NRSG531 - Medical: Person-centred Care for Medical Patients with Complex Conditions

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

Ageing populations and increased life expectancies are associated with an increased burden of disease requiring the delivery of nursing care that is increasingly challenging, and demands significant consideration be given to providing a multi-faceted approach to care. While personal and social factors, and clinical aspects of the patient’s experience contributes to the medical patient’s complex requirements, medical disorders have varying trajectories that requires multidisciplinary team engagement. Individuals with medical disorders have the right to be able to access acute care and be provided with short and long term support and care in settings where they are treated with respect and dignity, and where care is individually designed to cater to their preferences, diversity and complexity. It is critical that specialty medical nurses have the specialised skills, knowledge and attributes required to care for individuals with medical disorders.

This unit is required by students because the complexity of care required by individuals with medical disorders now demands medical nurses have depth of analytical, cognitive and advanced problem-solving skills to effectively and efficiently analyse the care requirements for complex medical patients. The effects of acute and chronic medical disorders can result in changes in health conditions, social and personal loss, and a loss of autonomy, physical and emotional challenges and a loss of mobility and cognitive capacity. It is critical that medical nurses are equipped with the specialist knowledge and skills to effectively advocate, guide and care for medical patients using evidence-based, ethical practice. Selection of content is based on the complexity of care required by patients with medical disorders and the recent advances in medical nursing. Key concepts relating to renal, endocrine and metabolic, immunity, cancer, oncology, palliative and end of life approaches to care, will be explored to assist students with skills in analysis, evaluation, and application of informed decision-making to ensure inclusive, respectful, person-centred care in the medical setting.

The aim of this unit is for students to critically appraise, evaluate and demonstrate knowledge and skills required for delivery of complex, diverse, inclusive and ethically based care to ensure medical patients are treated with dignity and respect.

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 impact of medical disorders, while critically reflecting upon the key pathophysiological concepts that contribute to comorbidity and the complex care required for medical patients (GA3, GA4, GA8, GA9)

LO2 - Examine the specific care needs that are present for medical patients and apply this knowledge to inform evidence-based, ethical, family-centred care to promote health, well-being and dignity in medical settings (GA1, GA3, GA4, GA5, GA10)

LO3 - Compare and contrast the potential ethical, physical, psychological, and psychosocial impacts experienced by patients with medical conditions, their families and carers (GA1, GA3, GA4, GA5, GA6)

LO4 - Appraise and evaluate specialised knowledge of appropriate treatment options and the use of pharmacological management for the delivery of evidence-based care to medical patients undergoing treatment (GA4, GA5, GA8, GA9)

LO5 - Assess the culturally sensitive, person-centered approaches required to assist patients, families and their carers to navigate treatment and management of medical disorders and palliative approaches to care (GA1, GA2, GA5, GA10)    

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

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:

Intrarenal and Postrenal Acute Kidney Injury

• Acute Tubular Necrosis
• Acute & Chronic bacterial pyelonephritis
• Myeloma kidney
• Polycystic kidney disease
• Medullary cystic disease
• Urinary tract infection
• Cancer of the urinary tract
• Pelvo-ureteric junction obstruction
• Renal calculi

Renal Disorders and End Stage Kidney Disease

• Diabetic Nephropathy
• Glomerulonephritis
• Hypertension
• Renal Replacement Therapy
• Haemodialysis and Peritoneal dialysis
• Management of comorbidities

Complex Care: Metabolic and Endocrine Disorders

• Hormones
• Diabetes Mellitus
• Chronic complications
• Metabolic Syndrome

The Immune System, Leukaemia & Haematological Tumours

• Autoimmune diseases
• Coeliac disease
• Cancer and the Immune System
• Immunosuppressive medications and therapies
• Anatomy and Physiology of blood & blood production
• Leukaemia
• Acute Lymphocytic Leukaemia (ALL)
• Chronic Lymphocytic Leukaemia (CLL)
• Rare forms of Leukaemia
• Lymphoma
• Myeloma

Cancer

• Brain & Central Nervous System Cancers
• Gliomas
• Spinal tumours
• Invasive tumour of the brainstem
• Head & Neck Cancers
• Side effects of radiotherapy
• Osteoradionecrosis of the jaw
• Breast
• Anatomy & Physiology
• Diagnosis & Treatment
• Surgery
• Neoadjuvant and Adjuvant Therapies
• Prostate
• Benign Prostatic Hypertrophy (BPH)
• Transurethral Resection of the Prostate (TURP)
• Cancer
• Radical prostatectomy
• Management

Emergency events in Oncological and Palliative Care Patients

• Spinal cord compression
• Superior Vena Cava obstruction
• Hypercalcaemia
• Acute airway obstruction
• Sudden severe haemorrhage
• Tumour Lysis Syndrome

Advanced Disease and Palliative Care

• Anorexia & Cachexia syndrome
• Paraneoplastic & Non-paraneoplastic syndromes
• Non-islet cell tumour hypoglycaemia
• Renal failure
• Liver failure

End of Life Care

• Planning for death
• Commencing Palliative Care
• Preparing for death
• Final moments
• Bereavement

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 the stages of the ageing process in relation to governance frameworks, continuous quality improvement systems, physiological considerations and end of life care within medical nursing settings. 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 nursing care that is guided by systems, processes and ethical perspectives to inform high quality, safe, diverse and individualised older person care delivery. 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 perform a literature review on a complex medical disorder in relation to the delivery of evidence-based nursing care. Knowledge and skills are then further developed in the final assessment where students apply learned knowledge to critically analyse and evaluate contemporary evidence in relation to planning, implementing and evaluating holistic and evidence-based, person-centred care for the patient with advanced disease and end of life care planning.

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 htps://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