NRSG528 - Gerontological Nursing: Promoting Health and Wellness in Older Persons

Year

Credit points

Campus offering

Prerequisites

NRSG524 Advanced Pathophysiology for Specialty Nursing Practice AND NRSG525 Evidence-based, Person-centred Family Care in Specialty Nursing Practice

Unit rationale, description and aim

The pathophysiological and psychosocial changes that occur during the ageing process contributes to the older person's vulnerability, and predisposes them to various risk factors and chronic health diseases that require complex, person-centred care. In order to be effective healthcare practitioners, nurses working in gerontological settings must have a range of knowledge and skills to successfully care for older persons with acute and complex care needs. Gerontological nurses must apply their understanding of scientific knowledge to inform risk assessment, clinical decision-making and implementation of risk mitigation strategies to ensure the delivery of quality and safe person-centred care to older persons.

This unit is required by students because older persons require a multi-faceted approach to care. Older persons are frail, prone to harm and require timely identification and escalation of deterioration. It is critical that gerontological nurses are equipped with the specialist knowledge and skills to effectively care for older persons through the application of evidence based, ethical practice. Selection of content is based on the complexity of care required by older persons and the recent advances in gerontology and gerontological nursing. Key concepts of health and wellness, aged related health conditions, pain, pharmacotherapy and comprehensive risk assessment of older persons will be explored to assist students with skills in analysis, evaluation, and application of person-centred care in the gerontological setting.

The aim of this unit is to support students to evaluate the complexity of older person care while developing knowledge and skills to critically appraise and evaluate evidence to ensure older persons are cared for in a way that is respectful and promotes health and wellbeing.

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 - Assess the ageing process, whilst critically reflecting upon the key pathophysiological concepts that contribute to comorbidity and complex care for older persons (GA3, GA4, GA8, GA9)

LO2 - Evaluate the psychosocial factors that contribute to the ageing process and how they influence the older person’s health and wellbeing (GA1, GA2, GA5, GA8, GA9)

LO3 - Examine the risk factors for older persons and appraise and implement a range of assessment techniques and strategies used for harm mitigation (GA4, GA5, GA8, GA9)

LO4 - Appraise the relationship between age related changes and the risk factors associated with pharmacotherapy in older persons (GA4, GA5, GA8, GA9, GA10)

LO5 - Analyse the complexity of person-centred and culturally safe care in older persons (GA1, GA3, GA5)

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 

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

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

GA10 - utilise information and communication and other relevant technologies effectively

Content

Topics will include:

 Health and Wellness

• Understanding the ageing process
• Attitudes
• Perspectives
• Physiological changes in older persons
• Physical changes
• Psychosocial changes
• Socioeconomic changes

Healthy Ageing

• Theoretical underpinnings – Psychosocial theories of ageing
• WHO ‘Active Ageing Framework’
• 6 domains – social, economic, civic, cultural, spiritual and physical
• Successful ageing - Promotion of activity & active participation in society
• Determinants of ageing
• Psychosocial factors of ageing

Age related health conditions

• Systems
• Skin
• Sensory, neurologic and musculoskeletal alterations
• Trauma
• Generational
• Cultural
• Person-centred care for aged populations

Dementia, Delirium and Depression

• Epidemiology of Dementia
• Risk factors
• Assessment and Screening

Risk Assessment of Older Persons

• Risks to older persons
• Falls
• Malnutrition
• Pressure injuries
• Infection

Pharmacology

• Physiological changes
• Pharmacodynamics in older persons
• Polypharmacy

Pain

• Nociceptive
• Neuropathic
• Psychological
• Pain in Dementia
• Pain management in older persons 

Learning and teaching strategy and rationale

This unit is offered in online mode and uses an active and collaborative learning approach to support students to analyse and critically evaluate approaches to providing evidence-based, ethical nursing care within a gerontological nursing setting. Students will engage in readings and reflections, e-Learning activities and opportunities to collaborate with peers in an online environment. This can involve, but is not limited to, online discussion forums, chat rooms, guided reading and webinar sessions. In addition, e-Learning and links to electronic readings will be provided to guide students’ reading and extend other aspects of online learning.

Through an online learning platform, students will have the opportunity to reflect on the complexity of delivering person-centred care to older persons in gerontological settings. Online learning in this unit will be supported by the provision of opportunities for students to attend online webinar sessions that allow synchronous exchange of information and facilitate responses to queries generated by students in relation to unit content. For those unable to participate in synchronous webinar sessions, recordings will be available.

Students are required to complete online activities and assessments to demonstrate the application of knowledge. The learning and teaching strategy used in this unit allows flexibility for students while ensuring they have expert support. These modes of delivery assist students in linking knowledge and skills to the gerontological nursing context, and to develop shared meanings through online experiential reflections and discussions.

Assessment strategy and rationale

In order to successfully complete this unit, a minimum combined total grade of all assessment tasks of 50% is required to pass this unit.

The assessment strategy used in this unit encourages depth of learning and provides the students the opportunity to develop their capacity to interpret, translate, apply and evaluate evidence-based care provision in gerontological settings. In order to develop gerontological nursing knowledge and skills required to achieve the learning outcomes and Graduate Attributes, students first demonstrate the ability to undertake a literature review on a common risk that results from age-related physiological changes in older persons. Knowledge and skills gained in this assessment task are then further developed in the final assessment where students apply learned knowledge and skills to demonstrate critical thinking skills, analysis and synthesis of evidence in relation to strategies used to promote health and wellbeing in older persons in gerontological specialty settings.

Overview of assessments

Representative texts and references

Arnold, E., & Boggs, K. U. (2019). Interpersonal relationships: professional communication skills for nurses (8th ed.). Saunders. https://www-clinicalkey-com-au.ezproxy2.acu.edu.au/nursing/#!/browse/book/3-s2.0-C20160046107

Bryant, B., & Knights, K. (2019). Pharmacology for health professionals (5th ed.). Elsevier. https://www-clinicalkey-com-au.ezproxy2.acu.edu.au/nursing/#!/browse/book/3-s2.0-C20170006882

Estes, M. E. Z., Calleja, P., Theobald, K., & Harvey, T. (2016). Health assessment and physical examination (Australian and New Zealand 2nd edition.). Cengage Learning Australia. https://ebookcentral.proquest.com/lib/acu/detail.action?docID=1990989

Hoffmann, T., Bennett, S., & Del Mar, C. (2017). Evidence-based practice across the health professions (3rd ed.). Elsevier. https://www-clinicalkey-com-au.ezproxy1.acu.edu.au/nursing/#!/browse/book/3-s2.0-C20160032369

Jackson, S. L. (2018). Understanding elder abuse : a clinician’s guide (First edition.). American Psychological Association. ttps://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/qpf7hm/alma991012873951202352

Johnson, A., & Chang, E. (2017). Caring for Older People in Australia. Principles for nursing practice (2nd Ed). Wiley. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/13lm7d8/alma991012703299302352

Matzo, M., & Sherman, D. (Eds.). (2019). Palliative care nursing: Quality care to the end of life (4th ed.). Springer. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/13lm7d8/alma991012953299002352

Miller, C. A. (2019). Nursing for wellness in older adults (Eighth edition). Wolters Kluwer. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/13lm7d8/alma991012790754402352

Taylor, K. (2019). Health care and Indigenous Australians: cultural safety in practice (3rd ed.). Macmillan International Higher Education: Red Globe Press. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/qpf7hm/alma991012985599202352

Vafeas, C., & Slatyer, S. (2021). Gerontological nursing : a holistic approach to the care of older people. Elsevier. https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/qpf7hm/alma991013098292902352