Module 6 The Bachelor s Degree in Nursing Nursing care chronically ill patients and citizens in their own homes

Transcription

1 MODULE DESCRIPTION Module 6 The Bachelor s Degree in Nursing Nursing care chronically ill patients and citizens in their own homes This module description has been drawn up in accordance with the Ministerial Order on Professional Bachelor Programmes in Nursing (Order No. 29 of 24/01/2008), Frameworks for the clinical training component of nursing programmes in the Capital Region of Denmark, February 2008, and the Portfolio of the Capital Region of Denmark, approved 30 June The module description was approved by RKU, 12 June Revised 9 July 2012 and 31 January Text for internal examination revised 23 May 2013.

2 Table of Contents 1. Learning objectives and core subject areas Documented activities focusing on clinical training Individual study plan and student interview Portfolio Reading list Frameworks Focus areas The work of the health visitor Specification of learning objectives Obligatory study activities Internal clinical test The written paper A nursing situation or case A clinical nursing problem The oral examination Assessment Withdrawal from internal clinical test and registration for resit/re-examination... 13

3 1. Learning objectives and core subject areas The module focuses on common ailments, patients/citizens with chronic conditions, and clinical methods of observation and intervention. It also focuses on the provision of health education. The module is implemented in the primary and/or secondary health services in relation to pregnant women, newborns, children, families and senior citizens. On successful completion of the module, students will have achieved the following learning objectives: The ability to explain the significance of cultural perspectives and societal conditions for understanding people s health and illness The ability to reflect on ethical issues in relation to patients with chronic conditions The ability to observe and identify phenomena in relation to public health, chronic diseases and people s reaction to them The ability to justify and apply clinical methods of observation, evaluation and intervention in relation to patients/citizens with chronic conditions The ability to plan, co-ordinate, provide and evaluate nursing activities for selected patients/citizens taking into consideration the situation of the chronically ill The ability to use methods, procedures and tools to administer medicine to selected patients/citizens The ability to identify and analyse selected phenomena and professional nursing issues, including risk factors and health-promotion initiatives for pregnant women, newborns, children, families and senior citizens/patients The ability to describe social provisions for pregnant women, newborns, children, families and senior citizens/patients The ability to enter into relationships, dialogue and interaction with pregnant women, newborns, children, families and senior citizens/patients, and to teach, advise and inform them in health related issues The ability to select and apply practice-, development- and research-based knowledge about health promotion, prevention, treatment, palliation and rehabilitation. For further details of the learning objectives, please refer to 9. Core subject areas: ECTS credits Subject Theory Clinical training Nursing care 1 11 Public health, including epidemiology and environmental medicine 2 1 Module 6

4 2 Documented activities focusing on clinical training The students bring in their portfolios and teaching-/guidance-/study plan for the theory part of the module (3 ECTS credits). The following e-learning courses must be completed and documented in the student s portfolio prior to the commencement of clinical training: E-learning in basic CPR (cardiopulmonary resuscitation) and skills training (equivalent to basic resuscitation course). Must be done at the educational institution (max. 2 years old) E-leaming in hand hygiene and use of gloves (max. 1 year old) E-learning in fire prevention and fire fighting (max. 1 year old) 3. Individual study plan and student interview Four student interviews are held during the clinical period. The individual study plan, which is compulsory, is drawn up after the initial interview. The plan is adjusted and evaluated at subsequent interviews. For more information about the requirements for and content of the individual study plan and student interviews, please refer to the Student Interviews section in Frameworks and guidelines for clinical training on the clinical website (in Danish) www-kurh.dk 4. Portfolio The portfolio provides the basis for reflection and learning, both in theory and in clinical practice, throughout the whole programme. It consists of three sections: presentation, learning and documentation. See the clinical website: 5. Reading list A reading list is drawn up and regularly updated on the basis of the subject areas and ECTS credits for the module. It is authorised by the clinical supervisor. See Frameworks and guidelines for clinical training at for further info. 6. Frameworks The module is a combined clinical and theoretical module, prescribed to 12 ECTS credits in clinical training and 3 ECTS credits in the theoretical part. The clinical supervisor plays a key role in the planning of the clinical period. The clinical supervisor is responsible for: selecting specific situations and cases that make it possible for the student to work in a targeted manner towards the achievement of the module s learning objectives creating the opportunity for progression in terms of what is offered to the students from observation and reflection to practical nursing interventions in relation to the module s learning objectives Module 6

5 facilitating learning processes that provide students with the opportunity to analyse, assess and relate critically to the nursing context, including providing guidance to the student before, during and after the provision of nursing care creating the opportunity for the student to participate in planned and structured individual/group reflection The student is responsible for participating in: planning of the learning process learning, guidance and reflection situations practical nursing, in close collaboration with the clinical supervisor and other nurses. The frameworks and content of the theoretical part may differ between the three educational institutions. 7. Focus areas The focus of Module 6 is on nursing care for groups of chronically ill patients and citizens in their own homes of all ages who live under a variety of different circumstances and with different social and health needs in relation to health promotion, prevention, treatment, relief and rehabilitation. The module is generally organised on the basis of the exemplary principle in relation to chronically ill patients and citizens in their own homes, including the latest practice-, development- and researchbased knowledge that can be related to the module's subject areas and learning objectives. The previous modules knowledge, skills and competences are incorporated into the module. The purpose of the theoretical teaching in the subject areas nursing, public health, epidemiology and environmental medicine (prescribed to theoretical 3 ECTS credits), is to facilitate learning processes that, together with the clinical training s subject areas, will give students the opportunity to achieve the module s learning objectives. The clinical training facilitates learning processes that create opportunities to process and analyse nursing problems in relation to individuals, families and local communities. The health needs of pregnant women, newborns, children, families and elderly patients and citizens are identified, and nursing care is provided to chronically ill patients and citizens in their own homes. Health-education activities, chronic diseases, clinical methods and interventions for chronically ill patients and citizens in their own homes are incorporated into the clinical training. 8. The work of the health visitor The introduction provides the student with insight into the legal, ethical and moral frameworks for the work of the health visitor. Module 6

6 It also provides insight into the organisation and structure of the relevant local authority s current health visitor system. The student takes part in the daily work of a health visitor. The focus during this activity is on achieving one or more of the learning objectives. Focus areas are selected in collaboration with the health visitor, and consist of defined areas. At the end of the study period, reflection interviews are held in groups, along with the clinical supervisors. The aim is to identify the learning objectives and exchange experiences. 9. Specification of learning objectives The following are examples of the specifications for learning activities related to learning objectives. The presentation should not be construed as exhaustive, but as a guide for students and supervisors, which enables students to acquire knowledge, skills and competences in nursing and health education. The ability to explain the importance for health and illness of human cultural perceptions and social factors The student possesses and applies to selected citizens his or her knowledge about: social inequalities in health and illness the influence of culture on points of view lifestyle and living conditions wound clinics health centres care and technology national, Capital Region of Denmark and local-authority health profiles and health strategies case programmes rehabilitation living with chronic illness ICF International Classification of Functioning, Disability and Health The ability to reflect on ethical issues in relation to patients/citizens with chronic conditions The student reflects on ethical issues where the patient/citizen has: common ailments and/or chronic diseases that challenge the concepts of autonomy, integrity, dignity and respect for the individual The ability to observe and identify phenomena associated with common ailments and chronic conditions, as well as reactions to them The students apply their knowledge of common ailments and chronic diseases and their consequences, e.g.: Module 6 6

7 The impact of illness on the patient The patients resources and limitations in everyday life The patients control over their life situations The reactions of those around the patient to common ailments and chronic illness Health promotion, prevention and rehabilitation The ability to justify and apply clinical methods to observation, evaluation and intervention in relation to patients/citizens with chronic conditions The student trains and applies clinical methods, e.g.: Fall screening Nutrition screening ADL evaluation The nursing process Clinical guidelines Action plans Measuring basic physiological values The ability to plan, co-ordinate, provide and evaluate nursing care for selected patients/citizens in a way that takes into account the situation of the chronically ill The students train and apply the clinical decision-making process by identifying the patient s needs/risks. For example: Planning and co-ordinating nursing care in relation to needs/risks, in co-operation with individual patients/citizens and taking into account their reactions and resources Providing nursing care in relation to needs/risks in collaboration with the individual patients/citizens, with respect for the situation and taking into account their need for care Evaluating the nursing care with the patient and documenting it in accordance with the clinic s usual practice The ability to use methods, procedures and tools to administer medicine to selected patients/citizens The student justifies and administers medicine, cf. current guidelines, to selected patients in their own homes The ability to identify and analyse selected phenomena and professional nursing issues, including risk factors and health-promotion initiatives for pregnant women, newborns, children, families and senior citizens/patients The student identifies and analyses nursing problems and plans, and, in relation to these, intervenes and evaluates nursing care in a public-health professional perspective, including: risk factors, such as nursing problems in relation to KRAM health behaviour in this group Module 6

8 The ability to describe social provisions for pregnant women, newborns, children, families and senior citizens/patients The students have, in relation to selected patients, knowledge of: social provisions for prevention, health promotion and rehabilitation local authority provisions for prevention, health promotion and rehabilitation, for example: o Birth control o Preventive home visits o Equipment o Case programmes The ability to enter into relationships, dialogue and interaction with pregnant women, newborns, children, families and senior citizens/patients, and to teach, advise and inform them The student maintains and enhances independent relationships with the above group via: health education and communication methods dialogue, interaction and relationships with citizens/patients and relatives behavioural change theories The ability to select and use practice-, development- and research-based knowledge of health promotion, illness prevention, treatment, palliative care and rehabilitation The students select and relate critically to practice-, development- and research-based knowledge in relation to. e.g.: clinical instruction local authority research and development projects Clinical guidelines 10. Obligatory study activities Participation in and documentation of the obligatory study activity are requirements for Module 6 and prerequisites for sitting the internal test, pursuant to Ministerial Order No. 29 of 24/01/2008 on Professional Bachelor Programmes in Nursing, Appendix 2, Section 4.2. The obligatory study activity focuses on health promotion, prevention, treatment, relief and rehabilitation, and consists of processing a real-life situation or a case from clinical practice. Based on a document from the learning part of the portfolio, the students prepare a written proposal, which is then discussed. The written paper must include a theoretical reflection on their personal experience of interaction with a citizen within the real-life situation or clinical practice. In the paper, students may opt for a combination of study methods such as: description of practice nursing narrative Visual material, such as mind maps, posters, etc., may be included as a supplement. Module 6 8

9 The written paper must not exceed 4,800 characters incl. spaces. The paper must comply with technical guidelines for writing assignments at the educational institution concerned, as well as Legal guidelines for the collection of patient data for use in assignments and projects Students must draw up a bibliography containing material read in relation to the fixed study activity (cf. technical guidelines for writing assignments). The reading list must be based on practice-, developmentand research-based knowledge, including any appropriate specific nursing standards, guidelines and manuals. The reading list is not included in the specified number of characters. The written paper and reading list are submitted online as a single document (in PDF format) to the clinical supervisor and if agreed the teacher from the educational institution by 12 noon, two working days before the discussion. The clinical supervisor and teacher from the educational institution each acknowledge receipt. The ensuing discussion can take one of the following forms: 1 Group reflection with two or more students and clinical supervisors and, if appropriate, the teacher from the school: o Each student has five minutes in which to present their personal experience of the situation, incorporating relevant theories and concepts from Module 6 that relate to the situation chosen o When all of the students have presented their situation to the clinical supervisors, teachers and their fellow students, the whole group analyses and discusses the various situations in order to identify similarities and differences between them o Analysis and discussion last max. 15 minutes per student o Five minutes per student are set aside for evaluation by the clinical supervisor 2 Reflection with the clinical supervisor and, where appropriate, the teacher from the school: o The student has five minutes in which to reflect on personal experience of the situation, incorporating relevant theories and concepts from Module 6 that relate to the situation chosen o The student then analyses and discusses the situation with the clinical supervisor/teacher for 15 minutes o Five minutes per student are set aside for evaluation by the clinical supervisor The choice is made by the student, in collaboration with the clinical supervisor, based on the options available at the clinical centre. The clinical supervisor uses the documentation form in the student s portfolio to certify that the student has successfully completed the obligatory study activity. Module 6

10 11. Internal clinical test The module is assessed by an individual internal clinical test. The test takes place at the clinical training centre during the last three weeks of Module 6. Every effort is made to ensure that the test is held after the students have completed their clinical training in health care. The internal clinical test documents whether the student has attained the module s learning objectives, which focus on pregnant women, newborns, children, families and senior citizens. A prerequisite for the internal clinical test is that the clinical supervisor is able to certify that the student has: completed and had certified the obligatory study activities met the compulsory participation requirement 1 The clinical supervisor introduces students to the internal clinical test and provides guidance, either individually or in groups. The guidance comprises one lesson per student. The internal clinical test consists of a written paper and an oral examination The written paper Before drafting the written paper, the student, in agreement with the clinical supervisor and based on the options available in each clinical centre, participates in discussion groups with other students, where the student presents his or her personal experience of the nursing situation or case for discussion, analysis and reflection. The written paper can be drawn up in one of the following ways: 1. A nursing situation or case 2. A clinical nursing problem A nursing situation or case The student chooses, in collaboration with the clinical supervisor, a nursing situation or a nursing case in which the student has provided nursing interventions for patients/citizens in their own homes. The students have to identify, reflect on and evaluate their own nursing interventions in relation to the nursing situation or case chosen. These nursing interventions should be seen in relation to the possible dilemmas between their own academic assessments and the patient/citizen s perspective, as well as the societal perspective. The paper must be written in the appropriate terminology, and must include: 1 The 80% compulsory participation requirement applies throughout the whole period. Module 6 10

11 a brief description of the nursing situation or case, including justification for the choice of nursing interventions, based on practice-, development- and research-based knowledge of health promotion, prevention, treatment, relief and rehabilitation A nursing assessment of the nursing interventions, including identification and incorporation of the patient/citizen s perspective reflection on and putting into perspective any dilemmas in the nursing provision from a social perspective The paper can consist of a combination of study methods, including: description of practice nursing narrative Visual material, such as mind maps, posters, etc., may be included as a supplement. The paper must be written using the appropriate terminology and must not exceed 9,600 characters (including spaces). The paper must be written in accordance with the technical guidelines for writing assignments at the educational institution concerned, as well as Legal guidelines for the collection of patient data for use in assignments and projects, A reading list must be attached, based on practice-, development- and research-based knowledge, including any specific nursing standards, guidelines and manuals. The reading list does not count towards the specified number of characters. The student submits the written presentation and reading list online as a single file (in PDF format) to the two examiners before 12 noon, no later than three working days before the internal clinical test. The two examiners must acknowledge receipt by, at the latest, the next day at A clinical nursing problem The student chooses, in collaboration with the clinical supervisor, a real-life nursing situation or nursing case of which they have personal experience, related to chronically ill patients and patients in their own homes. The paper must include: description of a real-life nursing situation or case dealing with people with a chronic illness or common ailment that can be related to health promotion, prevention or rehabilitation, including health education activities a clinical nursing situation, along with the justification for selection an analysis of the selected clinical nursing situation, using practice-, development- and research-based knowledge based on the analysis, suggestions of ways to further develop nursing practice The paper must be written using the appropriate terminology and must not exceed 9,600 characters (including spaces). The paper must be written in accordance with the technical guidelines for writing assignments at the educational institution concerned, as well as Legal guidelines for the collection of patient data for use in assignments and projects, 2009 A reading list must be attached, based on practice-, development- and research-based knowledge, including any specific nursing standards, guidelines and manuals. The reading list does not count towards the specified number of characters.

12 The student submits the written presentation and reading list online as a single file (in PDF format) to the two examiners before 12 noon, no later than three working days before the internal clinical test. The two examiners must acknowledge receipt by, at the latest, the next day at The oral examination The basis for the examination consists of the student s written paper, the oral presentation and the learning objectives for Module 6. Knowledge from previous modules that underpins the written and oral presentations may be incorporated into the examination. The oral examination lasts a total of 25 minutes. The student starts with a presentation (max. five minutes) during which selected, practice-, development- and research-based knowledge is presented with regard to health promotion, preventive measures, treatment, and palliative and rehabilitative activities. Articles, nursing standards, guidelines, instructions, projects and practice-, development- and research-based articles can be used. This is put into perspective in relation to the chosen patient and in relation to services provided by the local authority to citizens of all ages. Students are then examined for 20 minutes, based on the learning objectives for the module. The two examiners conduct the examination together. The clinical supervisor has the primary responsibility for posing questions during the examination. The examination concludes with deliberation and feedback to the students (max. 10 minutes) Assessment The student's performance is evaluated on the basis of the written and oral presentations as well as the actual exam. The test is assessed Pass/Fail (Order No. 262 of 20 March 2007 on grading scales and other forms of assessment). The performance is evaluated on the basis of the learning objectives for the module. The two examiners are on the same footing in relation to the assessment of the student s performance. In the event of disagreement, a consensus must be reached. Module 6 12

13 As stipulated in the current Exam Order, only the examiners may be present during the deliberation. The clinical supervisor and teacher from the school certify on the documentation form whether the test is passed/failed. Students receive copies of the result for their documentation portfolios. The teacher submits documentation of the grade Pass/Fail to the educational institution. For students at Metropolitan University College, the clinical supervisor collates the documentation and submits it to Student Services. 12. Withdrawal from internal clinical test and registration for resit/re-examination With regards to withdrawal from internal clinical examination, re-examination due to illness and resit in the event of failed clinical test, please refer to the frameworks and guidelines for clinical training at Module 6