Faculty of Health Science School of Nursing and Midwifery CNA315 Acute Care Nursing Semester 1, 2009 Unit Outline Part A Unit Coordinator Mark Zasadny 24 Hour Practice Phone Tasmania: 0439 017 730 CRICOS Provider Code: 00586B
Contact Details Unit coordinator: Campus: Email: Mark Zasadny Launceston m.f.zasadny@utas.edu.au Phone: 03 63 243574 Fax: 03 63 243952 Room number: Consultation hours: N223 Email for appointment Lecturer/s and other teaching staff: John Cooper, Unit Lecturer: Ph: 0362 264694 Email: J.F.Cooper@utas.edu.au Vanessa Kucharski Clinical Facilitator, Syd, Concord Telephone: 0405126605 Email: Vanessa.kucharski@email.cs.nsw.gov.au Sue Ward Clinical Facilitator, Sydney, RPA Telephone: 02 95154356 Email: wardf@emailcs.nsw.gov.au The University of Tasmania 2009
Unit Description Acute Care Nursing builds on the knowledge and skills already developed in the first and second years of the BN. This unit provides the opportunity for students to care for individuals and families who experience illness or accident, and require interventions in an acute care setting. Students will be working in a variety of acute care settings and contexts within those settings. They will explore the theoretical understandings of the pathophysiology of disease, pharmacology, nursing therapeutics, assessment and management as they relate to the patient s illness and how these influence the approaches to care. Students will be assessed by clinical teachers and lecturers in consultation with registered nurses in practice according to specific competencies taken from the Australian Nursing and Midwifery Council (ANMC). Unit Weighting This unit has a weighting of 37.5%. Learning Outcomes On completion of this unit, you should be better able to: 1. Perform all the core skills as listed in the Portfolio of Evidence to a satisfactory level 2. Practise in accordance with the Standards of Professional Practice as documented in the ANMC Competencies. 3. Demonstrate a professional approach to nursing and an understanding of the way in which nurses work in an acute care setting as assessed by the CNC/CNM of the clinical area. 4. Demonstrate a sound clinical knowledge base. 5. Demonstrate knowledge of medication management and the ability to be 100% accurate when calculating medications. 6. Administer medications safely under supervision in the clinical setting. 7. Demonstrate detailed understanding of illness, including pathophysiological, pharmacological and psychosocial dimensions, as evidenced through the completion of the person focussed clinical inquiry. 1
Teaching and Learning Strategies This unit is offered fully online via MyLO (my learning online). Learning Online - MyLO MyLO is the online learning environment through which you can access unit content, communicate with lecturers and other students and, sometimes, complete assessment tasks. It acts as a gateway to the abundant professional resources and academic literature available on the Internet. Learning online provides gives you opportunities to network with others with similar professional interests and learning needs regardless of geographical location. Please see Unit Outline Part B for further details about online learning and access student support for studying through MyLO at this UTAS website: http://uconnect.utas.edu.au/ Email contact for technical help with MyLO is mylo@utas.edu.au Phone support can be accessed at the ITR Helpdesk number: 6226 1818 or 1300 304903 (Local call charge within TAS, mobiles excepted) Practicum/work experience placements Students are expected to complete 312 hours of practice. You will be required to make yourself available for either an early or late shift for five days per week for 8 weeks. Students are required to promptly inform their Clinical Facilitator, practice agency and lecturer if they are ill or for any reason are unable to attend clinical practice. Students may be given the opportunity to attend further clinical practice however this will be up to the discretion of the lecturer. Confidentiality: At all times students are required to ensure that information about patients or clients remains confidential. As a legal requirement you are also required to complete a confidentiality agreement which will be kept at the School of Nursing and Midwifery. Other specific attendance and performance requirements To pass this unit you must: Complete and submit each item of assessment. Be assessed as competent in clinical practice; Achieve an overall grade of 50% or higher Clinical Placement You will receive support in practice by an academic, clinical facilitator in addition to a preceptor. Your completion of specified minimum practice hours is mandatory. In the case of absence from practice the unit lecturer/coordinator or clinical facilitator should be advised as soon as possible. In the case of sickness supporting evidence may be requested. 2
Resources Required UTAS Library resources and services will support you in completing assessment tasks: http://www.utas.edu.au/library/ Required texts 1. A suitable nursing, pathophysiology and pharmacology textbook chosen from the list below. You may already own a copy of one or more of these. 2. Medication Management for Registered Nurses (CD-ROM), 2005. School of Nursing and Midwifery, University of Tasmania, Launceston. Recommended reading You do not have to get these additional resources, but it is strongly recommended that you refer to a selection while you are studying this unit: Brown, D & Edwards, H. 2005, Lewis s Medical Surgical Nursing, Assessment and Management of Clinical Problems, Elsevier Mosby, Sydney. Bryant, Bronwen; Knights, Kathleen and Salerno, Evelyn. 2003, Pharmacology for Health Professionals, Elsevier Science, NSW, Australia. Burkitt, H., Quick, C. and Gatt, D. 2002, Essential Surgery, Problems, Diagnosis and Management, (3rd edn), Churchill Livingstone, Sydney. Corwin E.J. 2000, Handbook of Pathophysiology 2nd ed. Lippincott, USA Crisp, J & Taylor, C. 2005, Potter and Perry s Fundamentals of Nursing, 2nd Edition, Elsevier Mosby, Sydney. Gatford, J.D. & Phillips, N. 2002, Nursing Calculations, 6th Edition, Churchill Livingstone, Melbourne. Gould, B. 2002, Pathophysiology for the Health Professions, (2nd edn), W.B. Saunders, Sydney. Hopkins, Tracey B. 2005, Lab Notes Guide to Lab and Diagnostic Tests, F.A Davis Company, Philadelphia. Jarvis, C. 2004, Physical Examination and Health Assessment, (4th edn), W.B. Saunders Company, Sydney. (retained from yr 1 and 2) Langford, Rae W. & Thompson, June D. 2005, Mosby s Handbook of Diseases (3rd edition), Elsevier Mosby, Missouri. Nursing Board of Tasmania, Publications Nursing Code available online (see link in MyLO) Nursing Calculations CD ROM, Educational Innovations. Tiziani, A. 2006, Harvard s Nursing Guide to Drugs (7 th Edition), Elsevier Mosby, Australia. Websites Links to websites of particular interest for topics in this unit will be provided in MyLO throughout the semester. 3
Study Schedule Wk. Module and/or Topic Content readings Assessment 1 23/02 Introduction to unit Clarification of unit outline, content and assessment requirements. Read the unit outline carefully Review the common pathophysiology of the patients in your clinical setting. Your clinical teacher will direct you in this area. 2 02/03 VIVA preparation Discuss with your clinical teacher or lecturer an appropriate person to for you to deliver as your VIVA case study 3 09/03 4 16/03 5 23/03 6 30/03 Progress and portfolio review Complete required portfolio self assessment prior to progress review Asst 1: First progress review Module 1: Care of an acute surgical patient with complications Care of the person with intestinal disorders. Pre and post operative Nursing care. Asst 3: VIVA during practice days Module 1 Fluid and electrolytes Asst 2a: Case study discussion forum Asst 3: VIVA Module 1 Diabetes type 1 and therapeutic communication. Asst 2a: Case study discussion forum 7 06/04 Easter Break 09/04 to 15/04 inclusive 8 20/04 Progress and portfolio review Module 2: Care of a medical patient with complications Complete required portfolio self assessment prior to progress review Cardiovascular physiology. Pathophysiology of AMI ECG interpretation Asst 1: Second progress and portfolio review during practice days Asst 1: Portfolio completion 9 27/04 Module 2 Respiratory physiology. Pathophysiology of COPD and pneumonia. Asst 4: VIVA during practice days 10 04/05 Module 2 Stroke Asst 4: VIVA during practice days Portfolio; Monday 4 th May at 12 noon 4
Wk. Module and/or Topic Content readings Assessment 11 11/05 Module 2 Care of the patient with cancer. Pathophysiology of malignant blood disorders. Asst 2b: Case study discussion forum 12 18/05 Asst 2b: Case study discussion forum 13 25/05 Clinical Inquiry Asst 5: Clinical inquiry (3000 words), Monday 25th May 2009 at 12 Noon 5
Assessment Details Please note that the SNM requires all assignments to be clearly referenced in the Harvard style. Download a Guide to Harvard from the UTAS Library website and practice with it until you have a thorough understanding of how to reference correctly: http://www.utas.edu.au/library/assist/apps/harvardsystem_07rc.pdf Be sure to read the notes on Assessment Policy and how to resolve any issues concerning assessment in the Unit Outline Part B which is available in MyLO. Summary of Assessment Type of Task Weighting Due Date & Time Length 1 2 3 Portfolio of Evidence Un-graded Pass / fail Online case study discussion Un-graded Pass / fail Throughout semester: (see below) Due 4 th May 2009 2a. Weeks 5-6 2b. Weeks 11-12 VIVA (oral examination) 20% Week 4/5: time will be advised by lecturer in week 2 VIVA (oral examination) 30% Week 9/10: time will be advised by lecturer in week 7 Clinical Inquiry 50% Monday 25 th May 2009 12 Noon As set out in the portfolio template 500 words total (250 words max. each discussion comprised of short postings) Maximum of 20 Minutes Maximum of 30 Minutes 3000 words Assessment task 1: Assessment task 1: Portfolio of Evidence Due date Weighting Length Throughout semester - key points are: Wk 3 Progress review Wk 8 Practice completion review Wk 10 Final portfolio submission due Mon 4 th May at noon Satisfactory / unsatisfactory As required Learning Outcome 1, 2, 3, 4, and 5 Directions You must complete a mandatory 312 hours of clinical practice and, to document your progress throughout, document and submit a Portfolio of Practice. Your progress will be monitored regularly by the clinical facilitators in collaboration with the supervising RNs, Clinical Nurse Consultant (CNC), Clinical Nurse Manager (CNM) and academic staff within the Acute Care team. If you are absent from practice, the unit lecturer/coordinator or clinical facilitator should be advised as soon as possible. If you take sick leave, supporting evidence may be requested. You will meet with the Clinical Facilitator and in some cases the Unit Lecturer in weeks 3 and 8 to discuss your progress in achieving learning outcomes. Your clinical facilitator and/or lecturer will set 6
goals for you at the week 3 progress review of your Portfolio. You are expected to accurately document these progress meetings and have them signed by the clinical teacher as a true and accurate account within a week of each meeting. You will rank yourself prior to meeting with the clinical teacher/academic and he/she will then also rank your progress against the ANMC competencies. Your PORTFOLIO of PRACTICE includes: 1. Professional Development Summary This is a report completed by your CNC or CNM (or their deputy) at the end of your 8 week clinical placement. Their assessment of your progress is designed to highlight your developing sense of professional responsibility within a particular setting. It addresses specific criteria listed in your Portfolio of Evidence template. These are fundamental to being a registered nurse and working in an acute care environment. 2. Portfolio Skills Assessment It is expected that you will demonstrate skill and competency development on a 1-5 ranking over the 8 weeks in practice. To pass the unit, you must achieve a 5 ranking for the core skills (listed in your Portfolio of Evidence template) and a competent rating for the ANMC competencies at week 8. A minimum of 2 entries per skill is required. This document is essential to your clinical assessment. It provides evidence that you are achieving a satisfactory skill and competence level required to pass this unit. You should have this document in practice with you at all times. It is your responsibility to complete the skills and competencies within the document. The supervising RN only makes a brief comment and allocates a ranking. There are no specific weeks during which the skills assessments should be undertaken, however you are expected to keep up to date with skills development and take every opportunity to complete them. You are expected to rank yourself and then ask your supervising RN (who might be the clinical teacher or an RN on the ward) to rank you. 3. Episodes of Practice X 2 You must complete two episodes of practice from a range of days. These are reflective pieces of writing that report on how you dealt with specific situations, what you learnt from the experience, and an evaluation of your future learning needs. 7
Assessment task 2a and 2b: Case Study Reflections Due date 2a. Wks 5-6 (open 0800, 23/3/2009, close 2400 5/4/2009) 2b. Wks 11-12 (open 0800 11/5/2009, close 2400 24/5/2009) Weighting Length Ungraded pass/fail mandatory activities to pass the unit 500 words max. in total - 250 words max. each discussion comprised of short postings (quality not quantity is required) Learning outcomes 1,4,5,6 Directions Case studies form the core of theoretical learning for the unit and there is one study for each module. You will be allocated to small groups in MyLO and are required to participate in online activities associated with each case study. 1. Read the case study for each module. 2. Complete associated readings that will inform your understanding and responses to the case study scenarios from the recommended texts 3. Complete the online self-test about the parameters of the case study 4. Participate in an online discussion about the case study. Your postings should demonstrate that you have done extensive reading and can analyse the complexities of the patent s experience and appropriate medical and nursing interventions. Marking Criteria for the online discussions Posts at least 2 contributions for each Case Study discussion period Engages respectfully with the views of others in the group Writes in a succinct, relevant, informed manner and shows evidence of wider reading on the topic from academic literature Writes in an appropriate academic style and references work in accordance with SNM guidelines (Harvard system) 8
Assessment task 3: VIVA Due date Week 4/5: time to be advised in week 2 Weighting 20% Length 20 minutes Learning outcomes 3, 4, and 5 Directions In this viva you will be expected to demonstrate significant progress towards beginning level competence under the broad domains of the ANMC competencies. In this viva (oral test) you will be asked to discuss one patient for whom you have been caring. You will be required to describe the reason they were admitted, their assessment details, your nursing care and interventions, the applicable pathophysiology and the pharmacological management related to the patient. You will be asked probing questions about this patient and will be expected to be articulate and well prepared. You may take in ½ a page (A4) of notes in the form of dot points and the marking criteria to be used as an aid to prompt. Marking Criteria Articulate a brief history of the patient: Past history, Presenting symptoms, Diagnosis Rationalise the presenting pathophysiology/key diagnostic indicators and pharmacology and demonstrate links between them: Ability to discuss the pathophysiology with a clear understanding. Makes links between the presenting disease and past history if relevant. Able to state if the presentation is typical or atypical. Explains and rationalises diagnostic tests that have or will be performed and discusses the results. Discusses the usual medications and rationale. New medications and rationale. Possible interactions, Relevant side effects. Identifiy and justify nursing interventions What nursing care was done. Rationalises the reason for nursing care performed. Describes any alternative nursing strategies. Describe therapeutic and/or family interactions Home situation, Family circumstances, Community/social support, Therapeutic communications. Patients experience of illness. Discuss plans for discharge or future treatment Discharge information and follow up, Discharge medications, Community services/support 9
Assessment task 4: VIVA Due date Week 9/10 time to be advised in week 7 Weighting 30% Length 30 minutes Learning outcomes 3, 4, and 5 Directions In this viva you will be expected to demonstrate beginning level competence under the broad domains of the ANMC competences. In this viva (oral test) you will be asked to discuss one patient for whom you have been caring. You will be required to describe the reason they were admitted, their assessment details, your nursing care and interventions, the applicable pathophysiology and the pharmacological management related to the patient. You will be asked probing questions about this patient and will be expected to be articulate and well prepared. You may take in ½ a page (A4) of notes in the form of dot points and the marking criteria to be used as an aid to prompt. Marking Criteria Articulates a brief history of the patient: Past history, Presenting symptoms, Diagnosis Rationalise the presenting pathophysiology/key diagnostic indicators and pharmacology and demonstrate links between them: Ability to discuss the pathophysiology with a clear understanding. Makes links between the presenting disease and past history if relevant. Able to state if the presentation is typical or atypical. Explains and rationalises diagnostic tests that have or will be performed and discusses the results. Discusses the usual medications and rationale. New medications and rationale. Possible interactions, Relevant side effects. Identifiy and justify nursing interventions What nursing care was done. Rationalises the reason for nursing care performed. Describes any alternative nursing strategies. Describe therapeutic and/or family interactions Home situation, Family circumstances, Community/social support, Therapeutic communications. Patients experience of illness. Discuss plans for discharge or future treatment Discharge information and follow up, Discharge medications, Community services/support 10
Assessment task 5: Clinical Inquiry Due date Monday 25 th May 2009 12 Noon Weighting 50% Length 3000 words (Your word count must be documented on your title page) Learning outcomes 4 and 5 Directions You are required to submit a person focused clinical inquiry of someone you have cared for during the semester. This paper is a scholarly piece of work, designed to give you the opportunity to draw on your previous studies in the Bachelor of Nursing programme. It will enable you to explore the experience of providing care to an individual within an acute care setting and to demonstrate your clinical knowledge by engaging with the literature and applying a problem solving approach. The clinical inquiry should discuss the person s experience of illness, including psychosocial dimensions, and include the person s perception of their illness/condition. The nursing management, pathophysiology, pharmacological management, medical management and interventions should also be discussed. Verbal consent must be obtained from the person you have selected. To protect the person s anonymity, assign the person a pseudonym and remove identifying details. Your person-focused clinical inquiry must discuss a client you cared for during your placement. It enables you to reflect on the experience of caring and to demonstrate your developing clinical knowledge by engaging with relevant literature. You should write your inquiry in the first person with clear reference to your own engagement with the person in the practice setting. Marking Criteria Introduction of the person and the reason for admission into the acute care facility. Clear analysis of the client s experience of illness including principles of therapeutic communication. A description and rationale of the pathophysiology relevant to the person.. Demonstrated nderstanding of the pathophysiology presented Comprehensive description and rationale for the nursing management provided to the person, including evidence of assessment? Evidence of understanding and rationale for the pharmacological interventions and a clear link to the person and the pathophysiology. An analysis of the medical interventions and rationale Development of a coherent analysis of the case and evidence of a wide review of the literature relevant to the identified problems. Referencing and presentation is in accordance with University guidelines 11
PLEASE REFER TO UNIT OUTLINE PART B FOR FURTHER DETAILS CONCERNING: Expectations of Students Occupational Health and Safety Flexible and Online Learning Using the UTAS Library Assessment Policy Academic referencing Academic integrity and plagiarism Submission of assignments Requests for extensions Penalties for late work without a formal extension How your final result is determined Issues Resolution Communication Procedure Generic Graduate Attributes 12