Clinical Immersion 4B (Adult)
| Module title | Clinical Immersion 4B (Adult) |
|---|---|
| Module code | NURM101 |
| Academic year | 2023/4 |
| Credits | 30 |
| Module staff | Mr Enrico De Luca (Lecturer) |
| Duration: Term | 1 | 2 | 3 |
|---|---|---|---|
| Duration: Weeks | 4 | 8 | 0 |
| Number students taking module (anticipated) | 45 |
|---|
Module description
This immersion focuses on your transition from student to registered nurse, culminating in achievement of the NMC’s Standards of proficiency for registered nurses and registration in the adult field.
Your transition themes include applied management, leadership, teaching, supervision, clinical governance and decision-making. You will advance your leadership skills within the interdisciplinary team, and will work as an equal partner to deliver safe nursing care for people with complex co-morbidities and multiple care needs.
Practice supervisors and practice assessors will support, assess and provide feedback and feed forward, recording your progress in your Practice Assessment Document (PAD) and Ongoing Achievement Record (OAR). All areas will meet educational learning audit requirements through the shared quality assurance framework - Educational Audit Process.
Module aims - intentions of the module
- The main aim of the module is to demonstrate your safe transition from student to registered adult nurse.
- You will achieve and consistently apply the Standards of proficiency for registered nurses in all areas of your caring nursing practice (NMC, 2018) and will consistently adhere to the Code (NMC, 2015).
- You will embody excellence in nursing, displaying competent knowledge and skills to support holistic, person-centred care.
- You will demonstrate the ability to confidently respond to, lead, provide, evaluate and manage the challenges of safe quality nursing care for people with complex co-morbidities and multiple care needs.
- You will fully integrate Exeter’s seven pillars into your daily nursing practice.
Your fourth year of MSci Nursing sees you become an independent and interdependent nurse, with the professional and ethical accountability to innovate, create and act as an agent of change. The seven pillars are now integral to your daily professional practice and are demonstrated below:
Fundamental essentials of nursing care: as an Exeter nurse you will demonstrate the ability to perform all nursing procedures in accordance with the NMC (2018) Standards of proficiency for registered nurses. The fundamentals of nursing care will be at the heart of your practice, as you care for patients with increasingly complex co-morbidities. Your practice will be grounded in excellence in delivering the fundamental essentials of care. Everyone is an individual and should be treated according to their needs and wishes and you will provide the highest quality care including at the end of life. As an Exeter nurse you will develop expertise in monitoring and evaluating your care and that provided by other members of the multidisciplinary team. F
Patient and public involvement: as an Exeter nurse you will foster the principle of “nothing about us without us” and will position the service user as the most significant stakeholder in the promotion of evidence-based practice. You will promote and develop quality services in partnership with service users. You will apply the concept of recovery and will demonstrate consistent skills in mental health assessment, including the ability to accurately assess a person’s capacity to make sound decisions about their own care and to give or withhold consent. You will understand and apply the principles and processes for making reasonable adjustments and best interest decisions if someone does not have mental capacity, and will negotiate and advocate on behalf of people in order to facilitate their rights. PPI
Evidence for practice: as an Exeter nurse you will understand how to monitor and evaluate the quality of patients’ experience to inform and improve the quality of care and services in partnership with the patient and colleagues. Your advanced grasp of research methods and implementation science will enable you to produce, as well as locate and use, the evidence for practice. E
No health without mental health: you will demonstrate an understanding of the complexities of managing mental, cognitive, behavioural and physical care needs across a range of health and social care settings, at both an individual level and from a strategic viewpoint, with a view to improving self-care, effectively managing risk and using evidence based low intensity interventions for common mental health conditions. MH
Leadership and management: you will safely manage, lead and co-ordinate a team of nursing and support staff to ensure the delivery of a high standard of nursing care. You will engage in relationship management to include performance management and resource management. You will begin to contribute to personal and professional support mechanisms such as clinical supervision to promote transparency and improvements in practice. As you assume greater responsibility, an important aspect of your role is to understand local and national policies that inform and regulate your practice. This will include understanding the importance of safe staffing levels, skill mix, patient safety, quality of care and effective safe prescribing. L&M
Global health: you will understand and explain the principles, practice and evidence base for health screening and immunisation programmes to improve health outcomes and promote population health for communities locally, nationally and globally. You will enable people to make their own informed personal decisions. GH
Ethics and Professionalism: this pillar will allow the Exeter Nurse to demonstrate commitment and professional values including social justice, compassion, dignity and integrity and the flourishing of individuals, families and communities. E&P
Intended Learning Outcomes (ILOs)
ILO: Module-specific skills
On successfully completing the module you will be able to...
- 1. Demonstrate the knowledge, skills and ability to coordinate the care for a group of people with complex and multiple care needs and act as a role model in managing person-centred, evidence based approach to care. (L&M; E;F;PPI; E&P)(4PEC4.4)
- 2. Evaluate a team-based approach to the quality of care delivery and demonstrate understanding of the roles, responsibilities and scope of practice of all team members.(E;L&M; E&P) (5LMNCWIT 5.7, 5.10, A4.2.1)
- 3. Demonstrate leadership potential in the assessment, planning, implementation and evaluation of care within the practice setting through effective interaction and engagement with people, services and communities. (L&M;PPI;E;F;GH; E&P)(5LMNCWIT 5.5, 5.6)
- 4. Critically appraise the quality and effectiveness of nursing care, demonstrate how to use service delivery evaluation in practice and how to bring about service improvement and audit findings to improve care. (L&M;E;F;PPI;MH; E&P)(6ISQC 6.7)
- 5. Apply knowledge of pharmacology, how medicines act and interact in the systems of the body, and their therapeutic action. (F;E;MH) (4PEC 4.14, 4.15)
- 6. Prepare medications where necessary, safely and effectively administer these via common routes and maintains accurate records. (F;E;MH; E&P) (B11.2, B11.8)
- 7. Demonstrate proficiency and accuracy when calculating dosages for a range of prescribed medicines. (F;E;MH)(1BAP 1.15, 4PEC 4.13, B11.4)
- 8. Recognise and respond to adverse or abnormal drug reactions to medications. (F;E;L&M;MH; E&P) (B11.10)
- 9. Maintain safety and safeguard the patient from harm, including awareness of non-compliance, demonstrating understanding of the Mental Capacity Act (DH 2007) and the Mental Health Act (DH 2007), where appropriate. (F;E;MH;L&M; E&P) (6ISQC 6.1)
ILO: Discipline-specific skills
On successfully completing the module you will be able to...
- 10. Demonstrate the ability to consistently provide safe and effective care underpinned by the evidence base in order to meet the Nursing and Midwifery Council Standards of Proficiency for Registered Nurses (2018) and the Code (2018). L&M; E&P; NMC
ILO: Personal and key skills
On successfully completing the module you will be able to...
- 11. Confidently demonstrate proficiency in all communication skills for professional practice. F; E&P
- 12. Confidently demonstrate proficiency in numeracy, literacy and digital literacy skill to support lifelong learning and professional practice. F
Syllabus plan
Whilst the module’s precise content may vary from year to year, an example of an overall structure is as follows:
This module is based in the clinical setting.
In your clinical immersions you will practice under supervision and in collaboration with nurses, students and healthcare colleagues to develop your nursing skills including assessing, planning, implementing and evaluating complex nursing care. The indicative content for each pillar is listed below; the required NMC Standards of proficiency (2018) are clearly set out in your PAD.
As an Exeter nurse, you will ensure that the fundamental essentials of nursing care will be at the heart of your practice as you care for people with increasingly complex co-morbidities. You will identify and assess the needs of patients and carers at the end of life. You will be increasingly confident in your decision-making abilities, and will take account of mental capacity, best interests and the preferences of patients and service users.
Evidence for Practice and Leadership and Management are critical pillars in year four as your practice develops and you begin to manage caseloads and the nursing team. Another important aspect of year four is the ability to draw on wider perspectives and local and national policies, to inform care, challenge practice and lead quality improvement. You will analyse and then implement change management, working as part of a complex team to supervise others and manage care in contexts with different staffing requirements and skill mixes.
Leadership and management will be explored:
- Leadership, managing and team working.
- Implementing change management.
- Time management.
- Prioritisation skills.
- Assertiveness and resilience skills.
- Importance of maintaining safety of self and people in your care.
- Working as part of a team with people in your care and other professional groups.
- Staffing and skill mix.
- Value based practice: its effect on leadership and management decision-making.
These hours contribute to the NMC and EU Directive requirement of 2,300 clinical learning hours across the whole programme. This clinical immersion module equates to 412 hrs.
Learning activities and teaching methods (given in hours of study time)
| Scheduled Learning and Teaching Activities | Guided independent study | Placement / study abroad |
|---|---|---|
| 0 | 0 | 412 |
Details of learning activities and teaching methods
| Category | Hours of study time | Description |
|---|---|---|
| Clinical Practice Immersion | 412 | Practice based learning supported by a practice supervisor and practice assessor. |
Formative assessment
| Form of assessment | Size of the assessment (eg length / duration) | ILOs assessed | Feedback method |
|---|---|---|---|
| Mid-point assessment of progress as part of the Practice Assessment Document (PAD), including Episode of Care and Medicines Management assessments. | Observed practice assessment during the initial weeks of clinical immersion. | 1-12 | Direct verbal feedback and feed forward and/or written feedback and feed forward within PAD. |
Summative assessment (% of credit)
| Coursework | Written exams | Practical exams |
|---|---|---|
| 100 | 0 | 0 |
Details of summative assessment
| Form of assessment | % of credit | Size of the assessment (eg length / duration) | ILOs assessed | Feedback method |
|---|---|---|---|---|
| Practice Assessment Document (PAD) and Ongoing Achievement Record (OAR), including Episode of Care and Medicines Management assessments. (Pass/Fail) | 100 | Observed practice assessment throughout clinical immersion. | 1-12 | Direct verbal feedback and feed forward and/or written feedback and feed forward within PAD. |
| 0 | ||||
| 0 | ||||
| 0 | ||||
| 0 | ||||
| 0 |
Details of re-assessment (where required by referral or deferral)
| Original form of assessment | Form of re-assessment | ILOs re-assessed | Timescale for re-assessment |
|---|---|---|---|
| Practice Assessment Document (PAD), including Episode of Care and Medicines Management assessments (Pass/Fail) (100%). | Practice Assessment Document (PAD), including Episode of Care and Medicines Management assessments | 1-12 | A three-week consolidation period is available at the end of the academic year to make up learning hours missed due to illness etc. and to allow for reassessment. |
Re-assessment notes
The Practice Assessment Document, this module, is assessed as either pass or fail. Within the year four clinical immersion, proficiencies can be carried over from one clinical immersion to the next. However, they must be all achieved by the end of the year.
To progress and be recommended for registration as an adult nurse you must demonstrate that you have met the modular learning outcomes by demonstrating the professional values and agreed proficiencies specified in the PAD, in line with the NMC Standards of proficiency for registered nurses (NMC, 2018). Furthermore, you must pass the ‘Episode of Care 2’ assessment and the ‘Medicines Management’ assessment, as detailed in the PAD. The final practice assessor will confirm that the specified professional values and agreed skills have been achieved and will ensure that relevant proficiencies have been signed for. They will also undertake the ‘Episode of Care 2’ and the ‘Medicines Management’ assessments. Progression and recommendation for registration is supported and confirmed by the academic assessor for each year of the programme.
Indicative learning resources - Basic reading
Alligood, M.A. (2018) Nursing Theorists And Their Work, Elsevier.
Ashelford, S., Raynsford, J., and Taylor, V. (2016) Pathophysiology & Pharmacology for Nursing Students, Sage.
Bickley, L.S (2017) Bate’s Guide to Physical Examination and History Taking. Wolters Kluwer.
Bickley, L.S (2017) Bate’s Pocket Guide to Physical Examination and History Taking. Wolters Kluwer.
Blank, R.H., Burau, V., & Kuhlmann, E. (2017) Comparative Health Policy (5th ed.). Macmillan International.
Bradshaw, T., and Mairs, H. (eds.) (2017) Health Promotion and Wellbeing in people with Mental Health problems, Sage publications.
Brooker, C. and Nicol, M. (2015) Alexander’s Nursing Practice 4th ed. Churchill Livingstone.
Delves-Yates, C. (ed.) (2015) Essentials of Nursing Practice, Sage.
Edelman, C.L., and Kudzman, E.C. (2018) Health Promotion Across the Life span, Elsevier.
Giger, J.N. (2017) Transcultural Nursing; Assessment and Intervention (7th ed.), Elsevier.
Gould, D., & Brooker, C. (2008) Infection Prevention and Control; Applied Microbiology for Healthcare (2nd ed.) Palgrave Macmillan.
Griffith, R., & Tengath, C. (2017) Law and Professional Issues in Nursing: Transforming Nursing Practice, Sage.
Hubert, R.J., and Van Meter, K.C. (2018) Gould’s Pathophysiology for the Health Professions, Elsevier.
Innes, J.A., Dover. A.R., & Fairhurst, K. (eds.) (2018) Macleod’s Clinical Examination (14th ed.), Elsevier.
Naidoo, J., and Wills, J. (2016) Foundations for Health Promotion, Elsevier.
Polit, D.F., and Back, C.H. (2017) Essential of Nursing Research: Appraising Evidence for Nursing Practice. Wolters Kluwer.
Papadopoulos, I. (ed.) (2006) Transcultural Health and Social Care; Development of Culturally Competent Practitioners, Butterworth Heinemann.
Richards, D.A., and Hallberg, I.R. (eds.) (2015) Complex Interventions in Health. Routledge.
Sethia, B., and Kumar, P. (eds.) (2019) Essentials of Global Health Elsevier.
Stanley, D. (ed.) (2017) Clinical Leadership in nursing and Healthcare: Values into Action,(2nd ed) John Wiley& Sons, available at https://onlinelibrary.wiley.com/doi/book/10.1002/9781119253785
Stein-Parbury, J. (2018) Patient & Person: Interpersonal Skills in Nursing, Elsevier.
Tashiro, J., Shimpuku, Y., and Naruse, K., et. al., (2013) Concept analysis of reflection in nursing professional development. Japan Journal of Nursing Science 10(2):170-179 available at: https://www.evidence.nhs.uk/Search?q=nursing+reflection&sp=on
Tortora, G.J., Derrickson, B (2017) Principles of Anatomy and Physiology. Wiley.
Waller, D.G., Sampson, A.P et., al. (2014) Medical Pharmacology & Therapeutics, Saunders, Elsevier.
Watson, C. (2018) The Language of Kindness: A Nurse’s Story. Chatto & Windus.
Waugh, A. Grant, A. (2018) Ross & Wilson, Anatomy and Physiology in Health and Illness, Elsevier.
West, M.A., Armit, K., Loewenthal, L., Eckert, R., West, T., and Lee, A. (2015) Leadership and Leadership development in healthcare: The Evidence base. The King’s fund/CCL. Available at
https://www.kingsfund.org.uk/publications/leadership-and-leadership-development-health-care
Wilkinson, J. (2011). Nursing process and critical thinking, 5th Edition. Prentice Hall: New Jersey.
Wright, K.M., and McKeown, M. (2018) Essentials of Mental Health Nursing, Sage Publications.
Indicative learning resources - Web based and electronic resources
Department of Health: www.gov.uk/government/organisations/department-of-health-and-social-care
Nursing and Midwifery Council: www.nmc.org.uk
Royal College of Nursing: www.rcn.org.uk
National Institute of Health and Clinical Excellence: www.nice.org.uk
World Health Organisation: www.who.int
Healthtalk online: www.healthtalk.org
WeNurses (@WeNurses) · Twitter: https://twitter.com/WeNurses
NHS Improvement: https://improvement.nhs.uk/improvement-hub/quality-improvement/
NHS Leadership Academy: https://www.leadershipacademy.nhs.uk
The King’s Fund: https://www.kingsfund.org.uk/
https://www.elsevierclinicalskills.co.uk/
https://www.clinicalskills.net/
Indicative learning resources - Other resources
Journals:
American Journal of Nursing
British Journal of Community Nursing
British Journal of Nursing
Evidence-based Nursing
International Journal of Nursing Studies
Journal of Advanced Nursing
Journal of Clinical Nursing
Journal of Psychiatric and Mental Health Nursing
Nursing Ethics
Nursing Management
Nursing Older People
Worldviews on Evidence Based Nursing
| Credit value | 30 |
|---|---|
| Module ECTS | 15 |
| Module pre-requisites | NUR1000, NUR1100, NUR2000, NUR2100, NUR3050, NUR3150, NUR3300, NUR3400, NUR3500, |
| Module co-requisites | None |
| NQF level (module) | 7 |
| Available as distance learning? | No |
| Origin date | 28/06/2018 |
| Last revision date | 26/04/2023 |
