Unit rationale, description and aim
Effective clinical reasoning is a hall mark of Registered Nurse practice in all clinical environments. Registered nurses use methodical and consistent thought processes to; consider the specific aspects of each presenting situation, determine what cues and further information is required, process the information to identify problems, establish goals and determine course of action, evaluate outcomes and reflect on new learning. To achieve effective clinical reasoning communication with patients, family and the members of the nursing and interdisciplinary health team is essential.
This unit will assist students with their ongoing development of theoretical knowledge underpinning provision of nursing care for the person, family and significant others who are experiencing acute deterioration of health. Key principles that underpin best practice will be demonstrated by the use of evidence-based case studies. The nurse’s role in the provision of care for the person experiencing an acute clinical deterioration will be explored across a variety of settings and patient journeys within the context of interdisciplinary care. The content contained within this unit is instrumental in informing nursing students’ future clinical practice across a variety of settings.
The aim of this unit is to support students to extend and consolidate their development of clinical reasoning skills so that they can provide person-centred, evidence based nursing care of individuals experiencing acute deterioration of health. Most importantly this unit will consolidate students understanding of the fundamental clinical reasoning skills to improve patient outcomes and limit harm and adverse events in their chosen health care settings.
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.
Relate the care for individuals experiencing an ac...
Learning Outcome 01
Implement critical thinking and clinical reasoning...
Learning Outcome 02
Explain the principles and practices of quality us...
Learning Outcome 03
Apply ethical, legal, cultural and professional pr...
Learning Outcome 04
Critically apply the principles of teamwork, deleg...
Learning Outcome 05
Content
Topics will include:
Review of underpinning pathophysiology of:
- Respiratory function
- Inflammatory processes
- Cardiovascular function
- Psychosis
- Stress diathesis
Principles of managing a person with acute deterioration:
- Recognition of a person with acute clinical deterioration
- Assessment and monitoring
- Early warning scores
- Diagnostic procedures
- Risk factors and comorbidities
- Person centered focus
- Biopsychosocial, spiritual and cultural considerations for the individual
- Therapeutic communication with person and significant others
- Professional communication and collaboration in the interdisciplinary team
- Responding to a person with acute deterioration of health
- Nursing Actions
- Evaluation
- Reassessment
- Escalation of care
- Emergency Codes
- Health care team
- Patient and family escalation of concerns
- Setting goals
- Continuity of Care
- Quality use of medicines
- Discharge Planning
- Documentation
- Legal and ethical Issues
Clinical Reasoning for the patient with acute deterioration:
- Clinical reasoning for people with acute deterioration of respiratory function, their relatives, significant others and carers
- Asthma
- Acute Lung Injury/Syndrome
- Pulmonary Embolism
- Clinical reasoning for people with acute deterioration of cardiovascular function, their relatives, significant others and carers
- Acute Heart failure
- Cerebral-Vascular accident
- Clinical reasoning for people with acute deterioration related to Shock, their relatives, significant others and carers
- Hypovolaemic shock
- Septic shock
- Clinical reasoning for people with acute alteration of mental health/cognition, their relatives, significant others and carers.
- Acute psychotic episode
- Impairment from alcohol/drug
- Delirium
- Impact of hospitalisation on psychological state
- Anxiety/sleep/pain
Regulatory frameworks:
- National Health Standards
- National Safety and Quality Health Service Standards
- Professional
- National Board: Nursing and Midwifery Board of Australia (NMBA)
- Registered Nurse Standards for Practice, Codes & Guidelines
- Organisational
- Continuous quality improvement
- Organisational environment
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. To pass this unit, students must demonstrate achievement of every unit learning outcome and obtain a cumulative mark of 50% in the unit.
In this unit, there are three assessment items, these assessments are required to build student knowledge and skills which, by the conclusion of this programme, will enable the student to graduate as a safe and effective nurse.
Students will complete a project that will enable them to analyse the issues that enable or detract nurses and interprofessional health care teams when responding to the acutely deteriorating patient. The final assessment task requires students to build upon the knowledge and skills developed in previous years and this semester, to apply critical thinking and clinical reasoning to a complex and authentic case study. Students will use critical thinking and clinical reasoning to make sound clinical decisions that are in alignment with evidence based literature and nursing and health care professional standards of Australia.
Off campus intensive assessment of this unit will be transparently equitable with on campus mode offerings as endorsed by the relevant Course Implementation Committee.
Overview of assessments
Assessment Task 1 - Quiz This assessment will en...
Assessment Task 1 - Quiz
This assessment will enable students to demonstrate underpinning knowledge of pathophysiology and medication administration
10%
Assessment Task 2 - Project This assessment ena...
Assessment Task 2 - Project
This assessment enables students to demonstrate sound understanding of the application of professional nursing standards, national health standards and organisational policy related to patient deterioration.
40%
Assessment Task 3 - Case Study Enables st...
Assessment Task 3 - Case Study
Enables students to apply knowledge from unit learnings to an issue requiring extended clinical reasoning.
50%
Learning and teaching strategy and rationale
Modes of delivery in this unit include lectures, tutorials, 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 at university need to operate effectively as self-sufficient learners who drive their own learning and access the learning supports they require. To guide students in their learning, feedback is required to identify what is being done well, what requires additional work and to identify progress toward required learning outcomes. Located in the third year of the programme, this theory unit includes face-to-face teaching hours and an increasing online component of learning to build life-long learning skills. Online recorded lectures are utilised to convey content and central principles while tutorials provide an opportunity to consolidate students’ understanding of content through collaboration and discussion. Tutorials deliver interactive and student-driven learning sessions which require an increasing reliance on students to extend their community of learners and increase self-reliance. Online materials provide students with the opportunity to undertake directed, self-motivated study and continue to transition to independent study and life-long learning.
Optional formative online quizzes will be made available to students prior to week 4 of semester to provide feedback on their progress and guide their unit learning. A summative quiz will be provided mid-semester as an early low stakes assessment item.
This unit may be offered on or off campus in intensive mode for sponsored / special cohorts, with the learning and teaching strategies being equitable with on campus mode offerings as endorsed by the Discipline Curriculum Implementation Committee.
Nursing and Midwifery Board of Australia Registered Nurse Standards for Practice
In connection to the learning outcomes, these are the national Registered nurse standards for practice for all RNs. Together with NMBA standards, codes and guidelines, these Registered nurse standards for practice should be evident in current practice, and inform the development of the scopes of practice and aspirations of RNs.
Relating toAccesses, analyses, and uses the best available evidence, that includes research findings, for safe, quality practice
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toDevelops practice through reflection on experiences, knowledge, actions, feelings and beliefs to identify how these shape practice
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toRespects all cultures and experiences, which includes responding to the role of family and community that underpin the health of Aboriginal and Torres Strait Islander peoples and people of other cultures
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toComplies with legislation, regulations, policies, guidelines and other standards or requirements relevant to the context of practice when making decisions
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toUses ethical frameworks when making decisions
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toMaintains accurate, comprehensive and timely documentation of assessments, planning, decision-making, actions and evaluations, and
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toContributes to quality improvement and relevant research.
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toEstablishes, sustains and concludes relationships in a way that differentiates the boundaries between professional and personal relationships
Relevant Learning OutcomeLO2, LO5
Relating toCommunicates effectively, and is respectful of a person’s dignity, culture, values, beliefs and rights
Relevant Learning OutcomeLO2, LO5
Relating toRecognises that people are the experts in the experience of their life
Relevant Learning OutcomeLO2, LO5
Relating toProvides support and directs people to resources to optimise health-related decisions
Relevant Learning OutcomeLO2, LO5
Relating toAdvocates on behalf of people in a manner that respects the person’s autonomy and legal capacity
Relevant Learning OutcomeLO2, LO5
Relating toUses delegation, supervision, coordination, consultation and referrals in professional relationships to achieve improved health outcomes
Relevant Learning OutcomeLO2, LO5
Relating toActively fosters a culture of safety and learning that includes engaging with health professionals and others, to share knowledge and practice that supports person-centred care
Relevant Learning OutcomeLO2, LO5
Relating toParticipates in and/or leads collaborative practice, and
Relevant Learning OutcomeLO2, LO5
Relating toConsiders and responds in a timely manner to the health and wellbeing of self and others in relation to the capability for practice
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toProvides the information and education required to enhance people’s control over health
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toUses a lifelong learning approach for continuing professional development of self and others
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toAccepts accountability for decisions, actions, behaviours and responsibilities inherent in their role, and for the actions of others to whom they have delegated responsibilities
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toIdentifies and promotes the integral role of nursing practice and the profession in influencing better health outcomes for people.
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toConducts assessments that are holistic as well as culturally appropriate
Relevant Learning OutcomeLO1, LO2
Relating toUses a range of assessment techniques to systematically collect relevant and accurate information and data to inform practice
Relevant Learning OutcomeLO1, LO2
Relating toWorks in partnership to determine factors that affect, or potentially affect, the health and wellbeing of people and populations to determine priorities for action and/ or for referral, and
Relevant Learning OutcomeLO1, LO2
Relating toAssesses the resources available to inform planning.
Relevant Learning OutcomeLO1, LO2
Relating toUses assessment data and best available evidence to develop a plan
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toCollaboratively constructs nursing practice plans until contingencies, options priorities, goals, actions, outcomes and timeframes are agreed with the relevant persons
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toDocuments, evaluates and modifies plans accordingly to facilitate the agreed outcomes
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toPlans and negotiates how practice will be evaluated and the time frame of engagement, and
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toProvides comprehensive safe, quality practice to achieve agreed goals and outcomes that are responsive to the nursing needs of people
Relevant Learning OutcomeLO1, LO2, LO3, LO4, LO5
Relating toEvaluates and monitors progress towards the expected goals and outcomes
Relevant Learning OutcomeLO2, LO4, LO5
Relating toRevises the plan based on the evaluation, and
Relevant Learning OutcomeLO2, LO4, LO5