SAQA

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SOUTH AFRICAN QUALIFICATIONS AUTHORITY

REGISTERED UNIT STANDARD THAT HAS PASSED THE END DATE:

Maintain physical and psychological comfort in acute and/or chronically ill patients, and significant others

SAQA US ID	UNIT STANDARD TITLE
252090	Maintain physical and psychological comfort in acute and/or chronically ill patients, and significant others
ORIGINATOR
SGB Nursing
PRIMARY OR DELEGATED QUALITY ASSURANCE FUNCTIONARY
-
FIELD			SUBFIELD
Field 09 - Health Sciences and Social Services			Curative Health
ABET BAND	UNIT STANDARD TYPE	PRE-2009 NQF LEVEL	NQF LEVEL	CREDITS
Undefined	Regular	Level 7	Level TBA: Pre-2009 was L7	11
REGISTRATION STATUS		REGISTRATION START DATE	REGISTRATION END DATE	SAQA DECISION NUMBER
Passed the End Date - Status was "Reregistered"		2018-07-01	2023-06-30	SAQA 06120/18
LAST DATE FOR ENROLMENT		LAST DATE FOR ACHIEVEMENT
2024-06-30		2027-06-30

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

This unit standard does not replace any other unit standard and is not replaced by any other unit standard.

PURPOSE OF THE UNIT STANDARD

This unit standard will be useful for people working as clinically focused, service orientated, independent, registered staff nurses, who are able to render basic care to persons with stable and uncomplicated general health problems, as determined by the appropriate legislative framework.

This unit standard will recognise the essential knowledge and skills required to assess and maintain physical and psychological comfort in the acutely ill patient and significant others.

People credited with this unit standard are able to:

Assess the level of mental and physical discomfort of the acutely and chronically ill patient.

Care for patients before and after surgical interventions.

Implement evidence based nursing interventions for pain, and mental and physical discomfort in the acutely and chronically ill patient.

Assist the significant others of acutely ill patients to resolve emotional and psychological problems related to the illness of the patient.

LEARNING ASSUMED TO BE IN PLACE AND RECOGNITION OF PRIOR LEARNING

The credit calculation is based on the assumption that learners are already competent in terms of the following outcomes or areas of learning when starting to learn towards this unit standard:

Applied human and social sciences; Care in terms of activities of living.

ID 252098: Use communication skills to establish and maintain supportive relationships.

ID 252082: Carry out a health assessment of an individual of any age group.

ID 252100: Develop a care plan in collaboration with patients and or carers.

ID 252093: Implement planned nursing care to achieve identified patient outcomes.

UNIT STANDARD RANGE

Specific range statements are provided in the body of the unit standard where they apply to particular specific outcomes or assessment criteria. The following scope and context applies to the whole unit standard:

The Nurse functions within the scope of practice of a staff nurse as formulated by the SANC and the Nursing Act.

This unit standard is applicable to care of all age groups.

Specific Outcomes and Assessment Criteria:

SPECIFIC OUTCOME 1

Assess the level of mental and physical discomfort of the acutely and chronically ill patient.

ASSESSMENT CRITERIA

ASSESSMENT CRITERION 1

The definitions of acute and chronic are consistent with generally accepted medical usage, and examples provided of each are correct and consistent with the definitions.

ASSESSMENT CRITERION 2

Typical symptoms of a range of acute and chronic conditions are correctly identified in accordance with relevant medical guidelines, and generally accepted medical usage and practice.

ASSESSMENT CRITERION 3

Tools and regimes and/or protocols selected are appropriate to the particular context, and are correctly applied during assessments in accordance with their purpose and accepted nursing practice.

ASSESSMENT CRITERION 4

The effect of the symptoms on the individual are established in relation to levels of mental and/or physical discomfort for a particular patient.

ASSESSMENT CRITERION 5

The interpretation of assessment outcomes provides clear indications of the required treatment, or the effectiveness of the current treatment regimes.

ASSESSMENT CRITERION 6

The unpredictable nature of emergency situations is explained in terms of the symptoms presented, and the implications for assessment.

SPECIFIC OUTCOME 2

Care for patients before and after surgical interventions.

OUTCOME RANGE

Care includes:

Pre-and post-operative care.

ASSESSMENT CRITERIA

ASSESSMENT CRITERION 1

Information conveyed to patients before interventions or surgical procedures is accurate, relevant and at an appropriate language and conceptual level. Information provides a basis for patient decision making and consent, and is delivered in a supportive manner.

ASSESSMENT CRITERION 2

Informed consent is secured according to legal requirements. Once consent is secured, the patient is physically prepared for the intervention or procedure, in accordance with established procedures and protocols.

ASSESSMENT CRITERION RANGE

Preparation includes:

Cutting, shaving, washing; removal of artificial limbs/parts, identification of the patient (name tags)/operation area, allergies, secure personal belongings, clothing check, prescribed pre-med.

ASSESSMENT CRITERION 3

Immediate post-operation care is implemented according to established procedures and protocols to ensure that the patient is stable. Patient condition is closely monitored and recorded as required.

ASSESSMENT CRITERION RANGE

Care includes:

Monitoring vital signs; monitoring input and output; pain management; observations for bleeding and other complications; prevention of pressure; positioning of the patient (lie, sit, side).

ASSESSMENT CRITERION 4

The wound is accurately assessed in terms of size, depth, tissue condition, infection and drainage, and wound care is appropriate to the particular wound and consistent with topical medication and wound care techniques.

ASSESSMENT CRITERION 5

Aseptic techniques are applied during wound care, and wounds are monitored for normal healing and/or complications, in accordance with established procedures.

ASSESSMENT CRITERION RANGE

Care includes:

Basic care; sutures; drains; skin care; monitoring/guarding against infection.

ASSESSMENT CRITERION 6

Diets are ensured to be suitable for the particular patient condition, and in place in line with best dietary practice. Information shared with the patient provides the rationale for the diet and the benefits of compliance.

SPECIFIC OUTCOME 3

Implement evidence based nursing interventions for pain, and mental and physical discomfort in the acutely and chronically ill patient.

ASSESSMENT CRITERIA

ASSESSMENT CRITERION 1

Measures applied are appropriate to the particular condition, and promote patient comfort and prevent complications in accordance with national and institutional protocols and regimes, and generally accepted nursing practice.

ASSESSMENT CRITERION RANGE

Measures to prevent complications include:

Positioning of the limbs and joints; mobilization of the patient; care of pressure areas; position change; using appropriate technology; deep breathing; coughing exercises; prevention of cross-infection.

ASSESSMENT CRITERION 2

Alternative methods of pain relief applied are consistent with evidence based nursing practice.

ASSESSMENT CRITERION RANGE

Methods include:

Heat, medication, positioning, meditation.

ASSESSMENT CRITERION 3

Specific factors that promote recovery and healing are accurately identified and measures implemented as appropriate to the particular patient, in accordance with best nursing practice.

ASSESSMENT CRITERION RANGE

Factors include:

Nutritional factors; circulation and respiration; metabolic factors; environmental and occupational factors; mobility and exercise; psychosocial factors.

ASSESSMENT CRITERION 4

Support provided to patients presents information relevant to their condition and needs, and assists them to adapt to the illness and treatment.

ASSESSMENT CRITERION RANGE

Input includes:

Type of illness; coping mechanisms; typical symptoms and manifestations.

ASSESSMENT CRITERION 5

Support provides an opportunity for the patient to share of concerns and fears related to the illness. Support offered acknowledges fears, alleviates concerns where possible, and assists in the development of support mechanisms.

ASSESSMENT CRITERION 6

Prescribed medical treatment is implemented appropriately, in accordance with established protocols and treatment regimes. Information supplied to patients during treatment promotes their understanding of the process and adherence to treatment regimes.

ASSESSMENT CRITERION 7

Follow up of patients establishes the extent of compliance with treatment regimes, and promotes new behaviour patterns consistent with the management of the condition.

SPECIFIC OUTCOME 4

Assist the significant others of acutely and chronically ill patients to resolve emotional and psychological problems related to the illness of the patient.

ASSESSMENT CRITERIA

ASSESSMENT CRITERION 1

Responses of significant others to the patient's illness and treatment are noted and documented according to institutional policies and procedures.

ASSESSMENT CRITERION 2

Support provided is appropriate to the particular context, and promotes the mental and physical comfort of significant others in accordance with generally accepted nursing practice.

ASSESSMENT CRITERION 3

Significant others are enlisted and included in the management of the condition where possible, where their contribution is positive and does not endanger the health and well being of the patient.

ASSESSMENT CRITERION 4

Roles and responsibilities of significant others as care givers are outlined with reference to procedures, their own limitations, and the consequences for the health of the patient of their non-compliance.

ASSESSMENT CRITERION RANGE

Responsibilities include:

Ensuring compliance with treatment and therapies: (time, frequency, finishing the course, carrying out exercises); need to access appropriate help and support.

UNIT STANDARD ACCREDITATION AND MODERATION OPTIONS

Accreditation Option: Providers of learning towards this unit standard will need to meet the accreditation requirements of the relevant ETQA.

Moderation Option: The moderation requirements of the relevant ETQA must be met in order to award credit to learners for this unit standard.

UNIT STANDARD ESSENTIAL EMBEDDED KNOWLEDGE

The following essential embedded knowledge will be assessed through assessment of the specific outcomes in terms of the stipulated assessment criteria. Candidates are unlikely to achieve all the specific outcomes, to the standards described in the assessment criteria, without knowledge of the listed embedded knowledge. This means that for the most part, the possession or lack of the knowledge can be directly inferred from the quality of the candidate's performance. Where direct assessment of knowledge is required, assessment criteria have been included in the body of the unit standard:

Integration of knowledge and skills in the management of pain, psychological, physical discomfort of acutely and chronically ill patients, and significant others.

Understanding of acute illnesses according to body systems.

Special diets for surgical patients.

UNIT STANDARD DEVELOPMENTAL OUTCOME

N/A

UNIT STANDARD LINKAGES

N/A

Critical Cross-field Outcomes (CCFO):

UNIT STANDARD CCFO IDENTIFYING

Identify and solve problems and make decisions using critical and creative thinking.

Note: Identifying and implementing health care solutions implies problem-solving and effective decision making.

UNIT STANDARD CCFO WORKING

Work effectively with others as members of a team, group, organisation or community.

Note: Health care provision is team based.

UNIT STANDARD CCFO ORGANISING

Organise and manage themselves and their activities responsibly and effectively.

Note: Managing comfort requires effective organisation.

UNIT STANDARD CCFO COLLECTING

Collect, analyse, organise and critically evaluate information.

Note: Central to managing pain, and monitoring and evaluation components.

UNIT STANDARD CCFO COMMUNICATING

Communicate effectively, using visual, mathematical and/or language skills in the modes of oral and/or written presentations.

Note: Core competence maintaining psychological and physical comfort.

UNIT STANDARD CCFO SCIENCE

Use science and technology effectively and critically showing responsibility towards the environment and health of others.

Note: Used in assessment and monitoring, as well as pain management.

UNIT STANDARD CCFO DEMONSTRATING

Demonstrate an understanding of the world as a set of related systems by recognising that problem-solving contexts do not exist in isolation.

Note: Body as a system; part of the broader health care system.

UNIT STANDARD ASSESSOR CRITERIA

N/A

REREGISTRATION HISTORY

As per the SAQA Board decision/s at that time, this unit standard was Reregistered in 2012; 2015.

UNIT STANDARD NOTES

Notes to Assessors:

Assessors should keep the following general principles in mind when designing and conducting assessments against this unit standard:

Focus the assessment activities on gathering evidence in terms of the main outcome expressed in the title to ensure assessment is integrated rather than fragmented. Remember we want to declare the person competent in terms of the title. Where assessment at title level is unmanageable, then focus assessment around each specific outcome, or groups of specific outcomes.

Make sure that evidence is gathered across the entire range, wherever it applies. Assessment activities should be as close to the real performance as possible, and where simulations or role-plays are used, there should be supporting evidence to show the candidate is able to perform in the real situation.

Do not focus the assessment activities on each assessment criterion. Rather make sure the assessment activities focus on outcomes and are sufficient to enable evidence to be gathered around all the assessment criteria.

The assessment criteria provide the specifications against which assessment judgements should be made. In most cases, knowledge can be inferred from the quality of the performances, but in other cases, knowledge and understanding will have to be tested through questioning techniques. Where this is required, there will be assessment criteria to specify the standard required.

The task of the assessor is to gather sufficient evidence, of the prescribed type and quality, as specified in this unit standard, that the candidate can achieve the outcomes again and again and again. This means assessors will have to judge how many repeat performances are required before they believe the performance is reproducible.

All assessments should be conducted in line with the following well documented principles of assessment: Appropriateness, fairness, manageability, integration into work or learning, validity, direct, authentic, sufficient, systematic, open and consistent.

The following particular issues should be taken into consideration when assessing against this unit standard:

The SANC guidelines are used as a reference for integrated assessment:
> Formative Assessment: A variety of assessment strategies and/or approaches integrating theory and practice must be used. These could be tests, assignments, projects, demonstrations or clinical assessments or any other applicable method.
> Summative: This could take a form of oral, written and/or practical assessments as agreed to with the relevant ETQA.

Definition of Terms:

Terms have been clarified as far as possible through the use of range statements. Further clarification of terms is provided as follows:

The terms "patient" and "health care user" are used interchangeably in this unit standard. The term patient is used internationally, and the term health care user is used in the Nursing Act 33 of 2005, as well as the National Health Act 61 of 2003.

QUALIFICATIONS UTILISING THIS UNIT STANDARD:

	ID	QUALIFICATION TITLE	PRE-2009 NQF LEVEL	NQF LEVEL	STATUS	END DATE	PRIMARY OR DELEGATED QA FUNCTIONARY
Core	59257	Bachelor of Nursing	Level 7	NQF Level 08	Passed the End Date - Status was "Reregistered"	2023-06-30	As per Learning Programmes recorded against this Qual
Elective	59236	National Diploma: Nursing	Level 5	NQF Level 05	Passed the End Date - Status was "Reregistered"	2020-07-30	As per Learning Programmes recorded against this Qual

PROVIDERS CURRENTLY ACCREDITED TO OFFER THIS UNIT STANDARD:

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.

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