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SOUTH AFRICAN QUALIFICATIONS AUTHORITY 
REGISTERED QUALIFICATION THAT HAS PASSED THE END DATE: 

Master of Nursing 
SAQA QUAL ID QUALIFICATION TITLE
59346  Master of Nursing 
ORIGINATOR
SGB Nursing 
PRIMARY OR DELEGATED QUALITY ASSURANCE FUNCTIONARY NQF SUB-FRAMEWORK
-   HEQSF - Higher Education Qualifications Sub-framework 
QUALIFICATION TYPE FIELD SUBFIELD
Master's Degree  Field 09 - Health Sciences and Social Services  Curative Health 
ABET BAND MINIMUM CREDITS PRE-2009 NQF LEVEL NQF LEVEL QUAL CLASS
Undefined  271  Level 8 and above  NQF Level 09  Regular-ELOAC 
REGISTRATION STATUS SAQA DECISION NUMBER REGISTRATION START DATE REGISTRATION END DATE
Passed the End Date -
Status was "Reregistered" 		 SAQA 0480/09  2009-07-01  2009-07-01 
LAST DATE FOR ENROLMENT LAST DATE FOR ACHIEVEMENT
2010-07-01   2013-07-01  

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 is replaced by: 
Qual ID Qualification Title Pre-2009 NQF Level NQF Level Min Credits Replacement Status
83086  Master of Nursing  Level 8 and above  NQF Level 09  180  Will occur as soon as [NEW] is registered 

PURPOSE AND RATIONALE OF THE QUALIFICATION 
Purpose:

Learners credited with this qualification are able to function with advanced intellectual and practical competencies in complex and ill-defined specialized areas of nursing practice as leaders, consultants, educators and specialist practitioners in providing evidence-based care together with other team members. In addition, qualifying learners contribute to the continuous development of specific specialized areas of nursing through the development of scientific and professional knowledge for the advancement of nursing practice, research, management and education.

Qualifying learners work as clinical nurse specialists in the health sector. They are independent practitioners in their own right in the area of speciality.

This qualification affords learners access to doctoral studies, further increasing the candidate pool for leadership in nursing and/or midwifery. As qualified specialist practitioners, they have access to more senior positions, and are able to affect areas of policy change, development and implementation. The recently released Health Department Human Resources Plan makes provision for clinical nurse specialist positions, by offering progress and reward, without removing them from clinical practice.

Clinical nurse specialists are the trendsetters in the following areas of specialisation:
  • Orthopaedic Nursing.
  • Operating Room Nursing.
  • Palliative and Oncology Nursing.
  • Ophthalmic Nursing.
  • Emergency Care Nursing.
  • Occupational Health Nursing.
  • Nephrology Nursing.
  • Paediatric Nursing.
  • Critical Care Nursing (Adult).
  • Critical Care (Child and Adolescent).
  • Psychiatric Nursing.
  • Midwifery and Neo-natal Nursing.
  • Community Health Nursing.
  • Nursing and Health Services Management.
  • Nursing Education.

    Note: It is possible to complete a research masters, without a clinical component:
  • Nursing Research.

    This involves them in the development of new techniques, strategies and skills. Because of their competence, specialization, and nearness to practice, they have the opportunity to try out and develop new ways of working with people, and in the process of extending the scientific body of knowledge. This provides for them academic career options; the minimum requirement to lecture at university being a masters qualification. Further, internationally, the requirements for advanced practice nursing is a master's degree.

    More specifically, the qualification aims to:
  • Produce high quality graduates who are able to be competent advanced nursing practitioners in a range of health service settings.
  • Provide graduates with a range of skills, knowledge and attitudes that will enable them to set trends, and take leadership roles in 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:
    > Capacity to assess and implement health and other policy.
    > An ability to affect areas of policy change, development and implementation.
    > Ability to plan and implement and manage projects of a varied nature.
    > An ability to work independently and as part of a team.

    This qualification will be useful for:
  • Professional nurses who wish to progress within the field.
  • Persons at a commensurate level in Health and Allied Heath Sciences who wish to change direction and move into nursing.
  • Those wishing to progress towards qualification as a Doctor of Nursing and beyond.

    This qualification articulates:
  • All competency requirements and outcomes (academic, specialist theory and practical/workplace experience) that are 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 SANC, and the implications of non-compliance on use of the Professional Designation and right to practice and/or licence to practice.

    Scope of practice:

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

    Professionals 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.
  • They will take full responsibility for specialist areas in the health sector.

    Rationale:

    Note: The rationale for the Master's Degree is similar to that of the Master's Certificate, with the added dimension of significant research, which is the essential difference between the two.

    There is rarely any exposure of pre-registration nurses to the complex, and dynamic context of specialized nursing practice. The changing context of health care practice with a growth in debilitating health conditions demands a cadre of clinical nurse specialists who are able to provide nursing care to patients in need of specialized nursing care.

    The ongoing complexity of technology and the increasing acuity levels of the patients being cared for demand a capacity to self-evaluate, to exercise personal responsibility and initiative and indicate a depth of knowledge and a high level of skill and competence in specialized health care units.

    High levels of trauma and critical illness in the country lead to complex demands on nurses to utilize rapid meta-cognitive problem solving skills in the resolution of concrete and abstract critical issues.

    A significant report by Pick, Nevhutalu, Cornwall, and Masuku (2001, July) on the current situation of human resources in health in South Africa outlines a background of extreme economic and health inequalities of the past, and describes the current landscape still characterised by complex distortions of supply, production, distribution, and development of health personnel.

    Pick et al (2001) found that some of the professional categories (doctors, professional nurses, and therapists) were not available at all points of Primary Health Care delivery. Furthermore, 80% of midwifery and neonatal services in the country are delivered by midwives and in view of the high peri-natal and maternal mortality and morbidity rates, it is essential to have an advanced practitioner able to build the knowledge base and improve practice in midwifery and neonatal nursing. Advanced nurse practitioners will frequently function independently within their specialised scope of practice. Concerns around the 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.

    In practice, supply falls short of demand, and the gap is growing. According to the statistics published by the South African Nursing Council, in 1996, 2 259 learners graduated as professional nurses, with the qualification: Nursing Science (General, Community and Psychiatry) and Midwifery. In 2005, the number had dropped to 1 533.

    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 need for the continued supply of nurse researchers to lead knowledge production in an area of health sciences that is continuously changing and growing as new disease patterns emerge and raise new and unexpected questions, which can only be answered through scientific analysis cannot be overly emphasized.

    The registration of a Masters Degree: Nursing is seen as important in providing extended learning pathways, and promoting the uptake of graduate and postgraduate qualifications. 
    		•

    LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING 
    Competence must include achievement of requirements for a professional nurse:
  • Developing, implementing and evaluating population based health care.
  • Planning, implementing and evaluating nursing care for individuals and groups based on thorough assessment.
  • Delivering nursing care to sick or disabled individuals and groups.
  • Promoting rehabilitation in individual and groups with disabilities.
  • Diagnosing and treating minor and common ailments.
  • Maintaining professional nursing in practice.
  • Managing a health care unit.
  • Delivering safe midwifery care.
  • Understanding of research principles, methodologies and approaches.
  • Integration and application of knowledge of biomedical sciences, including body and functioning, microbiology and pharmacology as well as socio-psychology in the provision of nursing care within a comprehensive health care system.

    Recognition of Prior Learning:

    Learners may provide evidence of prior learning for which they may receive credit towards the qualification by means of portfolios, other forms of appropriate evidence and/or challenge examinations, as agreed to between the relevant provider and relevant ETQA or ETQA that has a Memorandum of Understanding in place with the relevant ETQA.

    RPL is particularly important, as there are people in the profession with a variety of qualifications of differing quality and scope. It is important that an RPL process be available to assist in making sense of existing qualifications, and helping to standardise qualifications around a common standard. A related issue is that the nursing profession is facing a new scope of practice, based on international standards. It is essential that existing qualifications and all new provision is aligned to the new scope of practice, and the vision for health care in South Africa.

    A further consideration is that there is a big change in the needs of the community that nurses have to serve; this partly explains the 'migration' amongst practitioners to other qualifications. Nurses are finding that their existing qualifications do not meet emerging needs or requirements, and they move to another to meet those needs.

    Existing registered nurses, as well as professional nurses qualified under the new Professional Degree may wish to obtain this qualification. Specialist Nurses who have already achieved the Masters Certificate: Nursing, may be given recognition of their learning, and required to do the research component to achieve the Masters Degree: Nursing.

    There are gaps between old qualifications and the requirements of the new scope of practice, and a consequent need to upgrade qualifications. RPL is seen as vitally important in every case to give recognition to learning already in place, make sense of the plethora of different levels and standards in the field, and provide a means for all to gain access to, and progress within, a common learning pathway for the profession.

    There is a strong need to bring about alignment to the profession, with one nationally recognized qualification providing for the comprehensive approach. The focus is on the integration of the various components of nursing, to ensure that these are allied in an integrated manner to provide comprehensive care. Professional Nurses are the managers of health care in all settings for health care delivery. They are independent practitioners, exercising judgement and make decisions around nursing care, and there is a strong need for critical and analytical thinkers to build the scientific knowledge base of nursing.

    Access to the Qualification:

    The South African Nursing Council requires the following for this qualification:
  • An equivalent of a diploma or degree in nursing at NQF Level 7.
  • Current registration with SANC as a professional nurse.

    Learners may provide evidence of prior learning for which they may receive credit towards the qualification by means of portfolios, other forms of appropriate evidence and/or challenge examinations, as agreed to between the relevant provider and relevant ETQA or ETQA that has a Memorandum of Understanding in place with the relevant ETQA.

    Learners must have access to clinical facilities of health service providers that are accredited by the relevant ETQA or ETQA that has a Memorandum of Understanding in place with the relevant ETQA for the practical component.

    Clinical and work-based experiences must comply with the regulations of the South African Nursing Council. 
    		•

    RECOGNISE PREVIOUS LEARNING? 
    Y 

    QUALIFICATION RULES 
    In order to be credited with this qualification, learners are required to achieve:

    Fundamental:

    All 15 Fundamental component credits are found in the following unit standard:
  • ID 117434: Conduct research, NQF Level 7, 15 credits.

    Core:

    All 176 Core component credits (Exit Level Outcomes 1-4). These are compulsory, regardless of the area of specialisation selected.

    Elective: [at present each elective option is registered as a separate qualification]:
  • At least 80 Elective component credits.
  • Candidates can choose from 16 different elective options.
  • Each elective is an area of specialisation, and carries a minimum of 80 credits.
  • Candidates must select whole elective options, and complete all of the exit level outcomes for that elective.

    Experiential learning (applicable to Clinical Based Masters) hours are credit earning hours and are calculated as one actual hour equals one notional hour. (SAQA 10 notional study hours equal one credit). These hours are spent under direct supervision of nurse lecturers as supervised practice, laboratory learning and project learning. All qualifications must include a minimum of 30 experiential learning credits.

    If candidates are busy with a masters, and have completed everything except the research (thesis), and do not wish to continue, they may apply for recognition of the Master's Certificate in the relevant field.

    Work Based learning hours under the supervision of a unit manager and registered nurse, are not credit earning hours but are important to become truly skilled as learners during clinical placement in health services. Work placement allows for the practicing of work/professional roles and competencies to a safe level under the supervision of unit managers or registered nurses. The required number hours and nature work-based learning are clearly stipulated by the SANC for each nursing specialization.
    Workplace learning is only for the clinical based Master's. 
    		•

    EXIT LEVEL OUTCOMES 
    Core:

    1. Function effectively as a clinical nurse specialist with other members of the health within the health care system.

    2. Analyse a range of research methods and approaches with regard to their appropriateness for investigating particular research problems in specialized nursing and midwifery.

    3. Manage and evaluate specialized nursing services at district, provincial and national level within the constraints of national health policy and international guidelines and in different settings.

    4. Apply advanced research methods in investigating complex and/or ill defined problems in nursing and midwifery education, management and practice.

    Elective:

    Note: The number of criteria per Exit Level Outcome varies according to the requirements of the particular outcome. They are not indicators of the size of the outcome, but rather directives for assessors and providers on critical evidence of competence.

    Elective 1: Orthopaedic Nursing:

    5. Work as a specialist practitioner with other team members within the health care system for the promotion of healthy musculo-skeletal functioning, rehabilitation and the prevention of orthopaedic morbidity.

    6. Demonstrate an informed and critical understanding of the principles, theories, issues and debates emerging in orthopaedic nursing.

    7. Apply specialist knowledge and skills in orthopaedic nursing in the care of individuals, groups and communities with orthopaedic problems.

    Elective 2: Operating Theatre Nursing:

    8. Work as a specialist practitioner with other team members within the operating theatre and surgical environment for the prevention of illness.

    9. Demonstrate an informed and critical understanding of the principles, theories and emerging issues and debates in operating theatre nursing.

    10. Apply specialist knowledge and skills in peri-operative care of individuals.

    Elective 3: Palliative and Oncology Nursing:

    11. Work as a specialist practitioner with other team members within the health care system for the promotion of health, prevention of malignant conditions and care of the dying patient.

    12. Demonstrate an informed and critical understanding of the principles, theories and emerging issues and debates in palliative and oncology nursing.

    13. Apply specialist palliative care and oncology nursing knowledge and skills in the care of individuals, groups and communities.

    Elective 4: Ophthalmic Nursing:

    14. Work as a specialist practitioner with other team members within the health care system for the promotion of ophthalmologic health and the prevention of visual impairment and blindness.

    15. Demonstrate an informed and critical understanding of the principles, theories and emerging issues and debates in ophthalmic nursing.

    16. Apply specialist knowledge and skills in the ophthalmologic health care of individuals, groups and communities.

    Elective 5: Emergency Nursing:

    17. Work as a specialist practitioner with other team members within the health care system for the prevention of mortality and morbidity, before, during and after emergencies.

    18. Demonstrate an informed and critical understanding of the principles, theories and emerging issues and debates in emergency nursing.

    19. Apply specialist knowledge and skills in the emergency nursing of individuals and groups.

    Elective 6: Occupational Health Nursing:

    20. Work as a specialist practitioner with other team members within the health care system for the promotion of occupational health and the prevention of occupational illness.

    21. Demonstrate an informed and critical understanding of the principles, theories and emerging issues and debates in occupational health nursing.

    22. Apply specialist knowledge and skills in the occupational health care of individuals and groups.

    23. Maintain excellence in practice as a specialist practitioner in a variety of settings (private, employed, self-employed, urban and rural).

    Elective 7: Nephrology Nursing:

    24. Work as a specialist practitioner with other team members within the health care system for the promotion of renal health and the prevention of renal dysfunction.

    25. Demonstrate an informed and critical understanding of the principles, theories and emerging issues and debates in renal nursing.

    26. Apply specialist knowledge and skills in the renal nursing care of individuals, groups and communities with renal health problems.

    Elective 8: Paediatric Nursing:

    27. Work as specialist practitioner with other team members within the health care system in the assessment of the health status of children, from healthy to very ill with specific understanding of the maturation and development of children.

    28. Demonstrate an informed and critical understanding of the principles, theories and emerging issues and debates in paediatric nursing.

    29. Apply specialist knowledge and skills in the provision of nursing care to sick children and their families.

    Elective 9: Critical Care Nursing (Adult):

    30. Demonstrate a practice-based understanding and knowledge of bio-medical technologies and nursing skills utilized in support of care of the critically ill person.

    31. Apply evidence-based knowledge and skills to understanding, interpreting and mediating the physical and emotional environment of the critical care unit for patients, their families and staff.

    32. Demonstrate a coherent understanding of principles, theories, emerging issues nationally and globally in critical care nursing.

    33. Interpret and apply information and data correctly to assess the critically ill adult.

    34. Apply specialist knowledge and skills in the care and physiological support of critically ill and high-risk adults and their families.

    Elective 10: Critical Care Nursing (Child and Adolescent):

    35. Demonstrate a practice-based understanding and knowledge of bio-medical technologies and nursing skills utilized in support of care of the critically ill person.

    36. Apply evidence-based knowledge and skills to understanding, interpreting and mediating the physical and emotional environment of the critical care unit for patients, their families and staff.

    37. Demonstrate a coherent understanding of principles, theories, emerging issues nationally and globally in critical care nursing.

    38. Interpret non-verbal information and other data presented by children and families of varying developmental phases to completely assess children who require critical care.

    39. Demonstrate specialist knowledge of congenital, child specific physiology and pathophysiology that requires critical care.

    40. Demonstrate ability to respond to rapidly changing clinical conditions, including the recognition and management of emerging health crises, organ dysfunction and failure in critically ill children and adolescents.

    Elective 11: Psychiatric Nursing:

    41. Work as a specialist practitioner with other members of health team within the health care system for the promotion of mental health and prevention of mental illness.

    42. Demonstrate a coherent and critical understanding of the principles, theories, emerging issues and debates in psychiatric nursing.

    43. Apply specialist knowledge and skills in the nursing of individuals, groups and communities with mental health problems.

    44. Enhance the functioning of the individual, group and community through expert psycho education.

    Elective 12: Midwifery and Neonatal Nursing:

    45. Work as a specialist practitioner with team members within the health care system for the promotion of maternal and neonatal health and the prevention of maternal and neonatal mortality and morbidity.

    46. Demonstrate a coherent and critical understanding of the principles, theories and emerging issues and debates in advanced midwifery and neonatal nursing.

    47. Apply specialist knowledge and skills in the provision of advanced reproductive health care for individuals, groups and communities.

    Elective 13: Community Health Nursing:

    48. Work as a specialist practitioner with other members of health team for the promotion of health for groups, communities and populations in striving to resolve public health issues that impact negatively on the attainment of optimal health for the population as a whole.

    49. Demonstrate a coherent and critical understanding of the principles, theories, emerging issues and debates in national and global public health.

    50. Apply specialist knowledge and skills in population-based care to meet the health needs of groups, communities and populations.

    51. Use advanced epidemiological research methods and epistemological thinking to assess needs, determine strategies to meet identified needs and identify best practices in public health and community-based nursing.

    Elective 14: Nursing and Health Services Nursing Management:

    52. Demonstrate a comprehensive and systematic knowledge and understanding of the components of the management process in the management of a health service.

    53. Demonstrate a coherent and critical understanding of principles and theories of management and leadership.

    54. Organize the management of a defined health care unit by identifying, analysing and dealing with complex issues using evidence-based solutions and theory driven arguments.

    55. Control the quality of management and performance of health care in the defined service by means of scientific-based solutions.

    56. Conduct fair and cost effective human resource management by engaging with current research and scholarly literature pertaining to sound human resource management.

    57. Formulate and implement an effective strategic plan for a defined health care service by taking cognisance of internal strengths and weaknesses and external threats and opportunities.

    58. Evaluate the effectiveness of the implemented strategic plan for the defined health care service by critical analysis, synthesis and independent evaluation of quantitative and qualitative data.

    59. Demonstrate coherent and in-depth understanding of principles of business management pertaining to the private health sector.

    OR

    60. Demonstrate coherent and critical understanding of the structure and functions of the public health services.

    Elective 15: Nursing Education:

    61. Create active learning environments in the teaching of nursing and midwifery both in clinical and classroom settings based on comprehensive and systematic understanding of adult development, learning and motivation theories.

    62. Lead curriculum change and/or transformation in the education of nurses and midwives based on critical analysis of educational philosophy, national and global policies and discourses such as managing diversity, RPL, and globalization with regard to their implications for nursing and midwifery education.

    63. Design, implement and assess classroom and clinical learning outcomes based on expected learning outcomes and a comprehensive understanding of principles and strategies of assessment of learning outcomes with specific reference to professional education.

    64. Develop a coherent curriculum for a particular nursing and/or midwifery programme taking into account the principles of the NQF and the stipulations of the ETQA for nursing and midwifery education (SANC) in collaboration with peers.

    65. Demonstrate a comprehensive and critical understanding of theories and approaches of educational management, including quality management systems, with specific reference to managing a nursing education institution (nursing colleges, university and technikon nursing departments).

    Elective 16: Family Nurse Practice:

    66. Work as a specialist practitioner with other team members within the primary care setting providing comprehensive clinical care.

    67. Demonstrate an informed and critical understanding of the principles, theories and emerging issues and debates in family nursing.

    68. Apply specialist knowledge and skills in providing advanced clinical care to individuals of all ages, and families, in a primary care setting.

    Elective 16: Nursing Research:

    69. Demonstrate ability to design and implement methodological research in nursing and health.

    70. Demonstrate ability to select and perform statistical calculation appropriate for descriptive, differential and inferential analyses in nursing and health related research.

    71. Initiate and manage health systems research with a specific focus on national health policy implementation.

    Critical Cross-Field Outcomes:

    This qualification addresses the following critical cross-field outcomes, as detailed in the associated unit standards:
  • Identifying and solving problems in which responses indicate that responsible decisions using critical and creative thinking have been made.
  • Working effectively with others as a member of a team, group, organisation or community.
  • Organising and managing oneself and one's activities responsibly and effectively.
  • Collecting, analysing, organising and critically evaluating information.
  • Communicating effectively using visual, mathematical and/or language skills in the modes of oral/written persuasion.
  • Using science and technology effectively and critically, showing responsibility towards the environment and health of others.
  • Demonstrating and understanding of the world as a set of related systems by recognising that problem-solving contexts do not exist in isolation.

    Learning programmes directed towards this qualification will also contribute to the full personal development of each learner and the social and economic development of the society at large, by making individuals aware of the importance of:
  • Reflecting on and exploring a variety of strategies to learn more effectively.
  • Participating as responsible citizens in the life of local, national and global communities.
  • Being culturally and aesthetically sensitive across a range of social contexts.
  • Exploring education and career opportunities; and developing entrepreneurial opportunities. 
    		•

    ASSOCIATED ASSESSMENT CRITERIA 
    Core:

    Associated Assessment Criteria for Exit Level Outcome 1:

    1.1. Specialised health information needs are identified and addressed through structured and unstructured health education.
    1.2. Formal and in-service education programmes for a specific category of clinical nurse specialists and other team members are designed and presented to ensure best practice in specialized nursing and health services.
    1.3. Programmes for personal and professional growth are designed, implemented and evaluated in collaboration with colleagues and other members of the specialized health care team.
    1.4. Community development programmes and/or projects are provided through advisory and facilitative processes.
    1.5. Consultancy and referral are provided to colleagues through a client, consultee and service-centred process.

    Associated Assessment Criteria for Exit Level Outcome 2:

    2.1. The analysis of research approaches and methods is comprehensive and coherent and including theoretical and or philosophical orientations about knowledge, reality and truth as well as the implications of these theoretical orientations for selection of techniques and strategies based on particular research problem(s) and questions.
    2.2. Analysis and interpretation of research reports (quantitative and quantitative) evidence comprehensive and systematic understanding of data collection techniques, data analysis procedures and principles and the current professional and clinical discourse in a specific area of nursing and midwifery specialization.

    Associated Assessment Criteria for Exit Level Outcome 3:

    3.1. Specialized health care units, programmes and services at district, provincial and national levels are evaluated and managed in an efficient and effective manner.
    3.2. Mentorship to others in the specialized health team is provided by documented short and longer-term relationships and role modelling.
    3.3. Team members are developed and supported to cope with the emotional demand of the specialty.
    3.4. Professional excellence and competence is maintained through continuing education and life long learning.
    3.5. Limitations in ethical, legal and policy guidelines are timeously identified with particular reference to a human rights approach on transforming legislation and civil structures through lobbying and advocacy.
    3.6. Patients, families and communities are empowered to access existing appropriate resources.
    3.7. The specialized disease profile at district, provincial and national levels and in different settings is correctly determined and interpreted in the formulation of specialized nursing needs of these communities and/or regions.
    3.8. Quality assurance activities are conducted to enhance quality in specialized health services.
    3.9. Information systems at an aggregate level are developed and maintained.

    Associated Assessment Criteria for Exit Level Outcome 4:

    4.1. Review of literature on any selected research problem in nursing and/or midwifery is carried out effectively as evidenced by the exhaustiveness of the type of data bases (textual and electronic) accessed as well as their relevance to the topic in question.
    4.2. Written research proposals evidence advanced knowledge of the research process, i.e. appropriateness of research design, selection of subjects, and/or other data sources, design and/or selection of data collection instruments, data collection and analysis procedures, ethical of considerations etc, with the identified research questions and/or objectives.
    4.3. Written research report in the form of a dissertation meets the standards of the nursing education scientific community for research report writing with regard to coherence, analysis and interpretation of results quantitative and qualitative and ethical considerations.

    Elective:

    Note: The number of criteria per exit level outcome varies according to the requirements of the particular outcome. They are not indicators of the size of the outcome, but rather directives for assessors and providers on critical evidence of competence.

    Elective 1: Orthopaedic Nursing:

    Associated Assessment Criteria for Exit Level Outcome 5:

    5.1. Factors, which promote or threaten mobility are identified, addressed and assessed by conducting appropriate screening methods.
    5.2. Musculo-skeletal health promotion, functioning, rehabilitation and illness prevention strategies are developed, implemented and evaluated in collaboration with other members of the orthopaedic health team.

    Associated Assessment Criteria for Exit Level Outcome 6:

    6.1. Orthopaedic nursing practice evidences critical understanding of current discourse in the field.
    6.2. A substantiated point of view regarding emerging issues and debates relevant to orthopaedic nursing.
    6.3. Presentations on issues in the field reflect an understanding of the dynamic and tentative nature of most forms of knowledge.

    Associated Assessment Criteria for Exit Level Outcome 7:

    7.1. Assessments of orthopaedic patients are done using all the following specialist techniques as applicable to the client's orthopaedic health problem, e.g.:
  • Ergonomic assessment.
  • Bone scan.
  • Bone marrow specimen collection.
  • Haematological studies.
  • Biochemical tests.
  • Serological tests.
  • Assist with specialized diagnostic procedures, e.g. ectromyography.

    7.2. Advanced procedures of orthopaedic nursing are effectively implemented as required by the client's condition, e.g.:
  • Application and removal of plaster of Paris.
  • Application of tractions.
  • Application of splints/orthotics.
  • Use of special beds, lifters mattresses.
  • All relevant assistive devices.

    7.3. Patients with specific orthopaedic conditions are competently managed using various competencies as applicable to the specific orthopaedic health problem,
    e.g.:
  • Arthritic conditions.
  • Amputations.
  • Para/quadriplegia.
  • Congenital and developmental.
  • Deformities/abnormalities.
  • Post-traumatic deformities.
  • Exercise and sport related disorders.
  • Neoplasms of the musculoskeletal system.
  • Soft tissue injury.

    7.4. Rehabilitation of people with new or established orthopaedic disability is promoted using evidence-based strategies.
    7.5. Referrals from primary health care practitioners of patients with orthopaedic problems or illnesses are accepted and effectively managed.
    7.6. Needs of orthopaedic patients and their families are championed through advocacy.

    Elective 2: Operating Theatre Nursing:

    Associated Assessment Criteria for Exit Level Outcome 8:

    8.1. Peri-operative factors that threaten health are identified and evaluated through appropriate assessment methods.
    8.2. Risk management strategies are developed, implemented and evaluated by assessing the overall health of peri-operative patients.

    Associated Assessment Criteria for Exit Level Outcome 9:

    9.1. Identify and integrate appropriate theoretical frameworks in clinical practice.
    9.2. A substantiated point of view regarding emerging issues and debates relevant to operating theatre nursing is articulated.
    9.3. The presentations of the learners on issues in the field reflect an understanding of the dynamic and tentative nature of knowledge.

    Associated Assessment Criteria for Exit Level Outcome 10:

    10.1. Assessment of peri-operative patients is done accurately, e.g. pre, intra, post operative assessment.

    10.2. Procedures associated with the role of a scrub nurse are competently implemented e.g.:
  • Preparing the theatre, instruments and equipment as well as medical and surgical sundries.
  • Scrubbing, gowning and gloving.
  • Preparing and setting up for the surgical intervention.
  • Effective co-ordination of the surgical team.
  • Timeous provision of all requirements during surgery through anticipation of needs.
  • Transporting, moving of patients.

    10.3. Procedures associated with assisting the anaesthetist are competently implemented.

    10.4. Cultural sensitivity is demonstrated the patient assessment preparation for surgery and disposal of any tissue:
  • Preparing and assisting with all methods of anaesthesia.
  • Anticipating special needs based on the condition of the patient.

    10.5. Procedures associated with the care of the patient in the recovery room are competently implemented, e.g.:
  • Identifying and managing complications.
  • Managing pain.

    10.6. The needs of clients are championed by advocacy.
    10.7. Quality assurance activities are conducted to enhance the quality of peri-operative services.

    Elective 3: Palliative and Oncology Nursing:

    Associated Assessment Criteria for Exit Level Outcome 11:

    11.1. Factors, which cause malignant conditions, and protective factors are identified and evaluated.
    11.2. Cancer prevention strategies are developed, implemented and evaluated by looking at the overall health of the community, e.g. screening and genetic counselling.
    11.3. Cultural sensitivity is demonstrated in the assessment, process and documentation of oncology care by utilizing and comparing various cultural customs pertaining to chronic illness and dying.

    Associated Assessment Criteria for Exit Level Outcome 12:

    12.1. Appropriate theoretical frameworks are identified and integrated in theoretical and practical work.
    12.2. A substantiated point of view regarding emerging issues and debates relevant to palliative care and oncology nursing is articulated.
    12.3. The presentation on issues in the field reflects an understanding of the dynamic and tentative nature of knowledge.

    Associated Assessment Criteria for Exit Level Outcome 13:

    13.1. Assessments of cancer patients whose care is complicated by bio-psycho-social or other factors are done accurately:
  • Pain assessment.
  • General and specific side effects of treatment.
  • Pre-treatment assessment.
  • Client's response to life threatening illness.

    13.2. Management of cancer treatment is done effectively using the following competencies:
  • Life-threatening complications related to treatment are anticipated and identified.
  • Safe handling and administration of drugs.
  • Safe practice with regard to radiation therapy is maintained.
  • Specialised counselling of clients undergoing treatment, reconstructive surgery and rehabilitation.

    13.3. Quality assurance activities are conducted to enhance quality oncology and palliative care services.
    13.4. Needs of oncology and dying patients and their significant others are championed by advocacy.

    Elective 4: Ophthalmic Nursing:

    Associated Assessment Criteria for Exit Level Outcome 14:

    14.1. Factors, which promote or threaten ophthalmologic health are identified, addressed and addressed and evaluated by conducting appropriate assessment and management methods, e.g. ocular screening.
    14.2. Ophthalmologic health promotion and illness prevention strategies are developed, implemented and evaluated, e.g. eye care information.

    Associated Assessment Criteria for Exit Level Outcome 15:

    15.1. Appropriate theoretical frameworks are identified and integrated in theoretical and practical work.
    15.2. A substantiated point of view regarding emerging issues and debates relevant to ophthalmic nursing is articulated.
    15.3. The presentation on issues in the field reflects an understanding of the dynamic and tentative nature of knowledge.

    Associated Assessment Criteria for Exit Level Outcome 16:

    16.1. Advanced procedures of ophthalmic treatment are competently implemented, e.g.:
  • Emergency eye care.
  • Removing foreign objects.
  • Prescription of corrective devises.
  • Selected surgical procedures.
  • Counselling.
  • Pharmacology.

    16.2. Rehabilitation of visually impaired clients are optimally implemented with in real life settings, e.g.:
  • Activities of daily living.
  • Coping with new environments.
  • Assistive devises.
  • Accessing resources, e.g. special training.

    16.3. Quality assurance activities are conducted to enhance quality ophthalmic health services.
    16.4. Needs of visually impaired clients are championed by advocacy.

    Elective 5: Emergency Nursing:

    Associated Assessment Criteria for Exit Level Outcome 17:

    17.1. Patterns of emergencies prevalent in specific areas are identified and analysed.
    17.2. Preventive strategies are planned, implemented and evaluated.
    17.3. Cultural sensitivity is demonstrated in the assessment, process and documentation of emergency care.

    Associated Assessment Criteria for Exit Level Outcome 18:

    18.1. Appropriate theoretical frameworks are identified and integrated in theoretical and practical work.
    18.2. A substantiated point of view regarding emerging issues and debates relevant to emergency nursing is articulated.
    18.3. The presentation on issues in the field reflects an understanding of the dynamic and tentative nature of knowledge.

    Associated Assessment Criteria for Exit Level Outcome 19:

    19.1. Assessments of emergency situations and casualties/patients are done accurately, e.g.:
  • Accident scene.
  • Disaster scene.
  • Primary and secondary survey.

    19.2. Advanced procedures of emergency care are competently implemented, e.g.:
  • Creating or ensuring a safe environment.
  • Airway management.
  • Breathing and circulation management.
  • Injury management.
  • Stabilization and transport.

    19.3. Complicated emergency cases are effectively managed using various competencies:
  • Assisting with and interpreting blood tests.
  • Deep peritoneal lavage.
  • Immobilization procedures.
  • Preparation and management of aero medical events.
  • Management of specific poisoning.
  • Initiation of pharmacological and technological measures to promote homeostasis.

    19.4. Quality assurance activities are conducted to enhance quality of emergency services.
    19.5. Needs of emergency clients are championed by advocacy.

    Elective 6: Occupational Health Nursing:

    Associated Assessment Criteria for Exit Level Outcome 20:

    20.1. Policies and procedures appropriate for the protection of the health of both employees and the community are analysed, developed and implemented.
    20.2. Risk related and disaster management programmes appropriate for a specific industry and hazard are developed in collaboration with essential interdisciplinary team members e.g. Occupational Hygienists, Toxicologists, Environmentalists, Safety and Ergonomic specialists.
    20.3. Management of occupational health issues demonstrates knowledge of legislation applicable to the occupational health environment.
    20.4. Health promotion programmes are based on a needs assessment and are relevant to and accepted by both the organisation and employees.
    20.5. A realistic health campaign e.g. on safety; AIDS prevention etc. is planned.

    Associated Assessment Criteria for Exit Level Outcome 21:

    21.1. Appropriate theoretical frameworks are identified and integrated in clinical practice.
    21.2. A substantiated point of view regarding emerging issues and debates relevant to occupational health nursing is articulated.
    21.3. The presentations of the learners on issues in the field reflect an understanding of the dynamic and tentative nature of knowledge.

    Associated Assessment Criteria for Exit Level Outcome 22:

    22.1. Advanced specialist assessments relevant to practice including possibly audiometry, lung function testing (as per attached unit standards) and additional electives such as vision testing, ECG, EAP etc.
    22.2. Differentially susceptible groups, and individuals vulnerable to risk are identified and their special need in the occupational setting is recognized e.g. reproductive health risk or genetic vulnerability with identified hazards.
    22.3. Relative risk of hazards is identified and priorities in a specific occupational context and appropriate management policies are recommended e.g. workplace risk assessment.
    22.4. A rehabilitation programme is designed, relevant to the needs of specific clients or groups e.g. COID disability management.

    Associated Assessment Criteria for Exit Level Outcome 23:

    23.1. A business plan is developed to address occupational health service needs.
    23.2. A private practice plan is developed in accordance with ethical and legal guidelines and business registration requirements. (SARS, Labour, Equity and Corporate Governance complaint).

    Elective 7: Nephrology Nursing:

    Associated Assessment Criteria for Exit Level Outcome 24:

    24.1. Factors, which promote or threaten renal health are identified, addressed and evaluated by conducting appropriate assessment methods.
    24.2. Renal health promotion and illness prevention strategies are developed, implemented and evaluated by looking at the overall renal health care of the community.
    24.3. Cultural sensitivity is demonstrated in the assessment of clients, canvassing of donors and counselling of recipients.

    Associated Assessment Criteria for Exit Level Outcome 25:

    25.1. Appropriate theoretical frameworks are identified and integrated in clinical practice.
    25.2. A substantiated point of view regarding emerging issues and debates relevant to nephrology nursing is articulated.
    25.3. The presentation of the learners on issues in the field reflects an understanding of the dynamic and tentative nature of knowledge.

    Associated Assessment Criteria for Exit Level Outcome 26:

    26.1. Detailed assessments of renal function and the effects of renal failure on body systems are done accurately, e.g.:
  • Initiating specific laboratory tests.
  • History of transplantation and dialysis.
  • Disease progression.
  • Nutritional assessment.

    26.2. All types of dialysis for children and adults are initiated timeously and maintained effectively using the following competencies:
  • Specialist counselling about renal replacement, therapy and rehabilitation.
  • Choosing and preparing apparatus.
  • Initiating, maintaining and terminating dialysis.
  • Pharmacotherapy.
  • Managing complications.
  • Water treatment.
  • Sterilizing and maintenance of apparatus and dializers.
  • Long term client management.
  • Home treatment.

    26.3. Paediatric and adult patients preparing for and undergoing kidney transplantations are competently managed using the following competencies:
  • Donor selection.
  • Pre-transplantation preparation.
  • Organ procurement.
  • Caring for immuno-suppressed patients.
  • Identifying and dealing with post kidney transplant complications.
  • Fluid and electrolyte management.
  • Immediate and maintenance pharmacotherapy.
  • Legal and ethical competence.

    26.4. Quality assurance activities are conducted to enhance quality renal care, e.g. infection control.
    26.5. Needs of renal patients are championed by advocacy.

    Elective 8: Paediatric Nursing:

    Associated Assessment Criteria for Exit Level Outcome 27:

    27.1. Assessment of complex developmental and maturation status of children at both physical, socio-emotional, intellectual and spiritual levels are understood and mastered. (including fine and gross motor, hearing, sight and behavioural).
    27.2. Primary assessment of a child to identify less common childhood conditions.
    27.3. Nursing assessment of ill children to identify basic needs is carried out, including: assessment of hydration, nutritional assessment, developmental, pain and anxiety, attachment and safety needs.

    Associated Assessment Criteria for Exit Level Outcome 28:

    28.1. Appropriate theoretical frameworks are identified and integrated in theoretical and practical work.
    28.2. A substantial point of view regarding emerging issues and debates relevant to paediatric nursing is articulated.
    28.3. Presentation of the learners on issues in the field reflects an understanding of the dynamic and tentative nature of knowledge.

    Associated Assessment Criteria for Exit Level Outcome 29:

    29.1. Comprehensive knowledge of anatomy, physiology and pathophysiology related to children; genetics, embryology, congenital and inherited conditions is applied to the care of children.

    29.2. Evidence-based nursing care and appropriate referral of the child with various conditions is planned and implemented, including complex pathological and/or differentially-abled conditions:
  • Conditions of all human body systems.
  • Children who require surgery including informed consent.
  • Acute illness including dehydration, pyrexia, seizure disorders.
  • Chronic illness.
  • Palliative care.
  • Child with special needs and disability.
  • HIV/AIDS in neonates and children.
  • Communicable diseases in children.

    29.3. The quality of child care practice is ensured while providing family-centred care with competence in child-particular care issues including:
  • Injury and disease prevention including immunisations.
  • Nutrition in children-feeding, food supplementation, weaning.
  • Hospitalisation.
  • Preparation for and positioning for invasive procedures.
  • Gaining cooperation from a child.
  • Limit setting and discipline.
  • Transporting infants and children.
  • Parental support, counselling and participation in care.
  • Understanding and applied knowledge of pharmacotherapy related to children, including specific dosages and drug interactions in children.
  • Familiarity with advanced procedures related to life support including CPR, intra-osseous infusion.

    29.4. Quality assurance activities are conducted to enhance quality child and adolescent health services.
    29.5. Needs of sick children and their families are championed by advocacy.

    Elective 9: Critical Care Nursing (Adult):

    Associated Assessment Criteria for Exit Level Outcome 30:

    30.1. Principles of ventilation are maintained in the application of various modes of ventilation.

    30.2. Technologically assisted assessment and support of the various organ systems in critically ill patients (adults and children) is accurately demonstrated, including:
  • Advanced monitoring techniques for all body systems.
  • Evaluation of laboratory tests.
  • Microbiological surveillance.
  • Evaluation of diagnostic tests including ECG and CXR.
  • Evaluation of pain.

    30.3. Advanced skill and knowledge in Advanced Life Support and resuscitation techniques of both adult and child is demonstrated.
    30.4. Principles of renal replacement therapies are applied in the provision of nursing care to individuals with severe and life threatening renal health problems.
    30.5. An understanding of the causes and pathophysiology of shock is demonstrated.

    Associated Assessment Criteria for Exit Level Outcome 31:

    31.1. The risks of the technological environment are effectively managed and prevented to ensure a safe environment (e.g. correct use of equipment, noise management, sensory overload and/or deprivation etc.).
    31.2. Implementation of infection control measures is promoted in order to enhance the safety of the critical care environment.
    31.3. The psychosocial, cultural and emotional needs of the critically ill patient and their family (including patient rights and advocacy) are anticipated identified and managed.
    31.4. Ability to contribute to a cohesive multi-disciplinary critical care team is demonstrated.
    31.5. Knowledge and skills for effective management of death, dying, and complex ethical issues, (e.g. withdrawal of therapy), within a high stress environment are continuously developed.
    31.6. Understanding of the importance of effective coaching, support and mentorship of the critical care team is demonstrated.

    Associated Assessment Criteria for Exit Level Outcome 32:

    32.1. Theoretical frameworks that underpin critical care nursing practice are integrated into clinical practice.
    32.2. Articulated points of view regarding emerging national and global issues and policies demonstrate in-depth and critical understanding of relevant discourses in critical care nurses.
    32.3. Contributions on complex and controversial debates on critical care nursing issues reflect an appreciation of the dynamic and tentative nature of most human knowledge.

    Associated Assessment Criteria for Exit Level Outcome 33:

    33.1. Understanding of advanced knowledge of anatomy and physiology of the adult, including metabolic and biochemical processes of all body systems is displayed.
    33.2. Assessment of the critically ill and high risk patient is conducted in an integrated manner and includes measures of physical, psychosocial emotional and spiritual needs.

    33.3. Specialist nurse competences are utilized effectively and correctly in the assessment of the functioning of specific body systems in critically ill patients:
  • Cardiovascular System, including haemodynamic and cardiac monitoring.
  • Respiratory System, including arterial blood gas analysis.
  • Neurological System, including invasive intracranial pressure monitoring.
  • Renal System, including acid-base balance.
  • Metabolic/Endocrine System, including glycaemic control, sleep/rest cycles.
  • Gastro-intestinal System, including nutritional assessment and elimination.
  • Integumentary System, including the assessment of wounds.
  • Haematological system, including coagulation studies.
  • Evaluation of immune system.
  • Assessment of pain and anxiety.

    33.4. Laboratory results and special investigations and procedures are interpreted with the clinical interface.

    Associated Assessment Criteria for Exit Level Outcome 34:

    34.1. Advanced knowledge of the pathophysiological basis for compromise of the various organ systems is applied to the care of critically ill adult.

    34.2. An advanced knowledge of the care of the critically ill adult using evidence-based interventions is demonstrated in respect of the following:
  • Airway management and respiratory support.
  • Cardiac support, including pacemakers and IABP.
  • Haemodynamic support.
  • Fluid therapy.
  • Electrolyte imbalance.
  • Acid base imbalance.
  • Nutritional support.
  • Endocrine and metabolic derangements.
  • Pain management and sedation.
  • Thermoregulation.
  • Sepsis surveillance.
  • Basic hygiene and comfort needs.

    34.3. Competence in nursing management of patients who require critical care, (including promotive, preventative and rehabilitative measures) of the following:
  • Compromised CVS function e.g. acute coronary syndrome, valvular disease, cardio-thoracic surgery, and vascular surgery.
  • Compromised respiratory function e.g. acute respiratory failure, ventilator dependency, obstructive and restrictive disorders, and adult respiratory distress syndrome.
  • Compromised neurological function e.g. head and spinal cord injuries, cerebro vascular accidents, neuromuscular disorders.
  • Compromised renal function e.g. acute renal failure.
  • Compromised endocrine function e.g. diabetic keto-acidosis.
  • Compromised gastro-intestinal and hepatic function e.g. abdominal trauma, acute pancreatitis, severe GIT haemorrhage, and liver failure.
  • Compromised haematological function e.g. disseminated intra-vascular coagulopathy.
  • Obstetric related illness e.g. HELLP syndrome.
  • Compromised Immune system e.g. immunosuppressive therapy, infectious diseases, and HIV/AIDS related illnesses.
  • Multisystem Disorders e.g.:
    > Multiple organ dysfunction syndrome.
    > Severe sepsis and related syndromes, including.
    > Systemic Inflammatory Response Syndrome.
    > Polytrauma.
    > Physiological shock-all types.
    > Acute Intoxications, including:
    > Accidental poisoning.
    > Recreational drug abuse.
    > Intentional drug overdose.
  • Burns.

    34.4. A comprehensive knowledge of the pharmacotherapy (including pharmacodynamics and pharmacokinetics) of the various drugs used in the management of the critically ill adult is exhibited.

    Elective 10: Critical Care Nursing (Child and Adolescent):

    Associated Assessment Criteria for Exit Level Outcome 35:

    35.1. Principles of ventilation are maintained in the application of various modes of ventilation.

    35.2. Technologically assisted assessment and support of the various organ systems in critically ill patients (adults and children) is accurately demonstrated, including:
  • Advanced monitoring techniques for all body systems.
  • Evaluation of laboratory tests.
  • Microbiological surveillance.
  • Evaluation of diagnostic tests including ECG and CXR.
  • Evaluation of pain.

    35.3. Advanced skill and knowledge in Advanced Life Support and resuscitation techniques of both adult and child is demonstrated.
    35.4. Principles of renal replacement therapies are applied in the provision of nursing care to individuals with severe and life threatening renal health problems.
    35.5. An understanding of the causes and pathophysiology of shock is demonstrated.

    Associated Assessment Criteria for Exit Level Outcome 36:

    36.1. The risks of the technological environment are effectively managed and prevented to ensure a safe environment (e.g. correct use of equipment, noise management, sensory overload and/or deprivation etc).
    36.2. Implementation of infection control measures is promoted in order to enhance the safety of the critical care environment.
    36.3. The psychosocial, cultural and emotional needs of the critically ill patient and their family (including patient rights and advocacy) are anticipated identified and managed.
    36.4. Knowledge and skills for effective management of death, dying, and complex ethical issues, (e.g. withdrawal of therapy), within a high stress environment are continuously developed.

    Associated Assessment Criteria for Exit Level Outcome 37:

    37.1. Theoretical frameworks that underpin critical care nursing practice are integrated into clinical practice.
    37.2. Articulated points of view regarding emerging national and global issues and policies demonstrate in-depth and critical understanding of relevant discourses in critical care nurses.
    37.3. Contributions on complex and controversial debates on critical care nursing issues reflect an appreciation of the dynamic and tentative nature of most human knowledge.

    Associated Assessment Criteria for Exit Level Outcome 38:

    38.1. Competence in the assessment of the physiologic, emotional, psycho-social and spiritual needs of children with complex acute and chronic health conditions is demonstrated and includes:
  • Vital indicators.
  • Respiratory effort, including monitoring of pulse oximetry and arterial blood gases.
  • Invasive and non invasive haemodynamic monitoring.
  • Monitoring cardiac sufficiency and electrocardiography.
  • Fluid and electrolyte monitoring.
  • Age-appropriate neurological assessment, intracranial pressure monitoring and seizure activity.
  • Hyper/hypoglycaemia.
  • Assessment of pain and anxiety.
  • Assessment of immune function.
  • Thermodynamics.
  • Comfort and sleep needs.
  • Interpretation of laboratory results & clinical interface.

    38.2. Comprehensive understanding of developmental challenges and responses of various age groups to life threatening or critical illness and ICU admission, including the responses of the parents and family is demonstrated.

    Associated Assessment Criteria for Exit Level Outcome 39:

    39.1. Knowledge of advanced anatomy and physiology of the newborn infant, including peri-natal challenges and the range of congenital and inherited (e.g. metabolic) conditions that result in medical emergency or high level care interventions is applied is the care of critically ill infants.
    39.2. Understanding of the challenges of physiological and psychological maturation and development as these present in the current South African situation, including AIDS related illnesses, malnutrition and trauma is demonstrated.
    39.3. Knowledge of advanced pathophysiology and insults of surgery, trauma and severe illness, especially as these present in children's immature systems e.g. differing cardiac conditions such as congenital, infective (myocarditis), toxins (organophosphate poisoning) and rheumatic heart conditions is applied in the care of critically ill children.

    Associated Assessment Criteria for Exit Level Outcome 40:

    40.1. Competence in the monitoring and management of the care of critically ill and/or high-risk children and adolescents is evidenced through performance of the following:
  • Oxygenation, artificial airway and ventilation.
  • Renal support in the regulation of fluid, acid-base and electrolyte balance.
  • Pain and anxiety management.
  • Metabolic and Nutritional support.
  • Cardiac and circulatory support.
  • Advanced life support.
  • Thermoregulation.
  • Comfort and prevention of injury.
  • Sleep and rest needs.
  • Parental and family stress responses and needs.

    40.2. Competence in diagnostic reasoning, clinical decision-making and advanced therapeutic interventions for children and adolescents with:
  • Complex and extended surgery including reconstructive surgery related to congenital conditions, cardiac surgery, neurosurgery, transplantation.
  • Multi systems trauma e.g. burns, near drowning, child abuse and neglect.
  • Acute respiratory distress and failure e.g. caused by infective, obstructive, congenital and inherited conditions.
  • Cardiac insufficiency e.g. caused by congenital, infective, toxic and rheumatic conditions, pulmonary hypertension.
  • Severe infections and care in immune compromised conditions e.g. AIDS.
  • Gastrointestinal malabsorption and congenital anomalies e.g. acute gastroenteritis, severe dehydration and necrotising enterocolitis.
  • Renal and hepatic insufficiency, e.g. congenital and infective causes, peri-operative and post transplant care.
  • Neurological conditions e.g. head injuries, congenital, infective conditions and seizure disorders.
  • Perinatal adaptation challenges for the Neonate who requires surgery or PICU admission.
  • Psychiatric emergencies, including suicide attempts, delirium, and acute confusion states especially in adolescents is demonstrated.

    40.3. The quality of child care practice while providing family-centred care is ensured with specific reference to child-particular care issues including:
  • Injury prevention.
  • Gaining compliance from the child.
  • Preparation for and positioning for procedures.
  • Limit setting and discipline.
  • Transporting infants and children.
  • Participative decision making and informed consent.
  • Parental participation in care and decision making.
  • Post Trauma responses.
  • Managing emotional and attachment disturbance in children.

    40.4. Understanding of an advanced knowledge of pharmacotherapy and safe administration of drugs in children, including side effects, problems of dilution of drugs (especially volume of fluid administration), the different pharmacodynamics of drugs in different age groups (drug dose per kg may be different depending on age group) is displayed.

    Elective 11: Psychiatric Nursing:

    Associated Assessment Criteria for Exit Level Outcome 41:

    41.1. Factors, which promote or threaten mental health are identified, addressed and evaluated by conducting appropriate methods.
    41.2. Mental health promotion and illness prevention strategies are developed, implemented and evaluated e.g. stigma prevention.
    41.3. The psycho-social well being of the community is facilitated, promoted and maintained through community upliftment programmes.
    41.4. Cultural sensitivity is demonstrated in the assessment, process and documentation of psychiatric nursing and mental health care by utilizing, understanding and comparing the various cultural customs pertaining to the practice of psychiatric nursing and mental health care.

    Associated Assessment Criteria for Exit Level Outcome 42:

    42.1. Appropriate theoretical frameworks are identified and integrated in theoretical and practical work.
    42.2. A substantiated point of view regarding emerging issues and debates relevant to psychiatric nursing is articulated.
    42.3. The presentation of the learners on issues in the field reflects an understanding of the dynamic and tentative nature of knowledge.

    Associated Assessment Criteria for Exit Level Outcome 43:

    43.1. Specialised mental health assessment instruments and techniques are utilized during assessment of patient with mental health or psychiatric illnesses.

    43.2. Complicated cases are referred or competently managed using various competencies, e.g.:
  • Develop, test and implement evidence-based high risk protocols.
  • Personality disorders.
  • Dual diagnosis.
  • Uncommon conditions.

    43.3. Specialist psychiatric nursing therapy is carried out by using a specific therapeutic method e.g. individual therapy, play therapy (if specializing in child psychiatric nursing), group therapy, family/marital therapy.
    43.4. Referrals from primary health care practitioners of patients with mental health problems or illnesses are accepted and effectively managed.
    43.5. Quality assurance activities are conducted to enhance quality mental health practice and psychiatric nursing.
    43.6. Needs of mental health clients and their significant others are championed by advocacy.

    Associated Assessment Criteria for Exit Level Outcome 44:

    44.1. Complex health education needs are identified and addressed structured and unstructured mental health education.
    44.2. Formal and in-service education programmes for psychiatric nurses and other team members are designed and presented to ensure best practice in mental health services.
    44.3. Programmes for personal and professional growth of psychiatric nurses are presented on a continuous basis.
    44.4. Evaluation of learners is done in a valid and reliable manner to ensure competent mental health practitioners.

    Elective 12: Midwifery and Neonatal Nursing:

    Associated Assessment Criteria for Exit Level Outcome 45:

    45.1. Factors, which promote or threaten maternal and neonatal health are identified and evaluated by conducting appropriate assessment methods.
    45.2. Maternal and neonatal health promotion and illness prevention strategies are developed, implemented and evaluated by looking at the overall reproductive health of the community.
    45.3. Cultural sensitivity is demonstrated in the assessment, process and documentation of maternal and neonatal health care by utilization and comparing the various cultural customs pertaining to the practice of midwifery nursing and maternal health care.

    Associated Assessment Criteria for Exit Level Outcome 46:

    46.1. Appropriate theoretical frameworks are identified and integrated in theoretical and practical work.
    46.2. A substantiated point of view regarding emerging issues and debates relevant to midwifery nursing is articulated.
    46.3. The presentation of the learners on issues in the field reflects an understanding of the dynamic and tentative nature of knowledge.

    Associated Assessment Criteria for Exit Level Outcome 47:

    47.1. Assessments of mothers and neonates complicated by psycho- social, physical, service related or other factors are done accurately.

    47.2. Advanced procedures of reproductive health are competently implemented:
  • STD Management.
  • Family planning.
  • Prescribe or administer specific medication.
  • Internal foetal monitoring.

    47.3. Complicated cases at ante-, intra and postnatal stage are referred or competently managed using the following competencies:
  • Development, testing and implementation of evidence-based high risk protocols.
  • Assisted delivery.
  • Resuscitation of the neonate.
  • Assist with operating theatre procedures.

    47.4. Referrals from primary health care practitioners of patients with midwifery problems or illnesses are accepted and effectively managed.
    47.5. Quality assurance activities are conducted to enhance reproductive services.
    47.6. Needs of mothers and neonates with high risk pregnancy and/or deliveries are championed by advocacy.

    Elective 13: Community Health Nursing:

    Associated Assessment Criteria for Exit Level Outcome 48:

    48.1. Factors, which promote or threaten public health are identified and evaluated by means of:
  • Epidemiological surveys.
  • Population based studies.
  • Participatory research.

    48.2. Public prevention strategies are developed, implemented and monitored against at specific indicators and factors.
    48.3. Cultural sensitivity is demonstrated during interaction with team members and communities.

    Associated Assessment Criteria for Exit Level Outcome 49:

    49.1. Appropriate theoretical frameworks are identified and integrated in theoretical and practical work.
    49.2. A substantiated point of view regarding emerging issues and debates relevant to public health nursing is articulated.
    49.3. The presentation by the learners on issues in the field reflects an understanding of the dynamic and tentative nature of knowledge.

    Associated Assessment Criteria for Exit Level Outcome 50:

    50.1. Complex public health issues are referred or effectively managed, within the a team approach, the following competencies:
  • The development, testing and implementation of evidence based protocol.
  • Environmentally focused strategies.
  • Health behaviour strategies.
  • Project/programme planning, implementation and evaluation, according to specific population group needs.
  • Human resource analyses and plans.
  • Supportive environments are promoted through targeted strategies addressing specific needs.

    50.2. Quality assurance activities are conducted to enhance quality public health service.
    50.3. Public health needs are made visible by advocacy.
    50.4. Epidemiological principles are applied in developing strategies to meet those needs.

    Associated Assessment Criteria for Exit Level Outcome 51:

    51.1. Principles and theories of causal analysis, conditional, individual and collective relationships, genetic and environmental factors, and their inter-relationships are identified and analysed in order to establish a population-based diagnosis of health status and disease burden.
    51.2. Epidemiological principles and methods of the natural history (course and outcome) of identified problems are applied, in order to support preventative and clinical strategies and influence behaviour and lifestyle changes in population wellness promotion.
    51.3. Appropriate and implementable control strategies for the management and prioritization of identified chronic, communicable and social pathologies are developed e.g. HIV/Aids, TB, Carcinoma, Heart Disease, Violence and others.

    Elective 14: Nursing and Health Services Nursing Management:

    Associated Assessment Criteria for Exit Level Outcome 52:

    52.1. Management of a health care system reflects the application of the management process.
    52.2. Evidence based practice will indicate that work related behaviour is grounded in the management processes.

    Associated Assessment Criteria for Exit Level Outcome 53:

    53.1. Management and leadership theories/models are critically analysed and compared.
    53.2. The choice of appropriate management and leadership theories relevant to a particular context are identified, implemented and combined with an understanding of the clinical realities.
    53.3. Analysis and interpretation of management research reports (quantitative and qualitative) evidences comprehensive and systematic understanding of data collection techniques, data analysis procedures and principles and the current scholarly discourse in management.

    Associated Assessment Criteria for Exit Level Outcome 54:

    54.1. The principles of organizing are applied to ensure the achievement of objectives in the defined health care service.
    54.2. Essential resources to implement managerial plans or programmes are mobilised within and outside the health care system through effective networking and grantmanship.
    54.3. Critical thinking, problem solving and decision-making skills are applied to optimize the organisation and functioning of the defined health care service.

    Associated Assessment Criteria for Exit Level Outcome 55:

    55.1. The quality control criteria for management and performance applicable to the service are selected and applied to improve the quality of the management and service delivery of the defined service.
    55.2. Professional excellence and competence is maintained through continuing education and life long learning.

    Associated Assessment Criteria for Exit Level Outcome 56:

    56.1. Planning for, and the provision of human resources are executed within the relevant legislation and policy guidelines.
    56.2. Maintenance of human resources is undertaken by taking cognizance of personal and professional needs.
    56.3. Effective utilisation of human resources is ensured by means of correct placement and appropriate skill application.
    56.4. Assessment and development of human resources is undertaken on continuous bases.

    Associated Assessment Criteria for Exit Level Outcome 57:

    57.1. On the basis of an assessment, the vision, mission, GAP analysis, objectives and action plans are developed.
    57.2. Develop and implement a strategic plan to ensure organisational goal achievement.
    57.3. An organisational structure for the defined service is designed and the implementation explained.
    57.4. Applicable policies and procedures are formulated to address the implementation of the action plan.
    57.5. The human resource plan includes task analysis, job descriptions, personal and professional development as well as a skills' development plan.
    57.6. A customer care plan incorporates all the relevant stake holders.
    57.7. Information and quality management programmes are developed and explained to stakeholders and implemented.
    57.8. An industrial relations policy and plan is developed and implemented for the health care service.
    57.9. A financial plan is developed which includes capital, operational and human resource budgets facilitating cost effective, quality patient care.

    Associated Assessment Criteria for Exit Level Outcome 58:

    58.1. A performance appraisal system is developed and implemented.
    58.2. Productivity is determined through appropriate measures and handled effectively.
    58.3. Customer and stakeholder satisfaction is determined through appropriate measures and rectified where necessary.
    58.4. Trends identified by means of the information system truly reflects the performance within the defined service.
    58.5. A meta-assessment of the evaluation process is performed.

    Associated Assessment Criteria for Exit Level Outcome 59:

    59.1. Knowledge and understanding of a health care organisation as a business and the implementation of general management principles are demonstrated.
    59.2. The functional management of marketing and public relations within a health care service context is applied.
    59.3. The financial function of a health care unit as a business, in terms of asset management, financial decisions, operations management, purchasing functions and activities, and the provision of human resources, are applied.
    59.4. Contemporary health care management issues such as absenteeism and high turnover rates, extreme staff shortages, private practice, diverse health environments and commissioning of a health service are critically analysed.

    OR

    Associated Assessment Criteria for Exit Level Outcome 60:

    60.1. An understanding of the nature, content, and scope of public administration is demonstrated.
    60.2. The typical clients of public health, welfare and housing services in South Africa and the available resources are described.
    60.3. The provision and organisation of public services are critically analysed.
    60.4. The interrelationship between management of public service provision, power and public functions are argued.

    Elective 15: Nursing Education:

    Associated Assessment Criteria for Exit Level Outcome 61:

    61.1. Critical analysis of adult development, learning (cognitive, behavioural, social, transformative and experiential) and motivation theories shows comprehensive understanding of a range of aspects including, conceptualisations of knowledge, teaching, learning, basic assumptions, and andragogical implications for nursing and midwifery education and is valid in accordance to current discourses about teaching/learning in professional education.
    61.2. Teaching practice in nursing and midwifery is based on understanding of adult development, learning and motivation theories as evidenced by the creation and maintenance of an active learning environment and thus allowing learners space to question their meaning perspectives about health and illness.

    Associated Assessment Criteria for Exit Level Outcome 62:

    62.1. Critical analysis and synthesis of the philosophical basis of nursing is based on recognized contemporary nursing theories, models and relevant to current socio-political context of nursing practice.
    62.2. Analysis of nursing and midwifery decisions is supported by a particular model or theory of nursing and takes into consideration the legal and ethical frameworks of nursing practice as well as the socio-political, economic and cultural context in which such decision have to be made.
    62.3. Critical analysis of educational philosophy with regard to its implications for nursing and midwifery education is in accordance with rules of consensual validation.
    62.4. Inferences on the implications of educational theory on teaching nursing and midwifery are based on comprehensive analysis of the current discourses on the nature and purpose of professional education.
    62.5. Critical analysis, synthesis and independent evaluation of global policies and issues impacting on nursing and midwifery education is supported by an extensive and integrated review of literature and current research on such issues (e.g. managing diversity in the learning environment, globalization and the nursing workforce, global health, RPL etc).

    Associated Assessment Criteria for Exit Level Outcome 63:

    63.1. A coherent and critical understanding of the importance of congruency between expected learning outcomes and the teaching/learning process supports evaluation of various teaching strategies with regard to their effectiveness in facilitating deep and self-directed learning in clinical and classroom setting.
    63.2. Teaching plans and implementation thereof, place emphasis on collaborative learning, learner needs and differences, development of self-directed learning, inquiring minds, as well as the complexity and unpredictability of clinical learning environments.
    63.3. Identification, selection and combinations of assessment approaches and strategies is based on a coherent and logical understanding of the requirements of applied competence and integrated assessment and meets the criteria for credible, trustworthy, feasible, and valid assessment.
    63.4. Assessment of clinical learning in particular is largely undertaken in a real-world practice environment where appropriate, and/or simulated clinical learning environments.
    63.5. Generic Assessment Criteria as per Unit Standard No. ASSMT 01 of NSB Education, Training and Development.
    63.6. Teaching scholarship is evident in the identified areas of research as well as application of best-practice evidence in nursing and midwifery education.

    Associated Assessment Criteria for Exit Level Outcome 64:

    64.1. Critical analysis of curriculum development theory and models includes philosophical underpinnings, and implications thereof for the curriculum development process in nursing and midwifery education.
    64.2. The designed curriculum is comprehensive and includes all the steps of curriculum development as verifiable with any standard curriculum development text in nursing and midwifery education and is a collaborative piece of work involving peers.
    64.3. The designed curriculum is appropriate in terms of SANC guidelines and regulations for a particular programme of nursing and/or midwifery, SAQA requirements and current national health policies on human resource development for health.

    Associated Assessment Criteria for Exit Level Outcome 65:

    65.1. Approaches and theories of educational management are interrogated and critically analysed in terms of their applicability and relevance to managing nursing education institutions within the context of the current situation in nursing education in South Africa with regard to governance, programmes, financing and provision.
    65.2. Analysis of the current situation in nursing and midwifery education evidences a comprehensive and reflective understanding of the implications of the dual systems of governance and provision of nursing education for coherent programming and financing of nursing education.
    65.3. Evaluation of a nursing education institution's quality management systems shows a broad understanding of principles and aims of institutional quality management systems in HE in South Africa and globally with specific reference to the requirements of the relevant ETQAs (HEQC and SANC) for quality improvement and assurance.

    Elective 16: Family Nurse Practice:

    Associated Assessment Criteria for Exit Level Outcome 66:

    66.1. Individual, family and community factors that influence and threaten the health of the patient are identified and evaluated through appropriate methodology.
    66.2. Risk management strategies are developed, implemented and evaluated by assessing the overall health of individuals and families.
    66.3. Facilitation and coordination of clinical care provide leadership.

    Associated Assessment Criteria for Exit Level Outcome 67:

    67.1. Appropriate theoretical frameworks are identified and integrated in clinical practice.
    67.2. A substantial point of view regarding emerging issues and debates relevant to family nursing is articulated.
    67.3. The presentations of the learners on issues in the field reflect an understanding of the dynamic and tentative nature of specialist knowledge.
  • Range: Evaluate research findings; analyse useful new knowledge; integrate research findings into practice; interpret research, pharmacology, pathophysiology of illnesses affecting all systems of the body; evidence based practice.

    Associated Assessment Criteria for Exit Level Outcome 68:

    68.1. Advanced health assessment of patients is carried out accurately (history taking, assessment, differential diagnosis).
  • Range:
    > Individual assessment; physical; cardio-vascular; respiratory; ear, nose & throat; ophthalmic; gastro intestinal; renal; reproductive; endocrine; muscular-skeletal; abdominal; dermatological; neurological and mental health assessment.
    > Health assessment is conducted on a sound understanding of pathophysiology, determinants of health (social, cultural, political, economic, psycho-social, family and community dynamics), epidemiology and biostatistics.

    68.2. Procedures associated with the role of a family practitioner are competently implemented. These include but are not limited to:
  • Physical assessment/examination of all systems.
  • Conduct/order and interpret investigations relevant for primary health care settings.
    > Range: biochemical; haematological; microbiological; pharmacological.
  • Order, read and interpret x-rays and sonars.
  • Perform and interpret ECG.
  • Carry out emergency procedures relevant for a primary care setting.
    > Range: Life support; management of ingestion of poisons and exposure to hazardous chemicals and body fluids; prophylaxis.

    68.3. Final clinical diagnosis, for health problems managed in a primary health care setting, is accurate and according to standards.

    68.4. A range of specialised care, treatment and services are provided according to established nursing standards.
  • Case management.
  • Health & risk surveillance.
  • Teaching, counselling & advocacy.
  • Communication, networking, referral and follow-up.
  • Treatment adherence.
  • Prescription of non-pharmacological and pharmacological treatment based on advanced pharmaco-therapeutic knowledge in accordance with professional prescripts.

    68.5. Continuity of care in a primary care setting is maintained by means of consultation, conferring, referring, acceptance of referrals and collaboration with relevant members of the health care team.
    68.6. The special health needs of individuals, families and communities are championed through advocacy by the family practitioner.
    68.7. Quality assurance activities are conducted regularly to ensure the quality of primary care services.

    Elective 16: Nursing Research:

    Associated Assessment Criteria for Exit Level Outcome 69:

    69.1. Methodological research is planned and conducted based on the correct principles and procedures of instrument and protocol design in both qualitative and quantitative research approaches.

    69.2. A validated measuring tool for research in nursing or nursing related field is developed and is suitable for research purposes.

    Associated Assessment Criteria for Exit Level Outcome 70:

    70.1. Understanding of the differences between parametric and non-parametric statistical procedures is correctly demonstrated.
    70.2. Evidence of appropriate statistics for descriptive, differential and inferential analyses in given research problems is presented.
    70.3. Calculations are conducted with computer-aided software for descriptive, differential and/or inferential analyses of data in nursing and health related studies.
    70.4. Interpretations of results of comparative, correlational and multivariate analyses are accurate.

    Associated Assessment Criteria for Exit Level Outcome 71:

    71.1. Methodological design and implementation of health systems research meets the criteria for quality research.
    71.2. Research reports engage national health policy or produces potential health related policy.

    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. 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 as agreed to by the relevant ETQA or ETQA that has a Memorandum of Understanding in place with the relevant ETQA. All summative practical assessments must be conducted in actual clinical practice or care settings.

    Assessment should take place within the context of:
  • Given Quality Assurance policies, procedures and processes.
  • A guided and supported learning environment.

    There will be some areas of specialisation where people will need a license to practice. These will be specified in regulations issued by the relevant ETQA. 
    		•

    INTERNATIONAL COMPARABILITY 
    Internationally, a person qualified for advanced practice nursing is defined as a person who has a master's degree.

    Attempts to benchmark South African nursing practice have seen a review of international best practice, as well as best practice on the African continent. 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.

    South Africa is an active and longstanding 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 proposed qualification would meet recognition requirements in most of the member countries of these organisations and throughout Sub-Saharan Africa.

    Comparison of qualifications:

    The UK, USA, Australia, Sweden, Netherlands, Czech Republic, and Belgium have master's programmes with approaches comparable to that in South Africa, a fact borne out by exchange programmes in operation between South Africa and these countries.

    Amongst African countries, Botswana and Lesotho have master's programmes, while advanced specialist nurses in Tanzania and Kenya are being trained by Botswana and South African universities in a collaborative study. In addition, UNISA had a collaborative study with African countries in leadership training for nurses.

    Where there are differences, it is that many of the international approaches tend to be more academic; a "theory of ..." approach. Typically these programmes are model based with a small component of research. The South African qualification provides for sound clinical grounding with a strong research component.

    This appears to be consistent with The World Health Organisation's position (1987) 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).

    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 team work.
  • 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.

    The proposed Master's Degree: Nursing NQF Level 8 provides for the specialisation required to provide leadership and direct quality improvement in all of these areas.

    Review of the Scope of Practice in South Africa:

    The Review of the Scope of Practice of Nursing and the profession of nursing began in 1999 when the South African Nursing Council prioritised the need to revise the scope of practice. The factors that influenced the review of the scope of practice was a changing health care system identified in the White Paper for the Transformation of Health and the changes in education system brought about by the National Qualifications Framework and the South African Qualifications Act.

    The purpose of the review is to align the practice of nursing to the changes in the national health policy and the legislative framework. Purpose includes:
  • Ensure that nursing practice is in keeping with and is responsive to a changing health care delivery system.
  • Develop a scope for nursing practice that is informed by the core competencies required for nursing practice.
  • Review the scope applicable to different categories of nurse to ensure that each category of nurse is enabled to practice independently within their scope.
  • The new scope of practice and the competencies required for nursing practice will then inform the education and training of nurses required for such practice. This will assist in facilitating the development of a framework for a single unitary education pathway for nursing qualifications that is in line with the principles of the National Qualifications Framework.

    Areas included in the scope for specialist nurses:
  • Orthopaedic Nursing.
  • Operating Room Nursing.
  • Palliative and Oncology Nursing.
  • Ophthalmic Nursing.
  • Emergency Care Nursing.
  • Occupational Health Nursing.
  • Nephrology Nursing.
  • Paediatric Nursing.
  • Critical Care Nursing (Adult).
  • Critical Care (Child and Adolescent).
  • Psychiatric Nursing.
  • Midwifery and Neo-natal Nursing.
  • Community Health Nursing.
  • Nursing and Health Services Management.
  • Nursing Education.
  • Nursing Research.

    Challenges facing Nursing Education:

    The changes in both the health care system and the education system has created numerous challenges for nursing education and training and some of these challenges are:
  • Promoting and maintaining a caring ethos within the nursing profession.
  • Ensuring National Health Priorities are addressed in all nursing education programmes.
  • Creation of a cadre of nurses who are lifelong learners and critical thinkers.
  • Promote the ability in every nurse to evaluate and assure quality in this/her practice.
  • Access to Nursing Education by learners is limited due to the slow implementation of the National Qualifications Framework in the Health Sector.
  • Selection and recruitment criteria in many instances remain restrictive limiting access to nursing qualifications.
  • The distinct nursing qualifications for each category of nurse is not in keeping with the NQF principles and thereby limiting access to higher education training opportunities for existing enrolled & auxiliary nurses.
  • Recognition of Prior Learning (RPL) as a selection criterion is not widely applied because RPL assessment is complex, costly and there is a general lack of knowledge on how to give recognition to prior learning.

    Challenges facing the profession:

    South Africa requires nurses that are comprehensively trained to provide nursing care in various contexts (Primary health care, institutional/hospitals, midwifery and mental health settings) and in both rural and urban setting. To ensure that these professionals are adequately supported, and that the quality of nursing care delivery is continuously monitored and improved, increasing numbers of specialist nurses are required in clinical practice.

    Conclusion:

    An examination of the Scope of Practice, as well as those in operation in ICN signatory countries, clearly indicates the alignment of this proposed qualification with international practice. 
    		•

    ARTICULATION OPTIONS 
    The Masters Degree: Nursing at Level 8 articulates vertically with the PhD in Nursing at NQF Level 8+ and/or any other PhD in the health and social sciences as determined by the provider. Horizontal articulation would include any other Masters Degree.

    The following shows the location of this qualification in terms of other possible qualifications within the field:

    Represented in categories:
  • Level 1: GETC: Ancillary Health.
  • Level 2: National Certificate: Fundamental Ancillary Health.
  • Level 3: National Certificate: Auxiliary Nursing; National Certificate: Community Health Work; National Certificate: Health Sciences and Social Services.
  • Level 4: Further Education and Training Certificate: Nursing; Further Education and Training Certificate: Community Health Work; National Certificate: Health Sciences and Social Services.
  • Level 5: Diploma: Nursing: Mental Health; Diploma: Nursing: Community Health; National Certificate: Community Health Facilitator Training.
  • Level 6: National Diploma: Nursing (leads to PD); Various: health/allied heath sciences; Various: research/teaching/education/management.
  • Level 7: PD: Nursing (PD prepares learners for Masters); Social sciences (social work; health/social services; C&YCW; Probation.
  • Level 8: Masters: Nursing; other related social sciences and health qualifications.
  • Level 8+: PhD: Nursing; any other PhD in the health and social sciences.

    Learners might move horizontally into a number of related areas in health and allied health sciences as these qualifications are developed, as well as research, education and nursing management, by achieving the credits specified in each qualification, mainly related to specialisation areas particular to each sub-field.

    Learners can move vertically by using this qualification as the basis for any of the qualifications indicated above NQF Level 8. 
    		•

    MODERATION OPTIONS 
  • This qualification can only be offered by a higher education and training provider as determined by the Higher Education Act.
  • The provider must have the required clinical facilities to meet the clinical requirements of the qualification as approved by the SANC.
  • The SANC guidelines are used as a reference for clinical competence and tertiary institutions offering this qualification must comply with these directives.
  • Moderation of assessment will be overseen by the relevant ETQA according to moderation principles and the agreed ETQA procedures.

    Internal and external moderation must be conducted by moderators appointed by the provider and accredited through the relevant ETQA. Both internal and external moderators must be in possession of an appropriate qualification at a NQF Level above this qualification (they must be registered as an educator or administrator or clinical specialist), as well as relevant clinical expertise and current experience. In addition external moderation will be conducted by the relevant ETQA for nursing and midwifery. Moderators must be trained and registered as Moderators. Competence in Design of Assessments is a further requirement. 
    		•

    CRITERIA FOR THE REGISTRATION OF ASSESSORS 
  • Assessors must be registered in terms of the requirements the relevant ETQA.
  • Both internal and external assessors must have relevant clinical practice expertise and must be appointed by the provider.
  • Both internal and external assessors must be in possession of a relevant postgraduate qualification at NQF Level 8 and/or above. 
    		•

    NOTES 
    This qualification has been replaced by qualification 83086, which is "Master of Nursing", Level 8 and above, 180 credits. 

    LEARNING PROGRAMMES RECORDED AGAINST THIS QUALIFICATION: 
    When qualifications are replaced, some of their learning programmes are moved to being recorded against the replacement qualifications. If a learning programme appears to be missing from here, please check the replacement.
     
    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.
     
    NONE 


    All qualifications and part qualifications registered on the National Qualifications Framework are public property. Thus the only payment that can be made for them is for service and reproduction. It is illegal to sell this material for profit. If the material is reproduced or quoted, the South African Qualifications Authority (SAQA) should be acknowledged as the source.