Principles of Ophthalmic Nursing Unit Outline

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1 Principles of Ophthalmic Nursing Unit Outline Continuing Professional Education (CPE) Course: Application for credit worthiness in progress Prerequisites: Nil Incompatible Units: Nil Co ordinator: Amanda Wylie Date: Semester 2, Rationale: As Australia s population ages the number of people affected by blindness or visual impairment is expected to double over the next 20 years (Vision 2020 Annual Report , p 8). With an increasingly significant proportion of the population requiring treatment for ocular disorders related to aging, diabetes, and obesity the demand for nurses with specialist skills in ophthalmic care will also increase. Visual impairment is known to negatively impact on the health and wellbeing of people in many ways, for example by affecting their ability to live independently, move about safely and work. With a significant proportion of the population requiring treatment for their ocular disorders, or for injuries incurred due to poor vision, the demand for nurses with specialist skills in ophthalmic care will also increase. This unit will ensure that there is an avenue of learning for registered nurses who wish to practice in this specialist nursing area. Ophthalmic nurses work in a variety of settings and fulfil a wide range of roles; from patient education to assisting in surgery. This unit will provide registered nurses with the information, formal learning opportunities, skills and confidence to practice as ophthalmic nurses and to promote ophthalmic nursing as a rewarding and viable career choice.

2 Aims: The aim of this unit is to provide students with contemporary knowledge and skills to meet the health needs of patients with a variety of disorders of the eye. Knowledge and skills developed during this unit will enable the student to provide high quality care in their practice as an ophthalmic nurse and the ability to think critically when planning and providing ophthalmic care. Objectives: After successful completion of this unit, you will be able to: 1. Apply knowledge of ocular anatomy, physiology and optics to care decisions for patients in the ophthalmic setting 2. Discuss common ocular disease processes, including macular degeneration, cataract, glaucoma and diabetic eye disease 3. Use critical thinking to plan individualised care for a variety of patients with ophthalmic conditions 4. Utilise principles of education to promote health, prevent disease and support patient autonomy in the ophthalmic setting 5. Apply principles of pharmacodynamics and pharmacokinetics relating to ophthalmic practice 6. Explain the applications and associated safety considerations of specific treatments to ophthalmic patients 7. Critically analyse a variety of sources including research, practice literature and policy documents in order to improve ophthalmic nursing practice

3 Content of the Unit: The modules comprising this unit are as follows: Week Module Topic Course Objective Approx No of Hours 1 Course Introduction Overview Role of the Nurse in Ophthalmology 1 1 Ocular anatomy and physiology Optics and care of the patient with an 1, 6 10 error of refraction a. Physiology of laser b. Laser safety and legal considerations 3 3 Role of the ophthalmic nurse as educator 3, 4, 6, 7 8 a. The ophthalmic health care team b. Evidence based practice c. Communication, teaching and learning 4 4 Ophthalmic pharmacology, patient safety 4, 5, 6 10 and nursing responsibilities a. Legal considerations Ophthalmic assessment of the patient 1, 3, 4, 5 20 a. Taking an patient history b. Ophthalmic assessment Care of the patient presenting with acute problems a. Red eye 1, 2, 3, 4, 6, 7 10 Case Study due The lens and care of the patient with 1, 2, 3, 4, 5, 6, 7 20 cataract a. Cataract b. Laser treatment relating to cataract c. Nursing care of the patient with cataract The angle, aqueous and care of the 1, 2, 3, 4, 5, 6, 7 20 patient with glaucoma a. Glaucoma b. Diagnosis and treatment c. Nursing care of the patient with glaucoma The retina, vitreous and care of the 1, 2, 3, 4, 5, 6, 7 20 patient with a condition of the retina a. Anatomy and physiology b. Diagnosis and treatment c. Nursing care of the patient with a Clinical retinal condition Portfolio due 2

4 Approaches to teaching and learning: This unit will be offered externally through Distance Education. Students will be provided with a Unit Outline in hardcopy and all course materials on CD ROM. In addition students will complete formative assessment activities on line via the University Blackboard site. Student centred, self directed learning is encouraged with a strong focus on a deepening understanding of, and improvement of professional practice. Assessment: Students are encouraged to critically reflect on their clinical practice in the ophthalmic setting and to relate their assessment tasks to their area of practice or expertise. Formative assessment will be: At the conclusion of each module students will be asked to complete activities or multiple choice questions though the Blackboard site. This activity will allow the student to assess their learning progression throughout the unit of study. In order to achieve a passing grade for this programme, participants will be expected to complete all Blackboard activities. Completion of all Blackboard activities will contribute 10% of the final grade for the unit. (Outcomes objectives 1 6) Summative assessment will be: 1. Clinical Case Report (Outcome 1 4, 7) 40% The student is required to write a clinical case report for a selected patient. Students are encouraged to choose a case to report by the end of the fourth week of the programme. It is advisable not to choose a rare or unusual problem as this may be difficult to research. The assignment should aim to demonstrate the student s ability to understand the total experience of the person with a diagnosis of an eye disorder, and to demonstrate understanding of the clinical decisions made for this person s care. The case study requires the student to think critically and creatively about the selected health needs of the whole person, and review concepts and principles related to ophthalmic care. The work

5 should demonstrate an evidence based approach through the use of relevant literature, systematic reviews, clinical care guidelines and other materials as appropriate. Structure of Clinical Case Report Following are suggested sub headings for the Clinical Case Report: a. Introduction b. Patient history; including: patient details (age, sex, etc), background, eg: social history, relevance to family and friends, psychological factors presenting complaint, description of signs and symptoms c. Assessment; including initial examination and nursing assessment d. Diagnosis; indicating diagnostic techniques and findings e. Differential diagnosis f. Management; indicating proposed plan, rationale and the evidence base for practice g. Patient education; identified needs and techniques employed h. Assessment of the success of the management; from a health professional and patient perspective i. Discussion; critically analyse the care this patient received. Discuss how it might have been improved. What is the evidence base for your recommendations? j. Conclusion k. References Presentation Requirements It is expected that students will use current, relevant nursing research and literature to support their findings and statements throughout the Case Study report. Evidence of broad reading is expected. Due Date: mid semester, end of week 7 Length: words

6 2. Submission of Clinical Portfolio (Outcome 2 7) 50% Aims of Clinical Portfolio Students will be expected to present a portfolio of learning activities, experiences and reflection they have undergone during the course of the unit. The student will record evidence in the clinical portfolio of: a. Their completion of a range of tasks or clinical experiences as outlined in each module b. Their ability to relate theory to clinical practice, specific to their own practice context c. Their ability to gather, analyse and report relevant clinical data d. Their clinical development during the unit of study, including clinical skills opportunities e. Their reflection on clinical practice Clinical Skill Opportunities During the unit of study the student will encounter many opportunities to observe and develop clinical skills. Students are expected to record clinical skills observed and learnt in the Clinical Portfolio, which is reviewed as part of the final assessment for this unit. Opportunities to observe and perform clinical skills will vary dependent upon the work environment of the student. Following is a list of essential skills, a record of which is compulsory in the assessment of the Clinical Portfolio. Autorefraction Patient education Instillation of eye drops and/or eye ointment * Visual acuity testing using the Snellen Chart * Examination of the eye using a pen torch * Swinging flashlight test (testing for RAPD) Eye toilet and dressing * Ocular irrigation Eye lid eversion A Scan

7 Measurement of intraocular pressure using the Tonopen, Perkins or Goldman tonometer Visual field testing Amsler Grid testing Fluorescein angiography Students who anticipate difficulty in accessing these clinical skill experiences should discuss this with the unit co ordinator at the commencement of their study. Arrangements will be made to accommodate such students. * Indicates clinical skills where evidence of performance and competence is mandatory. Clinical skill assessment tools will be provided to students for these activities. Students will be required to have a suitably qualified peer or expert ophthalmic nurse observe and assess their competency using the assessment tool. Students unable to access a suitable assessor should notify the course co ordinator so arrangements can be made to accommodate such students. Due Date: end of semester, end of week 13 Length: Maximum 3000 words Resource Materials: Set text book: Marsden, J (2006) Ophthalmic Care, Wiley, West Sussex. References: CD ROM (provided with course material) including relevant readings. Teaching staff and qualifications: Course Coordinator: Amanda Wylie Amanda Wylie has 15 years experience in ophthalmic nursing at various levels and in a wide range of practice settings. She is currently working in a clinical position in ophthalmology. Amanda has had extensive involvement in the Australian Ophthalmic Nurses Association of Queensland Inc (AONAQ) and has been a member of that organisation since 1994, serving on the Executive Committee for 12 of those years. She is currently involved in contributing to the

8 development of the Competency Framework for Ophthalmic Nurses in Australia. Amanda has a Masters in Nursing (Health Services) and Post Graduate Certificate in Ophthalmic Nursing and is a member of the Royal College of Nursing Australia. Assistant Coordinator: Carmen Newman Carmen Newman has 10 years experience in ophthalmic nursing at various levels and in a wide range of practice settings, including 2 years working in the developing world teaching health professionals in ophthalmic nursing. She is currently working in a management and clinical position in ophthalmology. Carmen has had extensive involvement in the Australian Ophthalmic Nurses Association of Queensland Inc (AONAQ) and has been a member of that organisation since 2000, serving on the Executive Committee for the last 2 years. She is currently involved in contributing to the development of the Competency Framework for Ophthalmic Nurses in Australia. Carmen has a Bachelor of Nursing and Post Graduate Certificate in Learning Innovation. Risk Assessment Statement: There are no out of the ordinary risks associated with this unit.

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