NRSG530 - Medical: Chronic Health, Frailty and Harm Minimisation

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 in patients with medical disorders contributes to their 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 medical settings must have a range of knowledge and skills to successfully care for medical patients with acute, chronic and complex care needs. Medical 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 medical patients.

This unit is required by students because medical patients require a multi-faceted approach to care. Medical patients may be frail, prone to harm and require timely identification and escalation of deterioration. It is critical that medical nurses are equipped with the specialist knowledge and skills to effectively care for medical patients through the application of evidence based, ethical practice. Selection of content is based on the complexity of care required by medical patients and the recent advances in medical nursing. Key concepts related to age related and common medical health conditions, clinical governance and risk management and effective discharge planning will be explored to assist students with skills in analysis, evaluation, and application of person-centred care in the medical setting.

The aim of this unit is to support students to evaluate the complexity of medical care while developing knowledge and skills to critically appraise and evaluate evidence to ensure medical patients 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 - Examine the significance of specialist medical nursing knowledge and skills, interprofessional communication and teamwork in the medical setting (GA4, GA5, GA7, GA10)

LO2 - Assess the ageing process, whilst critically reflecting upon the key pathophysiological concepts that impact on comorbidity and the complex care for older persons with medical disorders (GA3, GA4, GA8, GA9)

LO3 - Differentiate between the acute and chronic care trajectories for medical patients and evaluate how they influence the medical patient’s health and wellbeing (GA1, GA2, GA4, GA5, GA6, GA8)

LO4 - Assess the risk factors for medical patients and appraise and implement a range of assessment techniques and strategies used for harm mitigation (GA4, GA5, GA8, GA9)

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 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

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 

GA10 - utilise information and communication and other relevant technologies effectively.

Content

Topics will include:

Caring for Older Persons in Hospital

• Age related changes
• Common physiological problems in older persons
• Cognitive impairment and dementia

Infection Prevention and Control

• Hospital Acquired Infections
• Antimicrobial Stewardship

Common Clinical Risks in the Medical Setting

• Clinical Governance
• Risk Management
• Falls and Pressure Injuries
• Assessment
• Prevention
• Management

Common Cardiovascular Conditions

• Health assessment and screening
• Cardiovascular risk factors
• Chest pain
• ECG Interpretation
• Pharmacology
• Rehabilitation

Common Respiratory Conditions

• Respiratory assessment
• Chronic Obstructive Pulmonary Disease
• Pneumonia
• Asthma

Common Gastrointestinal Conditions

• Gastrointestinal assessment
• Abdominal pain
• Gastric ulceration, duodenal ulceration and Gastro-Oesophageal Reflux Disease (GORD)
• Gastrointestinal Tract (GIT) infections
• Chronic conditions of the GIT
• Inflammatory Bowel Disease
• Treatment options
• Obesity & Malnutrition

Complex Care for Patients with Neurological Disorders in the Medical Setting  

• The neurological system
• Raised Intracranial Pressure (ICP)
• Stroke
• Diagnosis
• Treatment
• Management
• Movement disorders
• Parkinson’s Disease
• Multiple Sclerosis
• Pain
• Legal and ethical issues

Effective Discharge Planning

• Person-centred approach
• Discharging patients with complex needs
• Barriers to effective discharge planning

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 medical 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 medical 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 medical 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 medical settings. In order to develop medical nursing knowledge and skills required to achieve the learning outcomes and graduate attributes, students first demonstrate the ability to create a narrated e-Poster presentation on a common risk that results from age-related physiological changes in older persons with medical disorders. Knowledge and skills gained in this assessment task are then further developed in the final assessment where students demonstrate the ability to undertake a case study review on a patient with a common medical condition. Through the application of learned knowledge students will critically analyse and evaluate the use of evidence-based practice to promote health and wellbeing in caring for patients with medical disorders.

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 

Brown, D., Edwards, H., Buckley, T. C. T., Aitken, R., Lewis, S. M. Bucher, L., Heitkemper, M. M., Harding, M., Kwong, J., & Roberts, D. (Eds.). (2020). Lewis's medical-surgical nursing : assessment and management of clinical problems. (5th Aust. & NZ ed.). Chatswood, NSW : Elsevier Australia https://go.openathens.net/redirector/acu.edu.au?url=https%3A%2F%2Fwww.clinicalkey.com%2Fstudent%2Fnursing%2Fcontent%2Ftoc%2F3-s2.0-C20170033220

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 

Bullock, S., & Hales, M. (2019). Principles of pathophysiology (2nd ed.). Pearson. https://ezproxy.acu.edu.au/login?url=https://ebookcentral.proquest.com/lib/acu/detail.action

?docID=5495513

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

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

Miller, C. A. (2019). Nursing for wellness in older adults (Eighth edition.). Wolters Kluwer.

https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/13lm7d8/alma991012790754402352

Patton, K., & Thibodeau, G. (2019). Anatomy & physiology (Adapted International ed..). Elsevier/Mosby. https://go.openathens.net/redirector/acu.edu.au?url=https%3A%2F%2Fwww.clinicalkey.com%2Fstudent%2Fnursing%2Fcontent%2Ftoc%2F3-s2.0-C20181027031

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