NURSING 7118 - Critical Care Essentials

North Terrace Campus - Semester 2 - 2021

This course will prepare clinicians practicing in critical care environments to assess, identify and manage those patients experiencing (or with the potential to experience) a critical physiological decline. This will include the identification of the deteriorating patient, incorporating advanced assessment skills and advanced life support skills. These specialised critical care skills will enable the clinician to participate in the holistic approach to the delivery of critical care within the framework of a multidisciplinary team.

  • General Course Information
    Course Details
    Course Code NURSING 7118
    Course Critical Care Essentials
    Coordinating Unit Adelaide Nursing School
    Term Semester 2
    Level Postgraduate Coursework
    Location/s North Terrace Campus
    Units 3
    Contact Flexible delivery mode and three on-campus workshops
    Available for Study Abroad and Exchange N
    Assumed Knowledge Anatomy and Physiology
    Restrictions Available to M.NSc and G.DipNurSc students only
    Course Description This course will prepare clinicians practicing in critical care environments to assess, identify and manage those patients experiencing (or with the potential to experience) a critical physiological decline. This will include the identification of the deteriorating patient, incorporating advanced assessment skills and advanced life support skills. These specialised critical care skills will enable the clinician to participate in the holistic approach to the delivery of critical care within the framework of a multidisciplinary team.
    Course Staff

    Course Coordinator: Mr Iain Everett

    Course Coordinators:

    Iain Everett

    +61 8 8313 4308

    iain.everett@adelaide.edu.au

    Adelaide Nursing School

    Course Timetable

    The full timetable of all activities for this course can be accessed from Course Planner.

  • Learning Outcomes
    Course Learning Outcomes
    1 Formulate and undertake a focussed and systematic advanced health assessment
    2 Through synthesis and analysis of the course content, identify those patients that have the potential to experience a critical physiological decline
    3 Appraise the findings of the systematic health assessment and interpret abnormal physiological parameters and other abnormal observations assisting in the identification of those patients experiencing a critical physiological decline.
    4 Develop and integrate clinical skills and academic knowledge in order to practice advanced assessment, life support and therapeutic skills
    5 Participate in the delivery of advanced critical care interventions within a multidisciplinary team
    6 Critique and discuss clinical practice in view of current evidence based guidelines and consensus statements.
    7 Debate the multi-disciplinary team approach to the recognition and response to the patient experiencing an acute physiological deterioration
    8 Engage in the delivery of high quality evidence based multidisciplinary care as either a team member or team leader.
    University Graduate Attributes

    This course will provide students with an opportunity to develop the Graduate Attribute(s) specified below:

    University Graduate Attribute Course Learning Outcome(s)
    Deep discipline knowledge
    • informed and infused by cutting edge research, scaffolded throughout their program of studies
    • acquired from personal interaction with research active educators, from year 1
    • accredited or validated against national or international standards (for relevant programs)
    4-8
    Critical thinking and problem solving
    • steeped in research methods and rigor
    • based on empirical evidence and the scientific approach to knowledge development
    • demonstrated through appropriate and relevant assessment
    2, 3 , 6 &7
    Teamwork and communication skills
    • developed from, with, and via the SGDE
    • honed through assessment and practice throughout the program of studies
    • encouraged and valued in all aspects of learning
    7-8
    Career and leadership readiness
    • technology savvy
    • professional and, where relevant, fully accredited
    • forward thinking and well informed
    • tested and validated by work based experiences
    3-5
    Intercultural and ethical competency
    • adept at operating in other cultures
    • comfortable with different nationalities and social contexts
    • able to determine and contribute to desirable social outcomes
    • demonstrated by study abroad or with an understanding of indigenous knowledges
    1-3, 6
    Self-awareness and emotional intelligence
    • a capacity for self-reflection and a willingness to engage in self-appraisal
    • open to objective and constructive feedback from supervisors and peers
    • able to negotiate difficult social situations, defuse conflict and engage positively in purposeful debate
    4 & 6
  • Learning Resources
    Required Resources
    Prescribed Texts
    The prescribed texts are integral to the course. This course will require the following texts and other resources:

    Aehlert, B 2017, ACLS Study guide, 5th edn, Mosby Elsevier St Louis.

    AND

    Talley, NJ & O’Connor, S 2018, Clinical examination: a systematic guide to physical diagnosis, 8th edn, Churchill/Livingstone, Elsevier, Sydney.

    Recommended Text

    Adam , S Odell , M  & Welch , J.  2013 , Rapid Assessment of the Acutely Ill patient , Wiley-Blackwell, Chiester.
    Note:  students are not required to purchase the recommnede texts. However , they provide a valuable supplementary reading on various aspects of the material covered within this course and so students are encourage to review them.

    Reader
    The readings for this course are available electronically via MyUni. There are also essential practice guidelines integral to the course available via MyUni.

    Please note: it is your responsibility to organise printing should you prefer a hard copy of the reader.
    Online Learning
    MyUni
    All students enrolled in a postgraduate coursework nursing program have access to the School of Nursing – Postgraduate Coursework Student Centre on MyUni. If you would like the opportunity to network with other students, you can use the Communication features in the site. This site will also feature information about the latest news and events at the School of Nursing.

    Unified
    http://unified.adelaide.edu.au/
    UNIFIED is your one-stop shop for email, calendar, MyUni and Access Adelaide. It even allows you to search the Library.
    UNIFIED is available to all active students; with a single login you can access your student systems and personal information through a central website. Login with your Student ID ("a1234567") and Password.

    For more information, including easy to follow instructions visit https://unified.adelaide.edu.au/web/mycampus/home.

    Library Resources
    Help for Nursing Students
    The University of Adelaide Library has a website to help nursing students use the library and its resource (www.library.adelaide.edu.au/guide/med/nursing).

    Remote student library service
    The University of Adelaide Library provides a document delivery and loans service to non-metropolitan students who do not visit a University of Adelaide campus to attend classes (www.adelaide.edu.au/library/docdel/external.html).
  • Learning & Teaching Activities
    Learning & Teaching Modes

    This course will be delivered through mixed modes, as follows:

    Self directed learning
    Students will be required to complete a series of readings, critical review and activities for each week. These will be supplemented with web links, resources and online activities – including articulate storyline lectures.

    Workshops
    There will be 3 x 8 hour workshops. There will be information to access and  review prior to each workshop which are scenario /Simulation based  interactive  tutorials and practical sessions. They will build on the discussions and activities developed by the weekly readings.

    Semester 1 Workshops*
    - Friday Week 3 : 0830-1630hrs
    - Friday Week 7: 0830-1630hrs
    - Friday Week 10 : 0830-1630hrs

    Semester 2 Workshops*
    - Friday Week 3: 0830-1630
    - Friday week 7 : 0830-1630
    - Friday Week 10 : 0830-1630
     
    * Please note the weeks are subject to change and timetabling, and so please refer to MyUni course home page to determine venue and date.

    Details will be provided via MyUni of workshop locations and timetables.

    The workshops are intended to be participative. In other words, the amount you learn from them will depend on your participation. It is essential that students do the necessary reading, review articulate storyline lectures so that we all start from common ground, as we will not have time to recap during the workshops. It is expected that the workshops will be both enlightening and enjoyable!

    Please ensure you attend the workshops appropriately attired with suitable clothing and shoes for clinical practice, as some workshops will be based in the clinical environment.

    Field based learning
    Students will develop the theoretical knowledge through clinical application. Students are required to work a minimum of 300 clinical hours in their area of specialty during this course.

    Workload

    The information below is provided as a guide to assist students in engaging appropriately with the course requirements.

    This course is delivered in a mixed mode. The student is required to undertake the readings, perform the reflective activities prior to attending the workshops. There are three 8 hour workshops throughout the semester.

    It is recommended that you plan your time commitment to the course at the beginning of the semester. This includes all study activities, attendance at workshops, readings and assessment. This course requires approximately 12 hours of study per week on average.

    Online Content

    A series of short powerpoint presentations and podcasts will be provided throughout the course, as a student, it is your responsibility access these prior to attending the workshops.

    Readings
    A reading list has been compiled for this course and will be made available through MyUni. Lecture and readings have been carefully chosen. All of these are required and recommended readings have been selected to optimise your knowledge on the topic and so that they will continue to be of use after you graduate.

    Worskshops
    The workshops are intended to be interactive. In other words, the amount you learn from them will depend on your participation. It is essential that students do the necessary reading and undertake the required activities so that we all start from common ground,. It is expected that the workshops will be both enlightening and enjoyable! The focus of the workshops will be the practical application and demonstration of skills associated with the patient likely to or experiencing critical physiological decline. The emphasis will be on practising the skills necessary to perform basic through to advanced life support for the patient, included will be consideration of team function and care of the relative/ significant other.

    Field based learning
    Students will develop the theoretical knowledge through clinical application. Students are required to work a minimum of 300 clinical hours in their area of specialty during this course.
    Learning Activities Summary

    This course considers the skills and knowledge required to enable early detection, assessment, monitoring and prompt and effective actions for minimising adverse events such as cardiac arrest, associated with the acutely deteriorating patient. Particular focus is given to early intervention, stabilisation and resuscitation care in this population. The importance of a system wide approach, effective clinical communication, and patient focused and appropriate care will be discussed. Membership of a multidisciplinary rapid response team will be reviewed.

     

     

    Critical Care Essentials Clinical Skills

    Assessment

    Performing a Primary Assessment / Primary Survey

    Performing a Respiratory Assessment

    Performing a Cardiovascular Assessment

    Performing a Neurological Assessment

    Airway

    Establishing an Artificial Airway

    Assisting with Intubation

    Endotracheal Tube Security

    Breathing

    Capnography

    Pulse Oximetry Technique

    Hand Ventilation with a Bag and Mask

    Performing Hand Ventilation of an Intubated/Tracheostomised Patient

    Circulation

    Care of a Patient requiring ECG Monitoring

    Principles of Monitoring with Transducers

    Defibrillation/Cardioversion

    External Cardiac (Transcutaneous) Pacing

    Equipment

    Function of a Defibrillator

    Operation of the Transport Monitor

    Setting up the Transport Ventilator

     

    Specific Course Requirements
    In order to enrol in this course, students must be employed in one of the following areas – Intensive Care , Cardiac or Emergency areas on an average of 24 hours per week.
    Small Group Discovery Experience

    It is our endeavour to have Small Group Discovery (SGDE) experiences for many of our tutorial based exercises during our face to face time with students. Groups will be allocated to work together on clinical scenarios and problems that will be explored for solutions/actions that reflect evidence based care, professional team work and best practice.
  • Assessment

    The University's policy on Assessment for Coursework Programs is based on the following four principles:

    1. Assessment must encourage and reinforce learning.
    2. Assessment must enable robust and fair judgements about student performance.
    3. Assessment practices must be fair and equitable to students and give them the opportunity to demonstrate what they have learned.
    4. Assessment must maintain academic standards.

    Assessment Summary
    Assessment Task Assessment Type Weighting Learning Outcome(s) being addressed
    Clinical Assessment Sheets (500 words) Formative 0% Pass/Fail 1-2
    Clinical Assessment Sheets II and III (1250 and 1500 words each) Summative 35% and 50% 1-3, 6-8
    Structured Clinical Assessment Formative Hurdle assessment 0%
    Pass/Fail
    1-8
    Quizzes Quizzes x 3, 5% each 15 % 1, 4, 5, 7, 8
    Assessment Related Requirements

    1. The diaries will be graded pass or fail. Failure to submit may preclude participation in the Structured Clinical Assessment
    2. Multiple Choice Questions (80% Pass mark required) this assessment provides immediate feedback for the student with regard to areas requiring further study/ revision prior to participating in the Structured Clinical Assessment. The multiple choice questions are provided online for the revision period up to and including the day prior to the structured clinical assessment. Multiple attempts are permitted.

    Assessment Detail
    Clinical Assessment Sheets (CAS)
    Students will be required to complete three Clinical Assessment Sheets (CAS I - III).
    CAS1 (500 words) is the formative assessment which is a NGP is due week 3 to provide early feedback to students

    The CAS are designed so that students directly relate the theory gained within the course to practice in the critical care environment. Students will be required to answer the CAS in relation to patients they care for. A high academic standard is expected.

    Note: Confidentiality
    The patient’s anonymity must be maintained. The use of a pseudonym is required. The pseudonym must also be clearly identified in text. For example: “Fred (pseudonym) was a 51 year male admitted with an acute exacerbation of chronic obstructive airways disease”.
    Do not include any other information that may potentially identify the patient or institution, including places, dates, times or events. Patient  Consent will be needed if required for the particular assessment. 

    Structured Clinical Assessment
    This practical-based examination will test the student's ability to apply knowledge to practice. The examination will cover the skills and knowledge taught in Critical Care Essentials.

    Procedure Guide—Structured Clinical Assessment
    The assessment will present the student with advanced life support scenarios in a series of skills stations. The stations will include:

    • Multiple Choice Questions (80% Pass mark required) this assessment provides immediate feedback for the student with regard to areas requiring further study/ revision prior to participating in the Structured Clinical Assessment. The multiple choice questions are provided online for the revision period up to and including the day prior to the structured clinical assessment. Multiple attempts are permitted.
    • ALS scenarios (students must pass all scenarios)
    Scenarios include:
    - Airway management
    - Defibrillation
    - Cardioversion
    - Transcutaneous pacing

    Clinical Skills Diary
    The assessment of skills will occur throughout the semester. Students will be assessed by the critical care registered nurses and clinical titleholders, with whom they work. Please refer to the information provided in the Clinical Skills Diary regarding skills assessment criteria.

    The diaries will be graded pass or fail. Failure to submit may preclude participation in the Structured Clinical Assessment.

    Diaries should be submitted to the School of Nursing via post or in person by 1630hrs on the due date.
    Submission
    Assessments, unless otherwise stated in your Study guide, are to be submitted electronically via Assignments in MyUni "through Turnitin" on the due date identified in this Study guide. Instructions for assignment submission are available for all students under Tutorials at www.adelaide.edu.au/myuni/.

    An assessment submitted via MyUni must be submitted as a .doc, .docx or .rtf file. If submitting a PowerPoint presentation for marking, the .ppt or .pptx must be submitted as .pdf file. It is also important to submit your file under your name, such as surname.firstname. MyUni stamps all the other details against your filename once you submit your assessment.
    Clinical Skills Diaries should be submitted via post or in person by 1630hrs on the due date.
    Postal Address:
    School of Nursing
    Frome Road
    The University of Adelaide
    Adelaide SA 5005

    In Person:
    School of Nursing
    Level 3, Eleanor Harrald Building
    Royal Adelaide Hospital
    Frome Road
    The University of Adelaide
    Adelaide SA 5005
    Course Grading

    Grades for your performance in this course will be awarded in accordance with the following scheme:

    M10 (Coursework Mark Scheme)
    Grade Mark Description
    FNS   Fail No Submission
    F 1-49 Fail
    P 50-64 Pass
    C 65-74 Credit
    D 75-84 Distinction
    HD 85-100 High Distinction
    CN   Continuing
    NFE   No Formal Examination
    RP   Result Pending

    Further details of the grades/results can be obtained from Examinations.

    Grade Descriptors are available which provide a general guide to the standard of work that is expected at each grade level. More information at Assessment for Coursework Programs.

     

    Plagiarism

    Students are reminded that plagiarism and other forms of academic dishonesty constitute a serious offence and can result in disciplinary procedures. Students are advised to read the policy Academic Honesty and Assessment Obligations for Coursework Students Policy & Coursework Students: Academic Dishonesty Procedures policy, available at www.adelaide.edu.au/policies/230/.  The following definitions should be noted. 

     

    Referencing: providing a full bibliographic reference to the source of the citation (in a style as determined by the School).

    Quotation: placing an excerpt from an original source into a paper using either quotation marks or indentation, with the source cited, using an approved referencing system in order to give credit to the original author.

    Paraphrasing: repeating a section of text using different words which retain the original meaning.

    Please note: changing just a few words does not constitute paraphrasing.

     

    Final results for this course will be made available through Access Adelaide (https://access.adelaide.edu.au/sa/login.asp)

     

     

                    Marking Guides

                Clinical Assessments Sheets

     

    Answer Content (70%)

           provides concise relevant and accurate patient history

           all components of the questions are addressed and covered appropriately

           demonstrates application of theory to clinical practice

           demonstrates a depth of understanding of the topic and associated significant issues

           demonstrates critical thought and insight by providing justification and rationale for answers.

    Writing Style, Presentation and Confidentiality (20%)

    Writing Style and Presentation (10%)

           the clinical assessment sheet answers are written with clear sentence structure, clarity of argument, precision of expression and the spelling and grammar are correct.

           the CAS answers are clearly identified

           presentation complies with the School of Nursing  Student Handbook and Style Guide.

    Confidentiality (10%)

           patient anonymity is maintained at all times

           the use of a pseudonym must be clearly identified

           all identifying features including patient admission dates, URN / hospital id, treating hospital have been excluded.

    Referencing (10%)

           the referencing style used throughout the paper is congruent with the School’s Student Handbook and Style Guide

           the reference list is accurate (i.e. no missing page numbers, volumes, correct title etc), complete (i.e. no references in the body of the paper are missing from the reference list) and consistent with the School’s Student Handbook and Style Guide

           the references cited are contemporary (i.e. less than 10 years old unless seminal papers)

           primary references are used predominantly (i.e. the original reference has been cited rather than a secondary source)

           there is evidence in the paper that the student has searched widely for information related to the topic/issue

           the student has acknowledged all sources of information

           direct quotations are only used to make crucial points or to support the discussion/argument.

     

    Final results for this course will be made available through Access Adelaide.

  • Student Feedback

    The University places a high priority on approaches to learning and teaching that enhance the student experience. Feedback is sought from students in a variety of ways including on-going engagement with staff, the use of online discussion boards and the use of Student Experience of Learning and Teaching (SELT) surveys as well as GOS surveys and Program reviews.

    SELTs are an important source of information to inform individual teaching practice, decisions about teaching duties, and course and program curriculum design. They enable the University to assess how effectively its learning environments and teaching practices facilitate student engagement and learning outcomes. Under the current SELT Policy (http://www.adelaide.edu.au/policies/101/) course SELTs are mandated and must be conducted at the conclusion of each term/semester/trimester for every course offering. Feedback on issues raised through course SELT surveys is made available to enrolled students through various resources (e.g. MyUni). In addition aggregated course SELT data is available.

    What are the best aspects of this course?
    The workshops
    Scenario based and hands on training
    Hands on interaction with quality teachers
    Teachers very helpfully and considerate.
    CLINICAL WORKSHOPS IN SIM SUIT

    Which aspects of this course need improvement?
    More workshops 







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  • Policies & Guidelines
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