, required and additional activities. You will also need to identify some specific clinical learning objectives of your own. These should be documented in the appropriate area of the Clinical Assessment Tool and discussed with your preceptor.




To assist you to identify specific objectives of your own for this placement, you could review your Professional Learning Portfolio documents from earlier units, as well as the feedback you received from facilitators/preceptors on previous clinical placements, and identify skills, knowledge and activities that require further development. These activities will provide the basis for identifying your own clinical learning objectives.


Core activity

Communication


Documentation







• Demonstrate physical and psychological comfort of patient’s whilst providing nursing care (2, 9)

Provision of care





REQUIRED clinical activities These activities are required to be undertaken during this clinical placement to help you achieve the objectives of this unit, HNN325: Comprehensive Nursing Practice. These activities will contribute to the development of your overall professional nursing competencies.


Delivery of person centred nursing care for patients with complexity of illness and/or comorbidities (5,6,7,8,10). This may include patients experiencing:

• Trauma

• Systemic inflammatory response syndrome

• Acute on chronic illness

• Cancer

• Pain

• Fluid and electrolyte imbalances

• Neurologic injuries or seizures

• Nutritional or metabolic alterations

• Respiratory dysfunction

• Symptoms and functional alterations associated with treatment

• Other physiologic and psychosocial disorders

Person centred care should encompass assessment, planning, implementation, and evaluation to ensure quality and safety

ADDITIONAL clinical activities These additional activities may be undertaken during this clinical placement if they are appropriate for the patients for whom you will be caring.


Assessment and management of a patient with a thoracic drain tube

In accordance with hospital policy;

• Perform and document the assessment of a patient with a chest drain in-situ including reviewing the CXR, drainage, swing, bubble

• Perform and document the assessment of a patient who has had a chest drain removed

• Set up wet/dry thoracic drainage system

• Perform and document a changeover the drainage chamber of an UWSD system

• Perform and document the safe removal of a chest drain, including indications for removal, analgesia, patient positioning and teaching, dressing and post-removal assessment





Assessment and management of a patient with a tracheostomy


• Perform and document the assessment of a patient with a tracheostomy, including airway, breathing, oxygenation, cuff, and safety equipment

• Set-up and check bedside suction equipment

• Perform and document the safe oral/tracheal suctioning of a patient with a tracheostomy, including the indications, assessment, technique and sputum

Care of a patient with a Central Venous Catheter


• Perform and document the assessment of a patient with a CVC including the insertion site, surrounding skin and dressing

• Perform and document a CVC dressing change, including the indication(s) assessment, removal of old dressing, cleaning, aseptic technique, dressing and projected date for change

• Perform and document the safe removal of a CVC including assessment, indication(s), technique, and post-removal assessment

Insertion and care of an intravenous cannula


• Perform and document the insertion of an intravenous cannula, including the indications, vein selection, equipment used, patient identification, and aseptic technique

• Perform and document the assessment of a patient with an intravenous cannula and/or intravenous therapy

Care of a patient with a Continuous and/or Manual Bladder Washout

• Perform and document the assessment of a patient with a continuous bladder washout, including indications for catheterisation, urinary catheter and urethral meatus, associated risks, and indications for cessation of washout

• Perform and document a manual bladder washout including indications, technique and assessment





ISBAR Handover Tool - Introduction

Clinical handover is the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person or professional group on a temporary or permanent basis (Australian Commission on Safety and Quality in Health Care, 2012). Handover is an essential component of quality and safe patient care. Handover commonly occurs at the end of a shift but is also conducted as required depending on patient needs. When handover occurs between nurses/midwives at shift change-over, the nurse/midwife on the oncoming shift is informed to be able to take over responsibility for patient care.

A relevant and comprehensive handover provides clear communication of information between members of the healthcare team and strengthens the capacity to plan and manage patient care. The ‘ISBAR’ (Identify, Situation, Background, Assessment, and Recommendation (& responsibility) framework provides a structure for handover between nurses/midwives and healthcare team members and is designed to provide a coordinated approach considerate of all patient care requirements.

ISBAR is a step by step process that provides a sequential approach to giving and receiving handover. The ISBAR tool also provides a guide for students to handover systematically.

Development of the skills necessary to handover a patient/client will enable you to further develop an insight into the complex roles and responsibilities of the professional nurse/midwife. You need to become familiar with, and use the ISBAR tool when handing over a patient/client in the Clinical Simulation Centre and in the clinical setting.

When on clinical placement you are expected to handover relevant patient/client information to nurses/midwives on the oncoming shift, and to members of the healthcare team as required. This tool will assist you with this process.

IDENTIFY Identify yourself, the patient and patient’s current location

SITUATION Admission diagnosis and current condition (improving, stable, deteriorating)

BACKGROUND Relevant medical and/or surgical history Allergies Nursing / Medical / Allied health consultations Previous diagnostic or collaborative management interventions

ASSESSMENT Assessment of symptoms, risk and function incorporating: - psychosocial aspects; - response to nursing intervention and medical treatment; and - actual and potential nursing problems.

RECOMMENDATIONS AND RESPONSIBILITY

Required nursing interventions Medical and allied health orders Pending treatments / diagnostic tests Discharge plan

Reference: Australian Commission on Safety and Quality in Health Care (ACSQHC), 2012, ‘Safety and Quality Improvement Guide Standard 6: Clinical Handover (October 2012)’, ACSQHC, Sydney.





ISBAR Handover Tool

Handover has been identified as an essential component of quality and safe patient care. The ISBAR framework provides a structure for clear communication between nurses/midwives and health care team members.

IDENTIFY • Identify yourself, the patient and patient’s current location




SITUATION • Admission diagnosis and current condition (improving, stable, deteriorating)

BACKGROUND • Relevant medical and/or surgical history • Allergies • Nursing/medical/allied health consultations • Previous diagnostic or management interventions




ASSESSMENT • Assessment of symptoms, risk and function incorporating:

- psychosocial aspects - response to nursing intervention and medical treatment - actual and potential nursing problems

RECOMMENDATIONS AND RESPONSIBILITY • Required nursing interventions • Medical and allied health orders • Pending treatments/ diagnostic tests • Discharge planning issues




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