NURSING 3010 - Nursing in Complex Settings III

North Terrace Campus - Semester 2 - 2015

This course describes the professional and legal issues associated with the role of the Registered Nurse in the critical care setting. It introduces the skills necessary for a thorough nursing assessment such as interview, inspection, palpation, percussion and auscultation for patients in the critical care setting. It facilitates the learning of the psychosocial care of patients with particular needs in critical care and perioperative environments. It is a practical `hands on' oriented course.

  • General Course Information
    Course Details
    Course Code NURSING 3010
    Course Nursing in Complex Settings III
    Coordinating Unit School of Nursing
    Term Semester 2
    Level Undergraduate
    Location/s North Terrace Campus
    Units 3
    Contact Up to 6 hours per week
    Available for Study Abroad and Exchange N
    Course Description This course describes the professional and legal issues associated with the role of the Registered Nurse in the critical care setting. It introduces the skills necessary for a thorough nursing assessment such as interview, inspection, palpation, percussion and auscultation for patients in the critical care setting. It facilitates the learning of the psychosocial care of patients with particular needs in critical care and perioperative environments. It is a practical `hands on' oriented course.
    Course Staff

    Course Coordinator: Suzanne Sharrad

    Course Timetable

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

    Week Lecture Tutorial Clinical Skills Session PBL Tutorial
    1 An introduction to critical care environments Drug Calculation Test Preparation for coroner's cases Critically Ill Patient 1
    Session 1
    2 Legalities and ethics in critical care areas Psychosocial and culturally competent care in the critically ill Preparation for coroner's cases Critically Ill Patient 1 Session 2
    3 Assessment of the critically ill Critically Ill Patient 1 Session 3
    4 Primary and Secondary Survey Mechanisms of injury and assessment of the trauma patient Emergency Assessment - primary and secondary survey Critically Ill Patient 2 Session 1
    5 Advanced methods of respiratory support - part 1 Advanced methods of respiratory support - part 2 Emergency Assessment - primary and secondary survey Critically Ill Patient 2 Session 2
    6 Care of the intubated / unconscious patient Organ Donation Workshop Critically Ill Patient 2 Session 3
    7 Metabolic and nutritional support in critical illness Nasoenterive feeding and insulin infusions Critically Ill Patient 3
    Session 1
    8 Mechanical and pharmacological methods for support of CV function An introduction to the principles of haemodynamics Critically Ill Patient 3 Session 2
    9 Neurological assessment and support systems in critical care Poisoning ICP assessment and monitoring Critically Ill Patient 3 Session 3
    10 Renal dialysis in critical care Massive Blood Transfusion ICP assessment and monitoring Critically Ill Patient 4 Session 1
    11 Heat Stroke and near drowning Critically Ill Patient 4 Session 2
    12 Multiorgan failure - sepsis and ARDS Critically Ill Patient 4 Session 3
  • Learning Outcomes
    Course Learning Outcomes


    1. Demonstrate nursing skills compliant with the ANMC standards required to provide competent care to critically ill patients 

    2. Articulate legal, ethical and cultural issues surrounding professional nursing practice in critical care environments.

    3. Apply nursing assessment skills to complex presentations including assessments used in trauma related incidents.

    4. Understand and relate anatomy and physiology, pathophysiology and pharmacology to care of critically ill patients 

    5. Describe the nursing and nutritional care needs for the critically ill patient 

    6. Describe the care of a critically ill patient requiring either invasive or non-invasive forms of ventilation

    7. Identify methods for haemodynamic support in critical care 

    8. Identify methods for neurological support and management in trauma related or degenerative neurological disorders

    9. Distinguish methods for dialysis in critical care settings

    10. Distinguish environmental emergencies such as near drowning, poisoning and heat stroke

    11. Describe the nursing management of a critically ill patient presenting with multi-organ failure.

    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)
    Knowledge and understanding of the content and techniques of a chosen discipline at advanced levels that are internationally recognised. ALL
    The ability to locate, analyse, evaluate and synthesise information from a wide variety of sources in a planned and timely manner. 3
    An ability to apply effective, creative and innovative solutions, both independently and cooperatively, to current and future problems. 3-11
    Skills of a high order in interpersonal understanding, teamwork and communication. 5-11
    A proficiency in the appropriate use of contemporary technologies. 5-11
    A commitment to continuous learning and the capacity to maintain intellectual curiosity throughout life. 1
    A commitment to the highest standards of professional endeavour and the ability to take a leadership role in the community. 1, 2, 3.
    An awareness of ethical, social and cultural issues within a global context and their importance in the exercise of professional skills and responsibilities. 2.
  • Learning Resources
    Required Resources
    Brown, D & Edwards, (2015), Lewis’s medical-surgical nursing: assessment and management of clinical problems. 4th Edn, Mosby, Marrickville.

    Bullock, S. and E. Manias (2011). Fundamentals of Pharmacology myhealthprofessionskit with eBook. Frenchs Forest, Pearson Education Australia.
     
    Kozier, B., G. Erb, et al. (2010). Kozier and Erb's Fundamentals of Nursing. Frenchs Forest, Pearson Australia.

    Tollefson, J. (2012) Clinical Psychomotor Skills: Assessment tools for nursing students 5th edition Cengage Learning South Melbourne.
    Recommended Resources
    Elliott, D., Aitken, L. and Chaboyer, W.  (2012)  ACCCN's Critical Care Nursing.  2nd Edition, Mosby Elsevier, Chatswood.

    Harris, P., S. Nagy, et al. (2015). Mosby's dictionary of medicine, nursing & health professions. Chatswood, Mosby Elsevier.

    Lewis, P. and D. Foley (2014). Weber & Kelly's Health Assessment in Nursing. Broadway, Wolters Kluwer Health | Lippincott Williams & Wilkins.

    Jenkins, G., C. Kemnitz, et al. (2011). Anatomy and Physiology From Science to Life Media Pack 2011. Hoboken, John Wiley & Sons Australia Ltd.
     
    Porth, C. & Matfin, G. (2009) Pathophysiology: Concepts of Altered Health States 8th edition Wolters Kluwer Health/Lippincott William and Wilkins, Philadelphia.
  • Learning & Teaching Activities
    Learning & Teaching Modes
    1. Face to face lectures and tutorials – this course benefits from the real time delivery of content. Face to face lectures and tutorials offer synchronous learning opportunities and enable students to quickly clarify complex descriptions and terminology. Much of the content for this course is supported by textbooks with web page and e-learning supports. The School of Nursing supports the audio and video capture of lecture content as an aid to revision
    2. Problem Based Learning Tutorial sessions – PBL session enable small group discussion and peer interaction around a particular content. The PBL facilitator manages a staged release of information regarding the case at hand of which students need to formulate hypotheses and suggest interventions. The student group drives the direction of the inquiry and prepares a range of learning and resources for the following week where more details of the case are distributed. The facilitator will encourage and develop students to apply critical thinking of the scenario
    3. Clinical Skills sessions - The Robin Warren Skills Laboratory within the Faculty of Health Sciences provides a state of the art clinical training venue with dedicated nursing lecturers with expertise in low fidelity simulation. Students will perform skills such as assessment of haemodynamic and ventilation support systems, conduct a primary and secondary survey and relate the fundamentals of care to the critical care nursing environment. Establishing effective communication exchanges using ISBAR and principles of Team Stepps will be very relevant for student’s clinical placement. Further enhancement of the lab facility will enable high fidelity simulation to ensure the skills development of students occurs across the three years of the program. Clinical placement (aka professional experience) - The Australian Nursing and Midwifery Accreditation Council mandates that programs leading to registration as a nurse must have a minimum of 800 hours of professional experience. This course provides skills and knowledge that enable students to participate at a level commensurate with their progression. Students work closely with university Lecturer A staff (Clinical Tutors) and clinicians to reinforce learning and ensure consistency of course objectives. The objective of the professional experience associated with this course is to provide students an opportunity to interact with critical care settings such as intensive care, emergency and coronary care. At this stage of the program students would, with supervision, be expected to assume responsibility (under supervision) for the care of 1-2 people who are critically ill.
    4. Clinical placement (aka professional experience) - The Australian Nursing and Midwifery Accreditation Council mandates that programs leading to registration as a nurse must have a minimum of 800 hours of professional experience. This course provides skills and knowledge that enable students to participate at a level commensurate with their progression. Students work closely with university Lecturer A staff (Clinical Tutors) and clinicians to reinforce learning and ensure consistency of course objectives. The objective of the professional experience associated with this course is to extend students skills in the advanced assessment of paediatric and maternal populations. A sound understanding of psychosocial development and pathophysiology is expected of students placed within a paediatric setting. At this stage of the program students would, with supervision, be expected to assume responsibility (under supervision) for the care of 4 people according to the nature of the clinical placement.
    Workload

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

    WORKLOAD
    The workload for this course requires attendance at:
    · 1 x 2 hour lecture / week
    · 8 x 1 hour tutorials / semester
    · 4 x 1 hour clinical skills sessions / semester
    · 12 x 2 hour PBL tutorial / semester
    Non contact hours for assessment and tutorial preparation will be 5 hours / week
    Learning Activities Summary


    Lectures and Tutorials
    1. An introduction to critical care environments
    2. Legalities and Ethics in Critical Care Areas
    3. Psychosocial and Culturally Competent Care of the Critically Ill Patient
    4. Assessment practices for the critically ill
    5. Primary and secondary survey
    6. Advanced methods of respiratory support – part 1
    7. Advanced methods of respiratory support – part 2
    8. Care of the intubated / unconscious patient
    9. Metabolic and nutritional support in critical illness
    10. An introduction to principles of haemodynamics
    11. Mechanical and pharmacological methods for support of cardiovascular function
    12. Neurological assessment and support systems in critical care
    13. Renal dialysis in critical care
    14. Poisoning
    15. Heat stroke and near drowning
    16. Mechanisms of injury and assessment of the trauma patient
    17. Multi organ failure – sepsis and ARDS
    18. Massive blood transfusion
    19. Organ Donation Workshop

    PBL
    1. Critically ill patient 1
    2. Critically ill patient 2
    3. Critically ill patient 3
    4. Critically ill patient 4 

    Clinical skills session
    1. Emergency assessment - Primary and secondary survey
    2. Nasoenteric Feeding & Insulin infusions
    3. Preparation for coroners cases
    4. ICP assessment and monitoring 

  • 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 No. Assessment Name Assessment Type Weighting
    1 Drug Calculation Test Formative 0%
    2 Construction of a Concept Map Summative 40%
    3 PBL Participation and Attendance Summative 10%
    4 Clinical Skills Worksheet Portfolio Summative 10%
    5 Clinical Record/NCAS/Clinical Summative Assessment Summative NGP
    6 Structured Clinical Assessment (Written) Summative 40%
    Assessment Related Requirements
    All rubrics and marking guides for each assessment item will be found in the study guide and on MyUni.
    Assessment Detail
    Assessment 1: Drug Calculation test

    Attendance to this Tutorial is Mandatory.
    A Drug Calculation Test of 20 items will be undertaken by students in the NP 3A tutorial time. Students will be provided with repeated opportunities to achieve 100% accuracy in this tutorial. However, failure to meet 100% accuracy will preclude students from administering medication in the clinical environment and will necessitate the implementation of an ‘Early Intervention Strategy’ for remedial work in drug calculations.

    No calculators will be permitted to be used in this test.


    Assessment 2: PBL Participation and Attendance

    Students will be required to sign a weekly attendance record. Attendance to PBL tutorials is compulsory and a medical certificate is required for non-attendance. An assessment of participation will be conducted, by the PBL Tutor weekly for students to be able to earn the allocated percentage for this assessment item.

    Assessment 3: Construction of a Concept Map

    Construction of a concept map and discussion paper. Creation of a concept map is described by Wheeler and Collins (2003) as a way to stimulate learning and enhance the reasoning process. You are required to select any of the Critical Care Cases from the PBL series for this semester and using the single case as a central theme, create a concept map.
    Students are encouraged to include concepts and information that pertain to the lecture and tutorial series of this course.
    A 1000 word briefing paper is to accompany the concept map. The briefing paper is an analysis of how the concept map was constructed rather than a description of the case you have chosen. The briefing paper should therefore provide a description of how your data has been integrated into the map.

    Assessment 4: Assessment of Clinical Skills Portfolio

    As per the timetable, students will be required to attend mandatory clinical skills session in the Robin Warren Clinical Skills Laboratory. In these sessions students will be required to complete a worksheet which pertains to the weekly activities. In each worksheet, students will also need to document a passage of self reflection which is no more than 250 words in length. These worksheets are to be used to formulate a portfolio of activities for the semester. This portfolio is to be submitted at the end of the semester for assessment. Satisfactory completion of the worksheets and compulsory attendance to the sessions will earn students the allocated percentage for this assessment item.


    Assessment 5: Clinical record / NCAS / Clinical Summative Assessment

    The Clinical Record (Tollefson) identifies a range of competencies as required by the Nursing and Midwifery Board of Australia Competency Standards of the Registered Nurse 2006. Students will have a range of skills records to complete during their clinical placement. The Clinical Record provides evidence that the student has demonstrated the required level of competency standard. Consistent with competency type assessments a non – graded pass is awarded. Some remedial opportunities will be available to those students who fail or are not exposed to certain competencies in the clinical setting. The Clinical Record forms part of the broader portfolio developed across each year of the program and provides a consistent reference for students nursing skill development. Due to the allocation of clinical placements from an external body, CLINEDSA, some components of the Clinical Record may be completed across Health Assessment and Clinical Nursing 3 and 4 however students must make satisfactory progress towards completing the record wherever possible. The Clinical Record also provides the 4Rs reflective framework for clinical teaching staff and students.

    In addition to the skills record each student is to obtain a completed NCAS (National Competency Assessment Schedule) at the end of each placement. There are a total of 8 competencies to be completed over the 3 year program. A written Summative Assessment must also be obtained at the end of each placement which will be completed by the supervising Registered Nurse and Clinical Lecturer.

    Assessment 6: Structured Clinical Assessment (written)

    Structured Clinical Assessment – a two (2) hour written assessment of a patient scenario, which will follow the same process as conducted in PBL and include all the lecture, tutorial and PBL content of Nursing in Complex Settings 3.
    Submission
    Using Turnitin
    Assessment submission information This semester we are using Turnitin for assessment submission. Please refer to your study guide for assessment details and the information below about Turnitin. Turnitin is an electronic program that enables students to check that they are referencing correctly. It also enables more efficient feedback as assignments submitted via Turnitin are assessed using an online process. Step-by-step instructions for submitting an assignment using Turnitin are on this webpage: http://www.adelaide.edu.au/myuni/student/tutorials/content/Turnitin-Submitting-a-Turnitin-Assignment-as-a-Student.html When you submit an assignment to this program, you will receive an "originality report" and an "originality score" - these will let you know if you have accidently used the words of other authors - any areas of your work that are too close to your cited or other resources will be highlighted. To see this report after you have submitted your assignment, go back into the program and click on "view" - this will show you your assignment with any similar text highlighted. Bear in mind that this program is very sensitive - don't worry too much if you seem to have a high originality score as the program includes quotes and references in the count. However, it is important that you check the text that is highlighted, if it is a correctly referenced quote or an item in your reference list that is highlighted then you can ignore it but if the highlighted text that isn't a quote or reference you will need to re-write those sections in your own words. After you have submitted your assignment you will receive an email confirming that your assignment has been submitted correctly. If you do not receive this email then go back and try again. Keep the email you receive, just in case there are any issues with your assignment submission as we may need to view it to confirm your submission date and time. You can submit multiple times to this program - each new submission supersedes the previous, so we will only ever mark the latest version of your assignment! We encourage all students to practice with Turnitin before the final due date to make sure you know what you're doing. A word of warning: although the program permits multiple submissions from a single student, Turnitin has a 24-hour lag between assignment submissions. For example, if you submit an assignment to the program at 10am on Sunday, you may not be able to submit again until 10am Monday! Be very careful to avoid a situation wherein you are unable to submit the final version of your assignment until after the final deadline. Falling into the 24hr lag window will not be grounds to avoid a lateness penalty, so if this happens you will need to use the online extension form. If at any time you are having trouble submitting your assignment, please let us know ASAP so we can make alternate arrangements and please contact the Service Desk on 08 8313 3000 (open 24 hours).
    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.

    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.

  • Student Support
  • Policies & Guidelines
  • Fraud Awareness

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