Course Title: Implement and monitor nursing care for clients with chronic health problems

Part B: Course Detail

Teaching Period: Term2 2013

Course Code: NURS5287C

Course Title: Implement and monitor nursing care for clients with chronic health problems

School: 155T Life & Physical Sciences

Campus: Bundoora Campus

Program: C5246 - Diploma of Nursing (Enrolled/Division 2 nursing)

Course Contact : Carylin Lenehan

Course Contact Phone: +61 3 99254837

Course Contact Email:carylin.lenehan@rmit.edu.au


Name and Contact Details of All Other Relevant Staff

City Campus:

Bundoora Campus:

Nominal Hours: 50

Regardless of the mode of delivery, represent a guide to the relative teaching time and student effort required to successfully achieve a particular competency/module. This may include not only scheduled classes or workplace visits but also the amount of effort required to undertake, evaluate and complete all assessment requirements, including any non-classroom activities.

Pre-requisites and Co-requisites

Not applicable

Course Description

This unit of competency describes the skills and knowledge required in contributing to the care of the client with a chronic illness by performing nursing interventions that support the client’s needs and assist in maintaining an optimal lifestyle.


National Codes, Titles, Elements and Performance Criteria

National Element Code & Title:

HLTEN513B Implement and monitor nursing care for clients with chronic health problems

Element:

1. Identify the impact of chronic health problems on the client and their family

Performance Criteria:

1.1 Clarify the clinical manifestations of chronic health problems on body systems
1.2 Clarify the physical and/or psychological impacts of a chronic health problem on activities of daily living through discussion with the client and/or family (with client consent)
1.3 Confirm the client's understanding of their underlying/presenting condition
1.4 Identify actual and potential health issues of a client presenting with a chronic health problem through discussion of information gained from a preliminary health assessment with the appropriate members of the health care team
1.5 Use a problem solving approach to assess the impact of chronic disease processes on the client and/or their family and the achievement of activities of daily living
1.6 Discuss available resources and support services with client/s and significant others where appropriate with the consent of the client

Element:

3. Perform nursing interventions to support health care of clients with chronic health problems

Performance Criteria:

3.1 Identify and prioritise nursing interventions according to client needs as documented in predetermined care plan
3.2 Base nursing interventions on client needs and individuality and perform with respect for client’s dignity and privacy
3.3 Reflect consideration of cultural and religious issues in the performance of nursing interventions
3.4 Encourage the client and/or their family to assist in the performance of nursing interventions as able
3.5 Consider physical, psychological and social needs in the performance of nursing interventions
3.6 Carry out nursing interventions in accordance within professional, legal, ethical and organisation requirements
3.7 Assist the client to meet their activities of daily living
3.8 Address gender and age issues in the performance of nursing interventions
3.9 Recognise emergency situations and respond according to organisation policy and procedures and within legal and professional requirements
3.10 Reflect on pre and post procedure care in nursing interventions and improve practices appropriately
3.11 Contribute to and support health-teaching plans for the client with a chronic health problem
 

Element:

4. Contribute to an emergency response

Performance Criteria:


4.1 Confirm the roles and responsibilities of members of the emergency response team
4.2 Prepare and/or check the equipment on the emergency trolley
4.3 Access in response to request from emergency response team, drugs commonly used during emergency resuscitation (including drugs for anaphylaxis)
4.4 Participate in performing emergency resuscitation techniques
5.1 Report client response to nursing interventions to the registered nurse or other appropriate health care colleague
5.2 Document client response to nursing interventions according to organisation policy and legal and professional requirements

 

Element:

5. Assist in evaluating the outcomes of planned nursing actions

Performance Criteria:

5.1 Report client response to nursing interventions to the registered nurse or other appropriate health care colleague
5.2 Document client response to nursing interventions according to organisation policy and legal and professional requirements

 

Element:


2. Contribute to planning care for the client with a chronic health problem in a variety of health care settings

Performance Criteria:

2.1 Gather and record admission data for the client with a chronic health problem, for inclusion in a care plan according to organisation policy
2.2 Gather and record ongoing clinical data for inclusion in the client’s care plan in line with organisation policy
2.3 Contribute information and data on the activities of daily living for the client with chronic health problem for inclusion in discharge plans
2.4 Implement client discharge procedures in line with organisation policy and procedures
2.5 Accurately gather, document and report changes in client condition to the appropriate health care team members
2.6 Contribute to planning the nursing care of a client requiring extended care, including restorative/ rehabilitation care
2.7 Identify community based care services for a client with a need for restorative/rehabilitation care
2.8 Contribute to planning the nursing care of a client with cancer and/or a life-limiting illness
2.9 Advocate for clients in health and/or community settings

Learning Outcomes


The essential learning outcomes of this course are that enrolled nurses will have an understanding of the common elements of chronic illesss and how they affect the client. They will also have an understanding of the basic pathophysiological processes at work causing and contributing to particular chronic illnesses.  Furthermore they will have a grasp of the various modalities available within and outside the health service to assist a client so afflicted.


Details of Learning Activities

Lecture
Student discussion & Group Work
Road Maps


Teaching Schedule

Lesson 1:

Introduction to Unit
· Describe the Course Content
· Assignments & Acceptation
· Clinical Skills
Lecture 1:
· Describe Acute and Chronic Illness
· Briefly discuss the management of chronic versus acute illness
· Identify 4 examples of both acute & chronic illness
· Identify 4 risk factors for chronic illnesses with a rationale to support each one
· Describe how a chronic illness impacts on the individual’s lifestyle.

Lesson 2

Rehabilation
· Define rehabilitation
· Discuss the importance and different types of resources available
· Outline the objectives of Rehabilitation management
· Discuss the principles of rehabilitation
· Briefly discuss the cultural considerations in nursing the chronically ill patients
· Identify and define the types of rehabilitation
· Discuss the role of a Division 2 nurse in the rehabilitation process
· Discuss the discharge planning, referral services & supports
Adult learning Activity: Community Resources & services
Students are to work in groups and define the following:
· HARP
· RDNS
· VHC
· HACC
· Ambulatory Care
· HITH

Lesson 3:

Diabetes
· Define Diabetes and describe the basic pathophysiology behind diabetes
· Identify and discus the difference between type 1 and type 2 diabetes
· Identify the clinical manifestations of diabetes
· Discuss the nursing/medical management of diabetes. Provide rationales to support your nursing interventions
· Demonstrate a basic understanding of the importance of patient education and self-care
· Identify and discuss 2 emergency situations that can arise for a diabetic patient.
· Discuss health teaching plans for diabetic patients
· Describe 2 scenario’s in which age, gender and cultural can cause an issue with a diabetic

Lesson 4:

Pain
· Discuss acute versus chronic pain
· Identify and describe interventions to manage patient pain
· Discuss the management of a patient with Chronic Pain
· Identify alternative therapies options for pain management

Lesson 5:

Palliative care
— Discuss the meaning behind palliative care nursing
— Discuss the legal and ethical issues surrounding palliative care
— Describe the principles of Palliative Care Nursing
— Develop a basic understanding of Victorian medico-legal legislation regarding end-of-life care
— Identify support services and organization protocols.
— Identify and discuss pain and symptom management
— Discuss the importance of nutritional support in a palliative care patient
— Identify 3 issues/areas for conflict around being a patient advocate and family involvement
 

Lesson 6:

Cancer Nursing:
• Define and discuss the types of cancer including their pathophysiology.
• Describe the nursing management of a patient with cancer
• Describe the types of cancer treatment available
• Describe the importance of pain/symptoms relief

Lesson 7:

Common Chronic Musculo-skeletal Conditions:

· Define and Describe the following conditions; Rheumatoid Arthitis , oesteoarthitis,osteoporisis
· Discuss appropraite nursing care of these patients
· Define back pain and discuss the pathophysiology behind chronic back painLesson 8:

Lesson *:

Neurological Conditions
· Define and briefly discuss the pathophysiology of following terms;Motor Neurone Disease; Parkinson’s Disease; Multiple Sclerosis; Hungtinsons Disease; Myasthenia Gravis; Dementia;Delium
· Identify the nursing interventions commonly utilized with these conditions and discuss how you would respond in evaluating the effectiveness of these nursing interventions.
· Define and discuss CVA & TIA including the pathophysiology behind these conditions.
· Acute and chronic management of CVA & TIA’s
· Patient education
· Community support services
· Discharge planning
· Discuss aphasia and nursing management of a patient with aphasia.

Lesson 9:

 Communiciable Diseases including; TB ,HIV, STDS,Hepatitis
· Discuss how the diseases are transmitted and prventative interventations that should be implemented.
· Identify policy & procedure guidelines.
· Explain the importance of early diagnsis,isolation and intervention
· Discuss the legal,ethical process of notifiable disease.
· Revision of Barrier Nursing
· Documentation

Lesson 10:
Chronic Renal Conditions
· Define and discuss acute and chronic renal failure
· Identify clinical manifestations of chronic renal failure
· Discuss the nursing management of acute and chronic renal failure
· Reinforce the essential aspects of Diabetes mellitus
· Define and discuss chronic kideny disease
· Discuss the nursing management of CKD
· Discuss the different diaysis options and the impact it has on someones livestyle.
 


Learning Resources

Prescribed Texts

No Prescribed text for this course


References


Other Resources

All classroom powerpoints will be posted on the student Blackboard


Overview of Assessment

Assessment is graded and is via a case study/assignment.


Assessment Tasks

All assessment tasks will be discussed on the first day of the course and expectations for assessment explained

All assessments must have a competency grade to be deemed competent in this course

Classroom attendance of 80% requirements

Clinical placement 100% attendance requirement

A mimimum competency grade of 60% to be deemed competent in each assessment of this program


Assessment Matrix

  • 60 -69       - CAG
  • 70 - 79       -CC
  • 80 - 89      - CDI
  • 90 - 100   - CHD

Other Information

 
Essential knowledge:
The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role
This includes knowledge of:
Activities of daily living
Admission and discharge processes
Age and gender considerations for practice
Anatomy and physiology
Application of nursing theory
Chronic rehabilitation strategies and techniques
Clinical manifestations of chronic disease states
Common sites where cancer develops
Cultural and religious considerations for practice
Emergency care and first aid procedures
Equipment used in chronic care environments
Health teaching principles and strategies
Legal requirements for practice
Medical nursing interventions and outcomes
Members of health care team and their roles
Organisation policy and procedure
Pathophysiology
Principles of bed rest
Principles of medical nursing and terminology associated with care of clients with chronic health problems, including cancer and requiring restorative/rehabilitation care
Problem solving process
Occupational health and safety legislation

Essential skills:
It is critical that the candidate demonstrate the ability to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the identified work role
This includes the ability to:
Apply professional standards of practice:
ANMC code of conduct
ANMC code of ethics
ANMC national Enrolled/Division 2 nurse competency standards
state/territory Nurse Regulatory Nurses Act
state/territory Nursing and Midwifery Regulatory Authority standards of practice
scope of nursing practice decision making framework
Perform nursing interventions, including:
application of prosthesis
assist clients with chronic pain
assist clients with continence problems
assist clients with hypoglyceamia
assist clients with naso-gastric tube feeds
baths and wet packs
blood glucose monitoring
care of indwelling catheters
complex nursing interventions
fundamental nursing interventions
incentive spirometry
observation of client undergoing peritoneal or haemodialysis
prevention of pressure and decubitus ulcers
range of active and passive exercises
rehabilitation and restorative care
stoma care
use of nebulisers/oxygen therapy
use of wheelchairs and walking aids
Use language, literacy and numeracy competence as required
Use effective communication skills
 

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