Course catalogue no : 7005 NRS
Course title : Critical Care Nursing Interventions 11
Field of Education Code
Program/s Gra...
- 2 -
Content
Overview of Course Content
Week Content Speaker
1
July 11
Introduction
Credentialling
Gerontological Alterat...
- 3 -
Weekly Objectives:
WEEK 1
Introduction
Credentialling
1. Discuss credentialling of the specialist critical care nurs...
- 4 -
Evans-Murray A. (2001). Wolff- ParkinsonWhite (WPW) syndrome: what the critical care nurse needs to
consider when ad...
- 5 -
1998, Thelan 406 -428
2002, Thelan 332 -342
WEEK 5
Myocardial Infarction
1. Discuss the complications of myocardial ...
- 6 -
4. Outline the nursing and medical treatment of Guillain Barre and Myasthenia gravis
- 7 -
Required Reading
Wong, F, (2000) Prevention of Secondary Brain Injury. Critical Care Nurse, Vol 20, No. 5, October p...
- 8 -
students’ professional practice skills, promote lifelong learning strategies, encourage critique and debate,
improve...
- 9 -
This will be a multi-choice and short answer written examination held at the end of the course on the date
specified...
- 10 -
3. Clinical Assessment
The clinical skills stations and advanced life support lectures follow the set curriculum of...
- 11 -
Penalties for Late Submission
Assessment items submitted after the due date without authorised extensions will be s...
- 12 -
CONTENT/UNDERSTANDING
Aspects missing/or inadequately covered
Misunderstanding of the subject matter
Little evidenc...
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Course catalogue no : 7005 NRS Course title : Critical Care ...

  1. 1. Course catalogue no : 7005 NRS Course title : Critical Care Nursing Interventions 11 Field of Education Code Program/s Graduate Certificate in Critical Care Nursing Convenor – Patricia Johnson School : Nursing Faculty : Nursing and Health Status of Course within program/s or academic plan/s Core course Credit point value 10 Prerequisites : Nil Year and semester : 2002 Semester 2 Course convenor Patricia Johnson (07)55528849 email: P.Johnson@mailbox.gu.edu.au Anne Evans-Murray (07)55718283 or page 404 email: anne_evans-murray@health.qld.gov.au Teaching team members : Date course outline was last modified June 2002 Objectives Students completing this course will: 1. Describe selected pathophysiological processes encountered by patients in the critical care environment. 2. Describe the role the critical care nurse plays in implementing, monitoring and evaluating complex therapies in the critical care environment. 3. Explain the use of selected technologies in management of critically ill patients. 4. Demonstrate an understanding of therapies utilised by other health care professionals in the critical care environment. 5. Critically evaluate research findings related to nursing care of the critically ill patient. Interrelationship of the Course with other Courses and the Program This course is one of four core courses within the Graduate Certificate of Critical Care Nursing. The other core courses are 7030NRS Introduction to Intensive Care, Coronary Care and Emergency Nursing, 7003NRS Critical Care Nursing Interventions 1, and 7007NRS Critical Care Nursing Interventions 111. This course will further develop and extend the knowledge and skills that were the focus of Critical Care Nursing Interventions I. Brief Description This course will focus on multi-disciplinary, technologically dependent approaches to patient care and the role the critical care nurse plays in implementing, monitoring and evaluating the efficacy of these approaches. Body system support, organ replacement technologies, complex infusion therapies and invasive monitoring will be discussed. Aspects of advanced practice, teaching, research or management in critical care will be explored.
  2. 2. - 2 - Content Overview of Course Content Week Content Speaker 1 July 11 Introduction Credentialling Gerontological Alterations Nutritional Support A. Evans-Murray /Trish Johnson Michelle Foster Heather James Alan Spencer 2 July 18 Advanced cardiac: SVT versus VT, BBB Pacemakers A. Evans-Murray Deborah Stiles 3 July 25 Cardiac Surgery Complications of M.I Haemodynamic monitoring George Cornwell Anna Davey A. Evans-Murray 4 August 1 Compulsory Attendance today Advanced Life support: Mega Code ARC standards Clinical skills workshop Anne Evans-Murray Deborah Stiles Robyn Harris Matt Scott 5 August 8 Clotting and thrombolytic therapy Coronary reperfusion Treatment of M.I Congestive Cardiac Failure Cardiovascular disorders Anne Evans-Murray Deborah Stiles Deborah Stiles Dr. Nasser Essack Anne Evans-Murray 6 August 15 Neurological dysfunction Neurological assessment Guillain Barre Myasthenia Gravis Meningitis Lyn Jenyns Robyn Harris Student contract 7 August 22 Management of spinal injuries Burnout/ bullying / communication Exam Review /Evaluation Leonie Dieckman Kay Laemmle Anne Evans-Murray September 5 Exam 9am A. Evans-Murray
  3. 3. - 3 - Weekly Objectives: WEEK 1 Introduction Credentialling 1. Discuss credentialling of the specialist critical care nurse. Gerontological Alterations and Management of the Elderly Patient in Critical Care 1. State the clinical significance of age-related physiological changes (neurological, cardiac, gastro- intestinal) and the expected nursing consideration or interventions used in caring for the elderly critical care patient. 2. Relate the age -related changes in hepatic function and accompanying pharmacolinetic changes to the administration of various cardiovascular medications. 3. Describe the age-associated physiological changes that occur in the elderly. (neurological, cardiac, gastro-intestinal) Required Reading 1998- Thelan, 271 to 292 2002 – Thelan, 199- 209 Nutrition Support 1. Review the nutritional assessment of a critically ill patient and identify the altered parameters in the critically ill individual. 2. Explain mechanisms for energy use in the critically ill including the hypermetabolic state. 3. Outline indications for parenteral and enteral nutrition for a critically ill patient. 4. Describe the nutritional solutions available. 5. Describe methods of evaluating nutritional support, nursing care and complications. Required Reading 1998 - Thelan, 121 - 126. 2002 – Thelan, 93 – 100, 109 -117 WEEK 2 Advanced cardiac Advanced Electrocardiology 1. Explain the pathology of pre-excitation of the ventricle. (Wolff-Parkinson-White and Torsades) 2. Describe the ECG changes associated with accessory pathway conduction. 3. Differentiate between the features and management of SVT and VT. 4. Identify ECG changes associated with selected disease processes. (ie. pericarditis, pulmonary embolus) 5. Describe the ECG pattern that is characteristic of right and left bundle branch block. 6. Discuss rate dependent bundle branch block 7. Compare the hemiblock patterns that may be seen in both fascicles of the left bundle branch. 8. Determine the electrical axis on the basis of given complexes in the six limb leads and state whether they are normal or abnormal. Pacemakers and Internal Defibrillators 1. Identify principles of cardiac pacing. 2. Outline the purpose and indications for cardiac pacemakers. 3. Differentiate between temporary and permanent pacemakers. 4. Describe the various types of pacemakers currently in use. 5. Describe the management of a patient receiving cardiac pacing. 6. Describe the nursing response associated with caring for patients with AICD, Automatic Implantable Cardiac Defibrillator. 7. Correctly interpret a 12-lead electrocardiography of paced rhythm (noting pacing spikes), capture, intrinsic, beats, etc). Required Reading Morton, P. 1997 ECG / Pacemaker Critical Care Nurse Vol 17, No 1 February. 1998, Thelan, 529 - 541 2002, Thelan, 440 – 450, 322 – 323, 338 – 339,
  4. 4. - 4 - Evans-Murray A. (2001). Wolff- ParkinsonWhite (WPW) syndrome: what the critical care nurse needs to consider when administering antiarrhythmics. Aust Critical Care 14 (1) :pp. 5-9. WEEK 3 Cardiac Surgery 1. Discuss current trends and indications for cardiac surgery. 2. Describe the effects of cardiopulmonary bypass. 3. Contrast the management of patients with valve replacement surgery to that of coronary artery surgery. 4. Outline assessment data in the post-operative period and implications for nursing management. 5. Identify specific complications and long term prognosis. Required Reading 1998, Thelan. 541 -550 2002, Thelan 466 –484 Recommended Reading Hudak p. 394 - 426 Cardiac:Haemodynamic Monitoring 1. Identify the principles of invasive pressure monitoring. 2. Explain the physiological significance of monitoring haemodynamic parameters. 3. Interpret data from arterial, central venous and pulmonary artery pressures, cardiac output, cardiac index, systemic and pulmonary vascular resistance readings and calculations including the significance of abnormalities. 4. Identify the indications for, nursing care of and complications related to haemodynamic monitoring. Required Reading Thelan, 442 to 480 Hudak, 226 to 242 Recommended Reading Flynn, 161 to 206 WEEK 4 Advanced Life Support 1. Discuss ARC’s policies on resuscitation 2. Demonstrate the team leader’s role in a mega code 3. Identify life threatening arrhythmias 4. Review treatment of life-threatening arrhythmias THE STUDENT WILL DEMONSTRATE SUCCESSFULLY THE TEAM LEADERS ROLE IN A MEGA-CODE. • Advanced airway and ventilation maintenance • Electrocadiographic monitoring • Arrhythmia analysis • Arrhythmia management (mechanical , chemical, electrical ) • Management of resuscitation equipment • Occupational health and safety issues • ARC advanced guidelines • Team leader decision-making • Documentation Required Reading Review life threatening arrhythmias from previous subject – Introduction to Critical Care
  5. 5. - 5 - 1998, Thelan 406 -428 2002, Thelan 332 -342 WEEK 5 Myocardial Infarction 1. Discuss the complications of myocardial infarction 2. Describe the medical and nursing treatment of myocardial infarction. 3. Briefly outline the clotting cascade and relate to thrombolytic therapy 4. Explain the use of thrombolytic therapy after myocardial infarction 5. Describe the nursing care of patients receiving thrombolytic therapy. Required reading 1998, Thelan, 490 to 501 2002, Thelan, 409 –414, 452 -465 Cardiovascular Disorders 1. Discuss the pathophysiology, clinical manifestations and treatment of the following cardiovascular disorders: • cardiomyopathy 2. Describe the pathophysiology of congestive cardiac failure. 3. Discuss the treatment of congestive cardiac failure and recent research into pharmacological agents. Required reading 1998. Thelan, 502-510, 2002, Thelan, 418 –420, 414 - 418 Recommended reading Hudak, 340 to 342 WEEK 6 Neuro 1: Management of Head Injuries 1. Describe autoregulation of intracranial pressure (including Munoe Kelly Doctrine). 2. Review the factors that alter intracranial pressure (ICP). 3. Describe the various methods to monitor ICP. 4. Explain the role of the nurse in the management of ICP monitors and CSF drainage systems. 5. Describe the nursing interventions to decrease ICP. 6. Describe the pharmacological management of increased ICP including the implications for nursing. 7. Explain the five critical areas of neurological assessment: • LOC • Motor Movements • Pupillary reaction and eye movement • Respiratory patterns • Vital signs 8. Differentiate between types of head injuries: • Scalp/skull injuries • Concussion • Brain injuries • Haematomas (subdural, epidural, intracerebral) 9. Describe the Babinski, Occulocephalic and Occulovestibular reflexes. Neurological Diseases 1. Discuss the presentation of meningitis 2. Outline the nursing and medical treatment of meningitis 3. Discuss the pathophysiology of Guillain Barre and Myasthenia gravis
  6. 6. - 6 - 4. Outline the nursing and medical treatment of Guillain Barre and Myasthenia gravis
  7. 7. - 7 - Required Reading Wong, F, (2000) Prevention of Secondary Brain Injury. Critical Care Nurse, Vol 20, No. 5, October pp. 18-27. Arbour, R, (1998) Aggressive Management on Intracranial Dynamics Critical Care Nurse Vol 18, No. 3, June, pp. 30-40 Smillova A, Walker E. (2000) Meningococcemia: A critical care emergency. Critical Care Nurse vol 20, N0. 5, October. pp. 28-37 1998, Thelan, 763 to 774, 812 - 814 2002, Thelan, 671 – 692, 701 -714 Recommended reading: Hudak: 665 to-670, 678 to 682 Hudak, 615 to 621, 624-627 WEEK 7 Neuro 2: Management Of Spinal Injuries 1. Describe the pathophysiology, complications and treatment of spinal shock. 2. Describe the pathophysiology of spinal cord transactions. 3. Describe the medical treatment of spinal cord injuries, and autonomic dysreflexia. 4. Explain the nursing care of spinal cord injuries. 5. Explain the complications of spinal cord injuries. Required Reading 1998, Thelan 1065 –1071 2002, Thelan 903- 909, 1037 Burnout / Communication / bullying Objectives will be given out in class Generic Skills Development This course will develop skills of problem solving and decision making, analysis and critical evaluation, information retrieval, teamwork, professional effectiveness, oral and written communication. Flexible Learning This course will have some print materials supplemented. Attendance is recommenced but not compulsory with the exception of the Compulsory Attendance day. Rationale for Content This course will further develop and extend the knowledge and skills that were the focus of Critical Care Nursing Interventions I. The skills and knowledge learnt in this course will enable students to practise in a variety of critical care settings. Organisation and Teaching Methods This course comprises 42 contact hours over seven (7) weeks. A variety of teaching and learning strategies will be used and will include lectures, tutorials, self-directed learning exercises and reflective sessions. On some weeks the students will utilise tutorial time to deliver their presentations. Students will undertake weekly reading and will be required to participate in discussions generated by the content of the material. This course will be coordinated through the Faculty of Nursing and Health, School of Nursing and conducted at the Gold Coast Hospital. Rationale for Teaching Methods The teaching and assessment strategies in this program reflect the philosophies and strategies of other graduate certificate level programs offered by the School of Nursing. That is, they are designed to advance
  8. 8. - 8 - students’ professional practice skills, promote lifelong learning strategies, encourage critique and debate, improve oral and written skills and facilitate interdisciplinary collaborative relationships. Assessment 1. Assignment (2000 to 2500 words) Weighting 40% Due: August 22nd 2. Examination Weighting 60 % Date: Sep 5th 3. Pass the clinical assessment in the workshop / megacode (ACCCN curriculum) *NB. All pieces of assessment must be passed to pass the course. 1. Evidence Based Practice Case Study. You may choose any one of the topics in the course outline, eg. Cardiac and respiratory emergencies, elderly patient, patient with a pacemaker, head injury etc. etc. Identify and discuss current treatment modalities for this patient presentation, focusing on the critical care nurses’ role in the provision of care for these patients in the Critical care environment. Reflective Practice: Critique your clinical practice in relation to this patient admission Suggested Format: Below is a suggested format to assist you in developing your assignment. Please feel free to structure it in whatever way you believe addresses the assignment requirements. Part A: Brief Patient Overview: You are to complete a case study for a patient you have cared for in the critical care environment Clearly identify the topic you have chosen at the beginning of your assignment. Include a brief overview of the patient’s presenting condition – using a biopsychosocial perspective. Part B: (Main Focus of the Assignment) Using Evidenced Based Practice concepts - discuss the patient’s presenting condition Provide an overview of the presenting condition ie. The aetiology of the condition or injury. Identify and discuss the latest treatment modalities (interventions) for this condition. Include in your discussion, the assessment and ongoing management for this patient, focusing on the critical care nurse’s role in caring for this patient. Provide clear referenced rationales for all interventions included. Include in your discussion any controversial issues you identified during your review of the literature for these patients. Support all aspects of your paper with relevant and current references to the literature. Part C: Reflective Practice: In the final section, you are to critique your own clinical practice (reflective practice) related to this patient’s care. Consider both positive and negative aspects of your care and what aspects you would change for future practice. This final section (reflective practice) may be written in the first person Please do not hesitate to contact the course convenor if you need assistance with this assignment. Please attach the Marking Criteria sheet for this assessment included at the end of this outline. 2. Examination
  9. 9. - 9 - This will be a multi-choice and short answer written examination held at the end of the course on the date specified above.
  10. 10. - 10 - 3. Clinical Assessment The clinical skills stations and advanced life support lectures follow the set curriculum of the accredited Gold Coast Hospital Advanced Life Support Course. This course is accredited through ACCCN Ltd. The program reflects current guidelines and policies of the Australian Resuscitation Council (ARC) throughout its content. Rationale for Assessment The two items address each of the objectives for the course in addition to promoting writing skills. In addition, the compulsory clinical assessment underpins the development and assessment of the advanced clinical and decision making skills required for this particular nursing specialty. Texts and Supporting Materials Thelan, L.A., & Urden, L.D., Lough, M., Stacy, K. (1998), Critical Care Nursing, St Louis. Mosby. OR Urden,L.D,. Stacy, K,M, & Lough, M,E. (2002) Thelan’s Critical Care Nursing Diagnosis and management (4th Ed) St. Louis: Mosby. Also recommended: Hudak, C., Gallo, B., & Morton, P. (1998). Critical Care Nursing: A Holistic Approach (6th Ed). Philadelphia: J.B. Lippincott. Required readings will be available to purchase from the Gold Coast Campus bookshop. Scope of Course Evaluation Student evaluation of the course will be undertaken informally throughout the semester by inviting students to discuss with the convenor any concerns or issues they have with the content relevancy, teaching/learning strategies, assessment items and/or guest lecturers. A formal student course evaluation will be undertaken at the end of semester. In addition, relevant professional bodies (for example, the Australian College of Critical Care Nurses) will be asked to provide feedback in relation to national developments. Administration Your attention is drawn to the following important policies and guidelines relating to assessment. Submission of Assignment: All written assignments must be submitted to the course convenor at the Staff Development Centre Gold Coast Hospital. The assignment must have the attached an Assignment Cover Sheet (this sheet is included in your Assignment Writing and Study Guide for you to photocopy). This sheet will be date stamped and filed as proof of submission. You are also advised to keep a copy of all assignments in case of accidental loss. All assignments will be due by 4.00pm on the designated date unless an alternative time is stipulated. Written submissions should be presented in accordance with the Faculty of Nursing and Health Science's Assignment Writing and Study Guide 1997 which specifies the appropriate format (section 6.1), or in accordance with A Writing Guide for First Year Students. (2002). Written by Dr Chris Vose and Dr Wendy Moyle, School of Nursing Griffith University. It is the student’s responsibility to keep a copy of all assignments – both electronic and hard copy, in case of accidental loss. Extensions If for medical reasons or for any other unforseen circumstances, you are prevented from completing an assignment on time, you may apply for an extension on the appropriate form in the Assignment Writing Guide. Such application should be made to the course convenor as early as possible, before the due date of submission.
  11. 11. - 11 - Penalties for Late Submission Assessment items submitted after the due date without authorised extensions will be subject to penalty. Marks will normally be deducted at a rate of 10% of the assignment for every working day it is late. A weekend will be counted as one working day. A late submission will be awarded 0% after five working days. Policies Students should consult the relevant sections of the Griffith University Assessment Policies which are on the net at: http://www.gu.edu.au/ua/aa/ppm/tal/content/aad_asspol_fs.html and the School of Nursing Assessment Policy (a copy of which is displayed on the School notice board, level 3, Health Science Building). It is the student’s responsibility to familiarise themselves with these policy documents. Award of Grades The Assessment Board will examine results recommended by the course convenor and determine final results for all students in the course according to the rules and regulations of the University. The following grades will be used in this course: High Distinction (HD), Distinction (D), Credit (C), Pass (P), and Failure (F), and Failure, No Submission (FNS). Course Communications The course convenor/s can be contacted by any means detailed on the front page.
  12. 12. - 12 - CONTENT/UNDERSTANDING Aspects missing/or inadequately covered Misunderstanding of the subject matter Little evidence of original thought on topic Irrelevant and/or inappropriate to topic RESEARCH Insufficient relevant or recommended reading Uncritical acceptance of author's viewpoints Insufficient or incorrect referencing of sources LOGIC Arguments illogical or relies on unsupported assertions Concepts appear muddled and inadequately explained Report rambles and lacks coherent structure Inappropriate introduction and conclusion PRESENTATION Not in accordance with Divisional requirements Grammatical, spelling and punctuation problems detract from making the meaning clear Paragraphs of inappropriate length for cohesive argument ASSESSOR COMMENTS MARKING CRITERIA FOR ASSIGNMENTS 1 2 3 4 5 |_____|_____|_____|_____| 1 2 3 4 5 |_____|_____|_____|_____| 1 2 3 4 5 |_____|_____|_____|_____| 1 2 3 4 5 |_____|_____|_____|_____| ---- 20 1 2 3 4 5 |_____|_____|_____|_____| 1 2 3 4 5 |_____|_____|_____|_____| 1 2 3 4 5 |_____|_____|_____|_____| ---- 15 1 2 3 4 5 |_____|_____|_____|_____| 1 2 3 4 5 |_____|_____|_____|_____| 1 2 3 4 5 |_____|_____|_____|_____| 1 2 3 4 5 |_____|_____|_____|_____| ---- 20 0 1 |_____| 0 1 2 3 |_____|_____|_____| 0 1 |_____| ---- 5 TOTAL ---- 60 CONTENT All aspects of the question covered Shows evidence that the topic is clearly understood Demonstrates original and creative thought Appropriate and relevant to assignment topic RESEARCH Shows evidence that relevant literature has been read Good critical understanding of authors referred to Citations appropriate and adequate (within the text and reference list) LOGIC Uses reasoned argument substantiated appropriately Concepts and ideologies clearly explained Report follows a logical order of development Appropriate introduction and conclusion PRESENTATION In accordance with Faculty requirements. Sentences grammatical and easy to follow with attention to spelling punctuation Paragraphs chunk information into meaningful units

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