SAQA

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SOUTH AFRICAN QUALIFICATIONS AUTHORITY

REGISTERED QUALIFICATION:

Bachelor of Nursing and Midwifery

SAQA QUAL ID	QUALIFICATION TITLE
102214	Bachelor of Nursing and Midwifery
ORIGINATOR
University of the Western Cape
PRIMARY OR DELEGATED QUALITY ASSURANCE FUNCTIONARY			NQF SUB-FRAMEWORK
CHE - Council on Higher Education			HEQSF - Higher Education Qualifications Sub-framework
QUALIFICATION TYPE	FIELD		SUBFIELD
National First Degree(Min 480)	Field 09 - Health Sciences and Social Services		Curative Health
ABET BAND	MINIMUM CREDITS	PRE-2009 NQF LEVEL	NQF LEVEL	QUAL CLASS
Undefined	480	Not Applicable	NQF Level 08	Regular-Provider-ELOAC
REGISTRATION STATUS		SAQA DECISION NUMBER	REGISTRATION START DATE	REGISTRATION END DATE
Reregistered		EXCO 0821/24	2021-07-01	2027-06-30
LAST DATE FOR ENROLMENT		LAST DATE FOR ACHIEVEMENT
2028-06-30		2034-06-30

In all of the tables in this document, both the pre-2009 NQF Level and the NQF Level is shown. In the text (purpose statements, qualification rules, etc), any references to NQF Levels are to the pre-2009 levels unless specifically stated otherwise.

This qualification replaces:

Qual ID	Qualification Title	Pre-2009 NQF Level	NQF Level	Min Credits	Replacement Status
8079	Bachelor of Nursing Science: General: Psychiatric: Community Nursing: Midwifery	Level 7	NQF Level 08	480	Complete

PURPOSE AND RATIONALE OF THE QUALIFICATION

Purpose:
There is a need for skilled professionals with highly developed critical thinking, analytical, and problem-solving skills that they will be able to use evidence-based practice to evaluate nursing practice in the interests of quality and continuous improvement. If the profession is to develop, it will need to be based on sound research, which demands that professional nurses be able to carry out research and write up results, as well as put in quality standards. In addition, the qualifying learner will apply evidence-based research to enhance the nursing practice.

The focus on more academic aspects of nursing will position professional nurses to look at new knowledge and new approaches to nursing care, which they will be able to monitor and evaluate. In this way they will be able to assess the impact of interventions.

This qualification will also prepare nurses for further specialisation as they move from general nursing practice to specialisation in particular areas, with a change in focus from practice to consultancy roles and clinical nurse specialists in their field. The focus will also shift from regional and institutional concerns to national and international issues.

The scope is of importance in this qualification is the scope. The graduate will be more comprehensively qualified than before, with a scope that includes obstetric skills, mental health, and primary health care (1st level contact and provision of health services with a referral system in operation when cases are beyond their scope). A person with this qualification will work with all patients, stabilised or not, and take responsibility for health care in any context. In addition, they will take responsibility for managing nursing care in a health care facility. The qualification will provide them with a comprehensive view of the field, and the necessary skills to screen patients and refer as required.

More specifically, the qualification aims to:

Produce high quality graduates who are competent nursing practitioners in a range of health service settings.

Provide graduates with a range of skills, knowledge and attitudes that will enable them to make a meaningful and sustained contribution to health services.

Equip graduates with a developed sense of equity, justice and service ethics that will ensure that they work in an accountable manner irrespective of their chosen work place.

Offer a wide range of transferable skills for application in other professions, disciplines and general life. These include:
> A methodical solution based approach to problem solving.
> An empowerment strength based approach to personal development.
> Competence in written and oral communication.
> Capacity to assess and implement health and other policy.
> Ability to plan and implement and manage projects of a varied nature.
> An ability to work independently and as part of a team.

Recipients of this qualification will be able to:

Apply knowledge of biomedical, biotechnological and psychosocial sciences to the practice of nursing.

Develop, implement and evaluate population based health care.

Assess, plan, implement and evaluate nursing care for individuals and groups based on thorough assessment.

Deliver nursing care to sick or disabled individuals and groups.

Promote rehabilitation of individuals and groups with disabilities.

Diagnose and treat minor and common ailments.

Maintain professionalism in nursing practice.

Manage a health care unit and facility.

Deliver safe obstetric care.

Utilise principles of science and methodology in investigating nursing and health related problems.

Learners will function within the current scope of practice of the professional nurse as formulated by the South African Nursing Council, in conjunction with the policies of the institutions of employment.

Professional Nurses will carry out their duties:

As a member, or leader of a team.

In accordance with the Professional Code of Ethics for Nurses.

In accordance with the provisions of the norms and standards for nursing.

Taking full responsibility for basic health care.

Rationale:
Nursing is an essential skill in any community and country, and the profession in South Africa has enjoyed an enviable reputation for quality and competence, and the comprehensive nature of training provided. There is concern to maintain this quality and comprehensiveness going forward as the country works to transform health care provision. The identified needs of South Africa's various communities are for comprehensively trained nurses. Planning for the development of nurses in response to these needs has indicated two key categories of nurses: The Staff Nurse and the Professional Nurse clearly distinguished in terms of their required competence and scope of practice.

This qualification will enable the learner to function as a clinically focused, service orientated, independent registered professional nurse, who is able to render comprehensive care across all spheres of health, as determined by the appropriate legislative framework. Comprehensive nursing in this context is defined in legislation as: "Nursing interventions that integrate and apply the scientific process of the full range of nursing that is general, community, obstetric, mental health that promotes and maintains the health status of health care users in all contexts of health care delivery".

As such, the qualification will also be valuable for those in the profession who may have been practising within the field, but without formal recognition for registration purposes.

This qualification will be useful for:

Staff nurses who wish to progress into nursing as a career.

Persons at a commensurate level in Health and Allied Health Sciences who wish to change direction and move into nursing.

Those wishing to progress towards qualification as a Master or Doctor of Nursing and beyond.

This qualification articulates:

All competency requirements and outcomes (academic, specialist theory and practical/workplace experience) that is necessary to achieve professional registration.

The requirements and provisions of the Professional Body for professional registration.

Designation/s that may be achieved. The ongoing requirements (including the Code of Ethics and the requirement for Continuing Professional Development) for retention of registration as stipulated by South African Nursing Council (SANC), and the implications of non-compliance on use of the Professional Designation and right to practice and/or licence to practice.

Given the shortage of doctors, it would seem likely that professional nurses will be required to undertake tasks formerly excluded from their scope of practice, with consequent implications for developing and recognising competence. The potential inability to hold professionals accountable for their actions can be addressed by building a hierarchy of skills in which, as professionals advance up the hierarchy, they fulfil their roles at the highest level but are not excluded from assisting in roles at lower levels.

Striking inequalities were found between urban and rural facilities in the staffing of nurses. It was recommended that the scopes of practice of all categories of nurses be revised to ensure that all categories are able to progress to the next level in the nursing skill hierarchy.

Based on the above findings, Pick et al (2001) then recommended that some of the tasks, traditionally provided by highly specialised professionals, be reassigned, with training and supervision, to workers at a different professional level. These proposals are likely to see an increased demand for staff and professional nurses, newly skilled in terms of the revised scope of practice for nursing in South Africa.

The decline of learners entering the nursing profession has been a matter of great concern to the South African Nursing Council and to the Ministry of Health. The problem is discussed in the Human Resources Plan for Health, which the Minister of Health launched in April 2006 and emphasis is given to recruitment of more learners into professional nursing. The registration of a Professional Degree: Nursing is seen as imperative to promote the uptake of graduate and postgraduate qualifications.

On successful completion of this qualification, the learner is eligible for registration with the relevant statutory body (currently the South African Nursing Council) as a Professional Nurse. Successful registration will license nurses to practice as a professional nurse as defined in the Nursing Act No.33 of 2005. [The Act defines a Professional Nurse as one who: "is educated and competent to practise comprehensive nursing, assumes responsibility and accountability for independent decision making in such practice, and is registered and licensed as a professional nurse under the Nursing Act"].

There is a strong need for professional nurses to be equipped to promote the quality of health care in South Africa. They are expected to initiate quality measures, and take full responsibility for all nursing practice. There is recognition in the health care field of the need to benchmark practices and work towards quality improvement, and to this end the qualification makes provision for a strong research component. Professional Nurses will act as professional team leaders, after having developed their practical skills, typically deployed as unit and/or zone managers. They are both the providers of health care, and managers; there is a strong coordination role for care provided by other caregivers. Professional nurses will look at developing the capacity of other team members.

The qualification, while solidly grounded in practice, will enable access to further academic routes and provides for high quality learning opportunities with a focus on specialisation and research.

This qualification links to the revised scope of practice for the profession, and to facilitate the upgrade of existing practitioners. It is further intended to assist in bringing coherence to training provision by providing clearly defined outcomes of learning, and a single standard for the sector.

LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING

Recognition of Prior Learning (RPL):
Students seeking access to the university through RPL should apply to the RPL Office at the Division for Lifelong Learning.

In line with the RPL policy of the university, the School of Nursing supports the ongoing development of procedures and practices at the institutional, faculty and departmental levels. The university's RPL stipulates procedures for access to or advanced standing in a nursing qualification.

The Senate may admit a candidate whohas attained the appropriate level of competence, to undergraduate studies. The School of Nursing will comply with the rules to follow the Senate guidelines, though may tailor the procedures to suit own purposes, e.g. South African Nursing Council (SANC). Admission remains the prerogative of Senate, and the School of Nursing may not admit candidates on its own authority.

Anyone wishing to ascertain the feasibility of making an RPL application should seek advice at the Division for Lifelong Learning (DLL). The DLL may then refer the candidate to the School of Nursing. Anyone wishing to seek RPL will be required to make a formal RPL application to the faculty of Community and Health Sciences at an appropriate time.

Entry Requirements:
The minimum entry requirement to this qualification is:

Senior Certificate and have achieved a pass in English, Mathematics, Biology and Physical Sciences.
Or

The National Senior Certificate granting access to Bachelor's Degree studies and have achieved a pass in English, another Language, Life Sciences, Mathematics or Mathematical Literacy.
Or

National Certificate (Vocational) NCV, Level 4, granting access to Bachelor's Degree studies and have achieved a pass in the three fundamental subjects and have achieved a pass in the four vocational subjects.

RECOGNISE PREVIOUS LEARNING?

QUALIFICATION RULES

This qualification comprises compulsory modules at Levels 5, 6, 7 and 8 totalling 500 Credits.

Compulsory Modules, Level 5, 115 Credits:

Human Development PSY 211, 10 Credits.

Human Biology 118, 15 Credits.

Human Biology 128, 15 Credits.

Physics 118, 15 Credits.

Chemistry, 10 Credits.

Microbiology and Parasitology for Nurses, 10 Credits.

Fundamentals of Nursing, 20 Credits.

Primary Health Care, 10 Credits.

Introduction to mental health, 10 Credits.

Compulsory Modules, Level 6, 125 Credits:

Human Biology 218, 20 Credits.

Human Biology 228, 20 Credits.

Child Health, 15 Credits.

Non-Communicable Diseases, 20 Credits.

Communicable Diseases, 20 Credits.

Introduction to Research, 10 Credits.

Pharmacology for Nurses, 20 Credits.

Compulsory Modules, Level 7, 140 Credits:

Community Based Maternal and Reproductive Health, 35 Credits.

Maternal and Infant Health Care: Low Risk, 35 Credits.

Maternal and Infant Health Care: High Risk, 35 Credits.

Research Methodology, 15 Credits.

Mental Health Nursing, 20 Credits.

Compulsory Modules, Level 8, 120 Credits:

Comprehensive Primary Health Care, 30 Credits.

Health Assessment Treatment and Care, 20 Credits.

Research Project, 20 Credits.

Ethos, Ethics and Professional Development, 20 Credits.

Health Service Management, 20 Credits.

Pharmacology and Nursing Practice: Dispensing, 10 Credits.

EXIT LEVEL OUTCOMES

1. Apply knowledge of theories, methods and techniques in the practice of safe clinical nursing that is responsive to the needs of the individual, the family and the community, in accordance with national legislative and policy frameworks.
2. Access and evaluate knowledge from various sources and produce new knowledge in nursing and midwifery practice.
3. Apply knowledge and practice of biological and natural sciences, psycho-social sciences and pharmacology in the provision of safe nursing and midwifery care, throughout the life span, through engagement in a variety of health care settings and communities in response to population needs.
4. Apply knowledge of biological and natural sciences, psycho-social sciences and pharmacology in the provision of safe nursing and midwifery care, throughout the life span, through engagement in a variety of health care settings and communities in response to population needs.
5. Identify and address ethical and legal issues based on critical reflection on the suitability of different ethical value (and legal) systems in the engagement in nursing and midwifery practice within a specific context and legal framework.
6: Apply steps in the research process in investigating nursing and health-related problems in order to improve quality of care.
7. Produce and disseminate evidence based information; and manage information, including health information systems, effectively in a range of settings and audiences.
8. Manage a health care unit and health facility based on the understanding of the roles and relationships within the health system.
9. Apply learning strategies effectively to address own and other's professional and personal on-going learning needs in a self-critical manner for life-long learning.
10. Manage a health care unit and health facility, including its resources, based on the understanding of the roles and relationships within the multidisciplinary team.

ASSOCIATED ASSESSMENT CRITERIA

Associated Assessment Criteria for Exit Level Outcome 1:

Demonstrate the application of nursing theories in the practice of nursing care within the health and nursing legislation.

Apply ethical principles and nursing care standards in meeting the health care needs of individuals, families and communities.

Apply evidence based practice in responding to the needs health care of individuals, families and communities.

Associated Assessment Criteria for Exit Level Outcome 2:

Critically appraise clinical cases and ascertain the sources for accessing and evaluating relevant knowledge required to address these clinical case.

Demonstrate skills for accessing, using and acknowledging sources of information.

Analyse, evaluate and synthesise sources of information to contribute new knowledge to nursing.

Associated Assessment Criteria for Exit Level Outcome 3:

Demonstrate practical competence in the delivery of basic and complex nursing care of individuals, families and communities.

Apply nursing skills in specific specialised health care settings for individuals throughout the lifespan.

Associated Assessment Criteria for Exit Level Outcome 4:

Demonstrate applied competence (knowledge, practical and reflective) in the consolidation of fundamental and core nursing knowledge in the delivery of basic and complex nursing care of individuals, families and communities.

Apply nursing skills, underpinned by relevant knowledge, in specific specialised health care settings for individuals throughout the lifespan.

Associated Assessment Criteria for Exit Level Outcome 5:

Identify and respond to human rights issues pertaining to nursing and midwifery practice within the various health care settings.

Apply relevant legislation within nursing and midwifery practice demonstrating sensitivity to contextually relevant ethical values.

Associated Assessment Criteria for Exit Level Outcome 6:

Identify a researchable health problem.

Access, process and synthesise information relevant to a researchable health problem.

Develop a research proposal to respond to the health problem.

Apply the research methodology in conduct the proposed research.

Associated Assessment Criteria for Exit Level Outcome 7:

Prepare information for dissemination using a variety of methods.

Disseminate the results of a research project using a variety of methods for different audiences.

Utilise health information systems appropriately to respond to problems and issues in various health contexts.

Associated Assessment Criteria for Exit Level Outcome 8:

Demonstrate skills to work effectively within a multidisciplinary team.

Display effective interpersonal skills in engagement with the multidisciplinary team members, patients and clients.

Demonstrate knowledge of the roles and responsibilities of the multidisciplinary team in a variety of health settings.

Effectively manage a health care unit/facility for effective patient/client care.

Associated Assessment Criteria for Exit Level Outcome 9:

Display awareness and respond to personal and professional learning needs.

Display contributions to the learning needs of colleagues and peers.

Develop willingness to engage in life-long learning.

Associated Assessment Criteria for Exit Level Outcome 10:

Utilise resources optimally in professional practice.

Demonstrate accountability of decisions and actions in professional practice within a health care unit.

Integrated Assessment:
The South African Nursing Council (SANC) guidelines for assessment and the competency framework are used as a reference for assessing clinical competence.

Formative:
A variety of assessment strategies and approaches must be used. This could include tests, assignments, projects, demonstrations or clinical assessments and/or any applicable method. There must be evidence of involvement in a research project. Formative assessments can include a mix of simulated and actual (real) clinical practice or care settings.

Summative:
Summative assessment can take the form of oral, written and practical examinations. All summative practical assessments must be conducted in actual clinical practice or care settings, or clinical laboratories.

INTERNATIONAL COMPARABILITY

Countries regarded as leaders, such as New Zealand and Canada, do not provide the comprehensive training that South Africa has done for the professional nurses. South Africa provides comprehensive training as basic whereas other countries provide it by way of additional courses. The reason is South Africa's emphasis on primary health care, nursing in the health care system, and our particular system and range of contexts. The scope of practice for nurses in South Africa is necessarily much broader.

The quality and scope of South African qualifications is endorsed by the fact that most first world countries readily accept South African nursing qualifications, and the United Kingdom (UK), United States of America (USA), New Zealand, Australia, Canada, Holland, and the United Arab Emirates (UAE) are keen to employ South African nurses. South African nursing standards exceed those in comparable economies such as Brazil, Indonesia, and India. In Africa, South Africa accepts nursing qualifications from Botswana, Swaziland, Tanzania, Namibia (which has only a diploma at present, although they are moving towards a Degree in nursing), Zimbabwe and Zambia. These nations, in turn, accept South African qualifications.

South Africa is an active member of the Internal Council for Nursing (ICN) as well as the Internal Labour Organisation (ILO), member of the African Union (AU), formerly the Organisation of African Unity (AOU), Southern African Development Community (SADC) and the Commonwealth. The qualification meets the recognition requirements in most of the member countries of these organisations and throughout Sub-Saharan Africa.

Comparison of qualifications:

In recognition of the reality of globalisation of nursing and nursing personnel, the International Council of Nurses (ICN) (2001) recommended "global" competencies for the generalist nurse. The ICN defined the generalist nurse as:

"A person who has completed a programme of basic nursing education and is qualified in her/his country to practice nursing. The educational programme prepares the nurse, through study of behavioural, life and nursing sciences and clinical experience, for effective practice and direction of nursing care, and for the leadership role. The first level (generalist) nurse is responsible for planning, providing and evaluating nursing care in all settings for the promotion of health, prevention of illness, care of the sick and rehabilitation; and functions as a member of a health team" (ICN, 200, p. 2).

The ICN further differentiates between what they refer to as a first and a second level nurse. The first level nurse refers to the generalist nurse or the equivalent of a professional nurse in current SA terms. The second level nurse on the other hand refers to a nurse who has completed a programme of study including "nursing theory and clinical practice" (p. 2) in preparation for practising nursing under the supervision of the first level nurse. This would be the equivalent of either the enrolled and nurse or the enrolled nursing assistant in South African terms.

The Role of the Generalist Nurse:

The role includes: "Promotion of health, and prevention of illness of individuals of all ages, families and communities, planning and management of care if individuals of all ages, families and communities with physical or mental illness, disabilities or rehabilitation needs in institutional and community settings and care at the end-stage of life" (p. 3).

Competencies of the Generalist Nurse:

The ICN defined competence as: "a level of performance demonstrating the effective application of knowledge, skill and judgment" (1997, 44; 2001, p. 3). Three broad categories of competencies are identified.

These include:

Professional, ethical and legal competence.

Care provision and management.

Professional development.

The World Health Organisation (1987) on the other hand has placed emphasis on the issues surrounding the relevance of the education of health professionals. The basic premise on which the WHO's recommendations are based is that effective education of health professionals must produce health professionals who are "responsive to needs to the needs of the populations they serve, in order to achieve the goal of health for all" (WHO, 1987, p. 5), and that such an education should be "based largely in the community, or in any of a variety of health service settings" (p. 5). In this regard, the WHO recommends that education of health professionals be community-based. The WHO views community-based education as "consisting of learning activities that use the community extensively as a learning environment".

Required Competencies of Graduates of Community Based Education Programmes:

The WHO work study group on community-based education classifies competencies of graduates of CBE programmes into:

General competencies for all Health Professionals.

All health professionals should be able to:

Respond to health needs and expressed demands of the community by working with the community, in order to stimulate self-care and a healthy life-style.

Educate both the community and their co-workers.

Solve or stimulate action for the solution of both individual and community health problems.

Direct their own and community efforts towards the promotion of health and the prevention of disease, unnecessary suffering, disability and avoidance of death.

Work as members of health teams and with other health other health teams.

Act as leaders of such teams when necessary.

Continue to learn throughout their working experience, in order to maintain and improve personal competence.

Professional functions include the following:

Provision of preventive care.

Provision of curative care.

Health education of the population.

Management of services.

Participation in health teamwork.

Training other members of the health team.

Participation in research activities.

Collaboration with other sectors involved in community development.

Finding solutions to unfamiliar problems.

Self-assessment and the continuous development of personal professional skills.

This qualification compares with the ICN requirements in the relevant categories of professional nurses.

ARTICULATION OPTIONS

This qualification offers horizontal and vertical articulation opportunities.

Horizontal Articulation:

Postgraduate Nursing Diploma, Level 8.

Vertical Articulation:

Masters in Nursing, Level 9.

MODERATION OPTIONS

N/A

CRITERIA FOR THE REGISTRATION OF ASSESSORS

N/A

NOTES

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LEARNING PROGRAMMES RECORDED AGAINST THIS QUALIFICATION:

When qualifications are replaced, some (but not all) of their learning programmes are moved to the replacement qualifications. If a learning programme appears to be missing from here, please check the replaced qualification.

NONE

PROVIDERS CURRENTLY ACCREDITED TO OFFER THIS QUALIFICATION:

This information shows the current accreditations (i.e. those not past their accreditation end dates), and is the most complete record available to SAQA as of today. Some Primary or Delegated Quality Assurance Functionaries have a lag in their recording systems for provider accreditation, in turn leading to a lag in notifying SAQA of all the providers that they have accredited to offer qualifications and unit standards, as well as any extensions to accreditation end dates. The relevant Primary or Delegated Quality Assurance Functionary should be notified if a record appears to be missing from here.

1.	University of the Western Cape