NRSG535 - Renal: Advanced Renal Care

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 unit provides students with the opportunity to develop and demonstrate specialised skills, knowledge and attributes required to care for a person with renal disease. Students will gain and develop advanced knowledge through exploration of evidence-based principles and practices in nursing that underpin renal disease and associated nursing care. 

In this unit, students will explore the pathophysiology and treatment of acute kidney injury disorders. Individuals with acute kidney injury are at an increased risk of subsequent long-term effects including development of chronic kidney disease and end-stage renal disease requiring advanced treatment such as dialysis and renal transplantation. Students will examine the complexities involved in renal transplantation. Issues around live and deceased donor, ABO compatibility and paired exchange will be discussed. The unit will also focus on person-centred nursing care and management of patients requiring renal transplant pre and post operatively and will address ethical, psychological and psychosocial issues experienced by individuals with end-stage renal failure and the impacts on their families/carers.

The aim of this unit is to provide nurses with advanced theoretical knowledge and critical thinking skills on the complexities of renal disease including ethical, psychological, and psychosocial issues around renal transplantation. 

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 - Critically evaluate and demonstrate specialised knowledge of the appropriate use of advanced treatment options (GA4, GA5)

LO2 - Synthesise and apply the best available evidence for planning, implementation and evaluation of care of people undergoing renal treatment (GA4, GA5, GA8, GA9)

LO3 - Demonstrate a person-centered approach required to assist patients and their families/carers navigate treatment and management of renal disease and palliative approaches (GA1, GA2, GA5)

LO4 - Critically analyse and discuss potential ethical, physical, psychological, and psychosocial implications experienced by patients with renal conditions and their families/carers (GA1, GA3, GA4, GA7)

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 

Content

Topics will include:

Pre-renal Acute Kidney Injury

• Renal hypoperfusion
• Sepsis
• Cardiorenal syndrome

Intrarenal Acute Kidney Injury

• Tubulo-interstitial disorders
• Peritonitis
• Nephrotoxins
• Acute Tubular Necrosis
• Acute and chronic bacterial pyelonephritis
• Myeloma kidney
• Adult polycystic kidney disease
• Medullary cystic disease

Postrenal Acute Kidney Injury

• Urinary Tract revision
• Ascending urinary infection
• Cancer of the urinary tract
• Pelvo-ureteric junction obstruction
• Renal calculi

Advanced treatment options

• Renal transplantation
• Immunological aspects of transplantation
• Deceased donor
• Live donor
• ABO incompatible transplant
• Human Leucocyte Antibody sensitivity
• Paired exchange

Care of the kidney transplant recipient

• Pre and post operative care requirements
• Patient survival
• Medications and immunosuppressive therapy
• Advancements in science

Ethical, social, and family issues

• Donors with issues
• Organ priority, allocation, processes and payment
• Society, family, and religion in kidney donation
• Patient education
• Health literacy
• Patient decision making
• Quality of life

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 renal 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 patients in dynamic healthcare environments and renal 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 renal 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 renal settings. To develop renal nursing knowledge and skills required to achieve the learning outcomes and graduate attributes, students first demonstrate the ability to critically analyse a case study and prepare a care plan providing the assessment findings, pathophysiological findings and the nursing (pharmacological and non-pharmacological) care required by an individual with renal disease. Specialised nursing care and clinical knowledge is vital for the holistic care of individuals undergoing renal treatment. Knowledge and skills gained in this assessment task are then further developed in the final assessment where students apply learned knowledge to critically analyse and evaluate strategies in relation to contemporary issues in management and treatment modalities for patients with renal conditions and their families/carers. 

Overview of assessments

Representative texts and references

Australian and New Zealand Dialysis and Transplant Registry. (n.d). https://www.anzdata.org.au/anzdata/

Axelsson, Alvariza, A., Lindberg, J., Öhlén, J., Håkanson, C., Reimertz, H., Fürst, C.-J., & Årestedt, K. (2018). Unmet Palliative Care Needs Among Patients With End-Stage Kidney Disease: A National Registry Study About the Last Week of Life. Journal of Pain and Symptom Management, 55(2), 236–244. https://doi.org/10.1016/j.jpainsymman.2017.09.015

Bryant, B., & Knights, K. (2019). Pharmacology for health professionals (5th ed.). Elsevier. Pharmacology for Health Professionals - ClinicalKey for Nursing

Bullock, S., & Hales, M. (2019). Principles of pathophysiology (2nd ed.). Pearson. https://ebookcentral.proquest.com/lib/acu/detail.action?docID=5495513

Danovitch, G. M. (2017). Handbook of kidney transplantation (6th ed.). Wolters Kluwer. https://acu.primo.exlibrisgroup.com/discovery/fulldisplay?vid=61ACU_INST%3A61ACU&tab=Everything&isFrbr=true&docid=alma991012722489402352&searchScope=61ACU_All&context=L&lang=en

Daugirdas, J. T. (2019). Handbook of chronic kidney disease management (2nd ed). Wolters Kluwer. https://ezproxy-acu-edu-au.ezproxy2.acu.edu.au/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=2356855&site=ehost-live&scope=site

Daugirdas, J. T., & Blake, P. G., & Ing, T. S. (2015). Handbook of dialysis (5th ed). Wolters Kluwer.

https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/f9cqvr/alma991012684849002352

Moura-Neto, Divino-Filho, J. C., & Ronco, C. (2021). Nephrology Worldwide. Springer International Publishing AG. https://link-springer-com.ezproxy2.acu.edu.au/book/10.1007/978-3-030-56890-0

Patton, K., & Thibodeau, G. (2019). Anatomy & physiology (10th ed.). Elsevier/Mosby. Anatomy and Physiology, Adapted International Edition - ClinicalKey for Nursing (acu.edu.au)

Schrier, R.W. (2015). Manual of nephrology (8th ed.). Wolters Kluwer. https://ebookcentral.proquest.com/lib/acu/detail.action?docID=2035707

Thomas, N. (2014). Renal nursing (4th ed.). Wiley Blackwell. Page 8 of 8 https://ebookcentral.proquest.com/lib/acu/detail.action?docID=1524294