Welcome from the course coordinators

Welcome to Critical Care Nursing 1 (NURS 5117). The teaching team for the graduate certificate (critical care) extends to you a warm welcome to the UniSA School of Nursing and Midwifery.
Caring for people in the critical care environment is a diverse, specialised, and complex area of practice. This course has been designed in recognition of the development and implementation of the role of the critical care nurse. Working in this area provides many opportunities and challenges to the contemporary Registered Nurse (RN). The area of Critical Care is a dynamic and evolving clinical specialty and this means that maintaining currency of knowledge can be a challenge. This course provides a strong focus on the essential components for provision of critical care nursing which are reflective of current practice, are evidence-based care, and integrates current research.

 

A fundamental goal of this course is to create a warm, collegial and supportive learning environment that enables you to value and respect the skills required to work with colleagues, patients, their families and/or significant others, as well as further your career.

 

Please note that this course includes a two (2) day on campus compulsory workshop and a further one (1) day workshop for an Objective Structured Clinical Assessment (OSCA). Workshop and OSCA dates are included in the course timetable and you will receive further information about both the workshop and the OSCA during the course. You should ensure that you are able to attend these three (3) days.

 

Throughout the course you will value each other’s contribution, respect each other’s integrity, and appreciate what you learn will make a positive difference to those patients in your care across the span of your professional career. The online discussion forums are the vehicle through which you will engage with each other in exploring the learning activities you should complete over the course. In our roles of facilitating your learning, we will post the relevant learning activities to the forums at the beginning of each topic. As your postings to the online discussion forums form part of your assessment, it is expected that you will actively engage with each other in these forums, both initiating postings and responding to the postings of others.

 

We know from our own current clinical backgrounds within diverse ICU contexts that the delivery of effective, high quality critical care nursing practice can at times be a challenge within contemporary health care settings. We trust that you will find this course not only of benefit but also as a valuable resource for support when caring for critically ill patients.

 

The course has been structured to demand your active preparation, participation and input. The quality of your learning experience will depend, to a significant degree, on your understanding of what is required of you and your personal resourcefulness in meeting these requirements. It is up to you to initiate communication if you have any questions or problems that relate to, or may affect, your progress in this course.

We hope that the depth of vitality and richness of the learning activities will engage you and help you to further your career within the complexity of critical care nursing and associated practice. On behalf of the teaching team, I look forward to working with you this study period.

Best wishes with your studies,

 

Mrs Kim Gibson

Dr Joanne Harmon

 

There are no prerequisite courses to be completed before this course can be undertaken.

There are no corequisite courses to be completed in conjunction with this course.

To enable registered nurses to develop the specialist knowledge and skills to provide comprehensive, evidence based nursing care to critically ill adult clients

On completion of this course, students should be able to:

CO1. Evaluate the physical, psychosocial, cultural and spiritual impact of critical illness on the client and their family

CO2. Demonstrate integrated comprehensive client assessment and clinical decision making in nursing management of clients with critical illness.

CO3. Apply specialist knowledge in recognising and responding to clinical deterioration in the critically ill client

CO4. Demonstrate competency in advanced life support of the critically ill client

CO5. Integrate best available evidence in the management of critically ill clients.

CO6. Demonstrate comprehensive understanding of ethical practice in the nursing management of critically ill clients

CO7. Critically analyse the use of technology in the management of critically ill clients.

Upon completion of this course, students will have achieved the following combination of Graduate Qualities and Course Objectives:

A graduate of UniSA:

GQ1. operates effectively with and upon a body of knowledge of sufficient depth to begin professional practice

GQ2. is prepared for life-long learning in pursuit of personal development and excellence in professional practice

GQ3. is an effective problem solver, capable of applying logical, critical, and creative thinking to a range of problems

GQ4. can work both autonomously and collaboratively as a professional

GQ5. is committed to ethical action and social responsibility as a professional and citizen

GQ6. communicates effectively in professional practice and as a member of the community

GQ7. demonstrates international perspectives as a professional and as a citizen

Evidenced based practice in critical care nursing; physiology and pathophysiology, comprehensive patient assessment, nursing management of the patient with clinical deterioration, advanced adult life support, nursing management of the patient with acute respiratory disorders, respiratory support, cardiac assessment and electrocardiography, cardiac disorders and management, neurological considerations, clinical leadership, decision making, legal and ethical aspects of nursing care.

9 units

You will need continual access to the following text(s) to complete this course. Where possible the Library will make the book available for student use. Please check the Library catalogue before purchasing the book(s). The Library will always seek to purchase resources that allow an unlimited number of concurrent users, however availability is dependent on license arrangements with book publishers and platforms. http://www.library.unisa.edu.au

Aitken, L, Marshall, A, Chaboyer, W (2015). ACCCN's Critical Care Nursing (3rd edition). Elsevier.

Gill, F, Kendrick, T and Greenwood, M (2015). ACCCN's Practice Standards for Specialist Critical Care Nurses (3rd edition). Online version.

All course related materials can be accessed through your learnonline course site which you will be able to access from the my Courses section in myUniSA.

All study related materials can be accessed through: https://my.unisa.edu.au

Student Clinical Portfolio

Details of assessment submission and return are listed under each assessment task. Assessment tasks will be returned to you within two to three weeks of submission.

If the Course Coordinator allows submissions in hard copy format, you will be required to attach an Assignment Cover Sheet which is available on the learnonline student help (https://lo.unisa.edu.au/mod/book/view.php?id=1843&chapterid=567) and in myUniSA.

The feedback proforma is available on your course site.

Instructions for on-going (weekly) forum posts during teaching weeks

 

1. Critically think and analyse
Define & clarify issues/ factors/evidence from multiple sources & perspectives
Demonstrate advanced critical thinking & analysis

2. Quality of response
Draw responses on a wide range of evidence & experience
Demonstrate logical & rational arguments
Develop critical analysis of contributions of others
Display sensitivity to & respect of others views
Lead discussion on a regular basis

3. Contribution to forums
Participate in all assessed online forums
Mix of original contributions (one third) & respond to the contributions of others

Case Study: PART A (Word count approx. 1500 words)

Choose a patient who you have cared for in the critical care setting whose response to treatment (this can be pharmacological or mechanical e.g. ventilation/dialysis or both) was not expected, i.e. they did not successfully respond to treatment as initially anticipated. Additional/alternate treatment was then given*. *Ensure you have chosen an appropriate patient to complete Part B of this assignment. You will need to have access to their case notes to complete this assignment. Please ensure the case notes and any other documentation are managed appropriately, and if any copies are made then the patient identification details are removed.
Instruction 1
Without describing any identifiable details (you must use pseudonyms for the patient and staff and must not identify the hospital), describe the patient’s age, past medical history, co-morbidities, lifestyle factors, family support and any pertinent information that may impact on the development of the illness and response to the critical illness.
Discuss the specific events leading to the patient’s admission to the critical care setting. For example, the acute events prior, such as a car accident, cardiac arrest at home, chest infection with the subsequent development of pneumonia, or surgery. If the patient had a chronic condition requiring critical care then describe the details surrounding their deterioration.
Instruction 2
Explain the patient’s critical illness with reference to evidence based literature. This explanation should include the pathophysiology, risk factors, prevalence, treatment and outcomes.
Instruction 3
Evaluate the physical, psychological and spiritual impact of the illness on the client and their family with reference to evidence-based literature. If the patient was heavily sedated/and or died and it is therefore difficult to evaluate their psychological and spiritual impact, then relate this to predicted long-term implications for them if they were sedated and also refer to their family’s psychological and spiritual well-being.

 

 

Case Study: Part B (Word count approx. 2500 words)

Instruction 1
Explain and provide a rationale for the initial treatment given to the patient for the critical illness. Use current evidence base literature to support the use of this treatment. What is your unit’s current policy for this?
Instruction 2
Discuss the common success rates of the initial treatment for this critical illness, supported by relevant evidence based literature.
Instruction 3
Explain the unpredicted response/lack of response of this patient to the initial treatment given and the effect on the patient’s health, e.g. did the patient continue to deteriorate and why? Refer in this discussion to current literature and research to support your explanations.
What were the implications for nursing care during this unpredicted response? Did this change the nursing care required? Did the nurses (or even yourself) assist in the diagnosis of this poor response? What observations or assessments were made?
Instruction 4
Describe whether there is an identified group of patients in the literature of who have been recognised to not respond as anticipated to this initial treatment. Explain the reason and associated factors that are identified to influence a patient’s response to the treatment. Make a comparison with this identified group to your patient.
Instruction 5
Describe the subsequent treatment given following the unsuccessful response to the initial treatment. Explain how the patient responded to this treatment. Refer to evidence based literature to support your explanation for this treatment. Describe the implications for nursing care in the delivery of this subsequent treatment.
Instruction 6
Is this alternate treatment included in your unit’s policy? In a short paragraph which is also part of the conclusion of this paper, design an entry that is to be added to the current protocol of the treatment/critical illness (fictional). Summarise the cohort of patients who do not respond to the initial treatment and reasons for this. Summarise the subsequent treatment option and the nursing implications for this.

 

Overview

Your clinical performance in this course will be assessed using reflection and completion of your student clinical portfolio. In order to gain a pass for this assessment item you will need to successfully complete all three (3) components.

 

Clinical Performance: Part A. Self reflection 

Word limit: 500-1000 words

Instructions:
1. Reflect on your current abilities in the area of critical care and level of professional competence as a registered nurse in your specialised field, highlighting areas of strength and personal attributes, using examples in your clinical practice.
2. Identify areas of improvement (this may be knowledge, behaviour or skill-based) within your current standard of practice.
3. Identify a set of short-term goals in relation to these areas of improvement, which are practical to achieve by the end of the Program (i.e. end of Critical Care 2).
4. How will you go about achieving these short-term goals? What resources will you use? For example, additional study/workshops/help from colleagues
Ensure you demonstrate comprehension in SMART goal setting and planning.
5. How will you be able to demonstrate or show evidence that you have improved your practice in the areas you have identified by the end of this course? For example, being allocated more complex patients or patients with specific therapies, leadership roles, accreditation, personal attributes.

 

 

Clinical Performance: Part B. Self reflection

Word limit: 500-1000 words

Instructions:
Refer back to Part A of the assignment and reflect on what where you hoping to achieve now that you have completed NURS 5117 (For example, was it new learning or consolidation of previous learning or a combination of both?).
1. In achieving your learning objectives from Assignment 1 Part A clinical performance self- reflection, what was the most significant learning experience for you? In your answer, outline your areas of strength that you have developed and those personal attributes you will need to improve on by using examples in your clinical practice and provide evidence.
2. Identify those areas of improvement that you found interesting, useful or informative (this may be knowledge, behaviour or skill-based) to achieve your objective. Outline what worked and what did not work in the processes you undertook to achieve your learning objective.
3. What challenged you the most in achieving your goals for NURS 5117? What aspects required further development and what resources did you use. For example, additional study/workshops/help from colleagues - outline how you are going to use this knowledge now for NURS 5118 and for your current area of employment.
4. How will you demonstrate or show evidence that you have improved your practice in the areas you had identified? For example, being allocated more complex patients or patients with specific therapies, leadership roles, accreditations, personal attributes.

 

 

Clinical Performance: Part C. Student Clinical Portfolio

The key clinical skills for NURS 5117 Critical Care 1 outlined in the portfolio document need to be completed (and awarded as competent) and provided to the Course Coordinator by 5th July 2019 5 pm. Failure to do so will result in you not being able to pass the Course. Please indicate to the Course Coordinator, Mrs Kim Gibson, well before the due date if you are having difficulty for some reason in getting these signed off. This in order for strategies to be put in place and to allow for timely communication with your Clinical Support Team. 

 

How is the OSCA being conducted?
1. Academic staff will assess students individually for approximately 45 minutes.

2. Students will be asked to respond to patient situations requiring the application of theoretical knowledge and clinical skills.

3. The assessment panel will observe the student during the simulation, then pose appropriate questions to enable judgment of the student’s competence in each of the assessment criteria. 4. Horizon Hospital and Health Service staff will be organizing the equipment for the scenario and running the OSCA, and may provide input into the grade awarded.

 

What is being assessed?
Each student will be assessed on the following 5 areas relating to an Advanced Adult Life Support scenario;
1. Client Assessment
Collection of adequate & appropriate data to make an informed decision about the client’s health problem/issue
Ability to make judicious & rational use of investigative options
Sufficient specialist knowledge to make an informed analysis of assessment data
2. Nursing Management of the critically ill patient
Safely performs all components of nursing care ensuring comprehensive, systematic and timely life support to the critically ill patient
Demonstrates advanced knowledge in the use of technology in assessment and life support of the critically ill patient
Functions in accordance to legislative law, policies and guidelines and best available evidence
3. Clinical Reasoning
Integrates comprehensive patient assessment and interpretive skills to achieve optimal patient outcomes
Draws upon knowledge of current evidence to make informed clinical decisions
Evaluates and responds effectively to changing situations
Develops and manages a plan of care to achieve desired outcomes
4. Team work and leadership
Collaborates with the critical care team to achieved desired outcomes Demonstrates effective leadership qualities in professional relationships
5. Theory

 

Questions will be posed related to the above 4 areas of assessment
What do students need to do?
1. Arrive 15 minutes prior to your designated OSCA time. If you are late you cannot be assessed and will forfeit your marks (that is gain zero grade).
2. Wear your clinical uniform or a white shirt and navy/black pants with enclosed shoes.
3. Please wait quietly in the cushioned area outside the Skills Laboratory, located to the left when exiting the elevator.
How will students receive their OSCA grade and academic feedback?
1. Your assessor will use your OSCA Assessment Form to grade your performance.
2. At a later date, the assessment panel will provide the student with written feedback on their performance.
3. The academic staff member will keep the hard copy of your assessment form so that your results can be entered into the online assessment section of the course.

 

When is my OSCA taking place?
1. Horizon Hospital and Health Service, Level 6, School of Nursing and Midwifery, Centenary Building, City East Campus
Where can I go for additional Information?
If you have additional questions, please contact your Course Coordinator or Lecturer (Additional briefing will occur on the day of the Workshop).

 

Resources:
Australian Resuscitation Council, Adult Advanced Life Support Guidelines, <http://www.resus.org.au>.
Burbach B, Barnason S & Thompson S 2015, ‘Using “Think Aloud” to Capture Clinical Reasoning during Patient Simulation’, International Journal of Nursing Education Scholarship, vol. 12, no.1. pp. 1-7.

 

 

See above under Assessment details.

This course does not have an exam.

Variation to exam arrangements does not apply to this course.

Supplementary assessment or examination offers students an opportunity to gain a supplementary pass (SP) and is available to all students under the following conditions unless supplementary assessment or examination has not been approved for the course:

1. if the student has achieved a final grade between 45-49 per cent (F1) in a course
2. if a student who has successfully completed all of the courses within their program, with the exception of two courses in which they were enrolled in their final study period, a supplementary assessment or examination may be granted where the final grade in either or both of these courses, is less than 45 percent (F1 or F2) and all assessments in the courses were attempted by the student. Supplementary assessment will not be available for a course under investigation for academic integrity until the investigation is completed, and determined that it did not constitute academic misconduct.

More information about supplementary assessment is available in section 7.5 of the Assessment Policy and Procedures Manual.
http://i.unisa.edu.au/policies-and-procedures/codes/assessment-policies/

All students must adhere to the University of South Australia's policies about assessment:
http://i.unisa.edu.au/policies-and-procedures/codes/assessment-policies/.

Students are required to pass assessment items Portfolio and Objective Structured Clinical Assessment (OSCA) in order to successfully complete this course.

Students with disabilities or medical conditions or students who are carers of a person with a disability may be entitled to a variation or modification to standard assessment arrangements.  See Section 7 of the Assessment Policy and Procedures Manual (APPM) at:  http://i.unisa.edu.au/policies-and-procedures/codes/assessment-policies/

 

Students who require variations or modifications to standard assessment arrangements should make contact with their Course Coordinator as early as possible in order to ensure that appropriate supports can be implemented or arranged in a timely manner.

 

Students can register for an Access Plan with UniSA Access & Inclusion Service. It is important to make contact early to ensure that appropriate support can be implemented or arranged in a timely manner. See the Disability Hub for more information:  http://www.unisa.edu.au/Disability/Current-students

Students are advised there is a deadline to finalise Access Plan arrangements for examinations. Further information is available at:  http://i.unisa.edu.au/campus-central/Exams_R/Before-the-Exam/Alternative-exam-arrangements/

Deferred assessment or examination is not available for this course. APPM 7.6.4

Special consideration is not available for this course. APPM 7.7.4

Variation to assessment methods, tasks and timelines may be provided in:

Unexpected or exceptional circumstances, for example bereavement, unexpected illness (details of unexpected or exceptional circumstances for which variation may be considered are discussed in clauses 7.8 - 7.10 of the Assessment Policy and Procedures Manual). Variation to assessment in unexpected or exceptional circumstances should be discussed with your course coordinator as soon as possible.

Special circumstances, for example religious observance grounds, or community services (details of special circumstances for which variation can be considered are discussed in clause 7.11 of the Assessment Policy and Procedures Manual). Variations to assessment in expected circumstances must be requested within the first two weeks of the course (or equivalent for accelerated or intensive teaching).

 

Students with disabilities or medical conditions please refer to Students with disabilities or medical conditions.

Academic integrity is the foundation of university life and is fundamental to the reputation of UniSA and its staff and students. Academic integrity means a commitment by all staff and students to act with honesty, trustworthiness, fairness, respect and responsibility in all academic work.

An important part of practising integrity in academic work is showing respect for other people's ideas, and being honest about how they have contributed to your work. This means taking care not to represent the work of others as your own. Using another person's work without proper acknowledgement is considered Academic Misconduct, and the University takes this very seriously.

The University of South Australia expects students to demonstrate the highest standards of academic integrity so that its degrees are earned honestly and are trusted and valued by its students and their employers. To ensure this happens, the University has policies and procedures in place to promote academic integrity and manage academic misconduct. For example, work submitted electronically by students for assessment will be examined for copied and un-referenced text using the text comparison software Turnitin http://www.turnitin.com.

More information about academic integrity and what constitutes academic misconduct can be found in Section 9 of the Assessment Policies and Procedures Manual (APPM): http://i.unisa.edu.au/policies-and-procedures/codes/assessment-policies/. The Academic Integrity Module explains in more detail how students can work with integrity at the University: https://lo.unisa.edu.au/mod/book/view.php?id=252142

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