NRSG372 - Principles of Nursing: Chronic Illness and Disability

Year

Credit points

Campus offering

Prerequisites

NRSG267 Integrating Practice 4 AND NRSG264 Integrating Practice 3

Unit rationale, description and aim

The Registered Nurse plays an important role in the multidisciplinary team in provision of care for people with long–term chronic illness and disability. This unit is required by students to assist them achieve knowledge and skills in relation to chronic illness, disability and evidence–based practices to enable safe, effective and culturally sensitive care, including educating clients and supporting them to manage themselves long–term.

Case studies, informed by the Australian National Health priorities, will enable students to explore the common diseases and disabilities across the life span to support the provision of holistic evidence–based care. The role of the Registered Nurse in facilitating patient centred care for persons with chronic illness and/or disability will be examined in relation to a variety of settings and patient journeys.

The aim of this unit is to assist students to critically analyse the impact of chronic illness and/or disability on the person, family and community.

2020:

The Registered Nurse plays an important role in the multidisciplinary team in provision of care for people with long–term chronic illness and disability. This unit is required by students to assist them achieve knowledge and skills in relation to chronic illness, disability and evidence–based practices to enable safe, effective and culturally sensitive care, including educating clients and supporting them to manage themselves long–term.

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - demonstrate advanced understanding of developmental, lifespan, social, spiritual and cultural factors that impact on the quality of life of people experiencing chronic illness and/or disability and their families; (GA1, GA4, GA5)

LO2 - critically apply the Roper-Logan-Tierney Model of Nursing across the lifespan, to the principles of caring for people experiencing chronic illness and/or disability and their families; (GA1, GA, GA5, GA9)

LO3 - use advanced pathophysiological knowledge to implement the Levett-Jones’ Clinical Reasoning Cycle across a range of settings, to plan safe, evidence-based, culturally sensitive, person-centred care; (GA3, GA4, GA5, GA8, GA9)

LO4 - critically apply quality use of medicines, non-pharmacological therapeutic interventions, complementary therapies, goal setting and eHealth strategies in the chronic illness and disability context; (GA1, GA3, GA4, GA5, GA7, GA8) 

LO5 - apply legal and ethical principles related to the chronic illness and disability context; (GA3)

LO6 - reflect on the lived experiences of the person with chronic illness and/or disability, their family and community. (GA1, GA2)

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity 

GA2 - recognise their responsibility to the common good, the environment and society 

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA7 - work both autonomously and collaboratively 

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA9 - demonstrate effective communication in oral and written English language and visual media 

NMBA REGISTERED NURSE STANDARDS FOR PRACTICE

The Nursing and Midwifery Board of Australia’s Registered Nurse Standards for Practice developed in this unit are:

Content

Topics will include:

• Principles of chronic illness and disability
• Global overview of chronic illness and disability 
• Chronic illness and disability in an Australian context
• Differentiation of key terms: Chronic illness, Chronic disease, long term conditions, disability and co-morbidity  
• Trajectory of illness: Range of settings and continuum of care
• Impact of chronic illness and/or disability for person, family and community
• Physical
• Psychosocial
• Cultural
• Spiritual
• Lifespan

• Therapeutic use of professional relationships 
• Nurses role in restorative practice
• Collaboration
• Partnerships
• Relationships
• Building capacity and resilience in the person, their family and carer
• Self-awareness
• Professional communication
• Therapeutic use of self and communication strategies
• Active listening skills
• Motivational Interviewing
• Teaching skills

• Principles for Practice
• Pathophysiology of selected chronic illnesses and disability (those identified as National Health Care Priorities or relating to National Health Care Priorities) 
• Patient-centred care,  and goal setting 
• Role of the nurse including assessment, planning and evaluation of care
• Coordination of care
• Role of the interdisciplinary/multidisciplinary teams and multi-sectorial partnerships
• Models of care for management of chronic illness and/or disability
• Chronic condition self-management
• NDIS
• Legal and ethical issues 
• Chronic pain management 
• Common therapeutic approaches
• Pharmacological
• Non-pharmacological
• Complimentary therapies and alternative medicines
• Issues of Sexuality  

• Optimising function 
• Self-management
• Promoting independence
• Restorative practices
• Educational resources for health promotion and prevention
• eHealth mediation and management of chronic disease
• Telehealth and the management of chronic conditions in rural communities
• Rehabilitation and habilitation

Learning and teaching strategy and rationale

Modes of delivery in this unit include lectures, seminars, tutorials, laboratiories, simulations, online activities and self-directed study. Consistent with adult learning principles, the teaching and learning strategies used within these modes of delivery will provide students with foundational knowledge and skills relevant to professional nursing practice. These strategies will also support students in meeting the aim, learning outcomes and graduate attributes of the unit and the broader course learning outcomes. Learning and teaching strategies will reflect respect for the individual as an independent learner. Students will be expected to take responsibility for their learning and to participate actively with peers. 

Students exiting university need significant life-long learning skills to deliver sound, ongoing, evidence-based graduate practice as a member of the professional workforce. To embed life-long learning skills students must demonstrate increasing reflective capacity to identify what is being done well and what requires additional work in progressing toward required learning outcomes. Located in the third year of the programme, this theory unit includes some face-to-face teaching hours and an increased online component of learning. Lectures are utilised to convey content and central principles while tutorials deliver interactive and student-driven learning sessions to extend the community of learners, and increase their self-reliance, critical reflection and debate. Online materials provide students with the opportunity to undertake directed, self-motivated study and continue to transition to  independent study and life-long learning. 

Assessment strategy and rationale

A range of assessment items consistent with University assessment requirements and policy will be used to ensure students achieve the unit learning outcomes and attain the graduate attributes.

Third year sees students continue their transition towards independent learning. In this unit, there are two 50% assessment items, therefore the importance of each item is higher in terms of achievement of unit learning outcomes and graduate attributes. The written assignment uses a case study to engage students with chronic illness and disability and to demonstrate an understanding of the identification and prioritisation of issues of care – critical skills required by the Registered Nurse. The health promotion resource reinforces the need for discharge and community education as well as the long-term care of an individual and community. Skills necessary for graduate practice include an understanding that the role of a nurse can extend beyond the immediate care they provide into the long-term management of individuals following their move away from health facility management. 

Overview of assessments

Representative texts and references

Australian Institute of Health and Welfare. (2014) Australian Health 2014. Retrieved from http://www.aihw.gov.au/australias-health/2014/

Chang, E., & Johnson, A. (2014). Chronic illness and disability. Principles for nursing practice (2nd ed.). London, U.K.: Elsevier.

Haley, C. (Ed.). (2015). Pillitteri's child and family health nursing in Australia and New Zealand (2nd ed.). North Ryde, N.S.W.: Wolters Kluwer.

Holland, K., Jenkins, J., Solomon, J.,& Whittam, S. (2008). Applying the Roper-Logan-Tierney Model in Practice. London: Churchill Livingston.  

Larsen, P. D., & Lubkin, I. M. (2016). Chronic illness: Impact and intervention (9th ed.). Sudbury, Massachusetts: Jones and Bartlett.

Levett-Jones, T. (2013). Clinical Reasoning: Learning to think like a nurse. Frenchs Forest, N.S.W.: Pearson.

World Health Organization. (2015). Non communicable diseases. Retrieved from http://www.who.int/ncds/en/