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92454 Medical Surgical Nursing

Warning: The information on this page is indicative. The subject outline for a particular session, location and mode of offering is the authoritative source of all information about the subject for that offering. Required texts, recommended texts and references in particular are likely to change. Students will be provided with a subject outline once they enrol in the subject.

Subject handbook information prior to 2019 is available in the Archives.

UTS: Health
Credit points: 6 cp

Subject level:

Undergraduate

Result type: Grade and marks

There are course requisites for this subject. See access conditions.

Description

This subject builds on previous clinical subjects. Students develop their understanding and application of nursing processes with increasing emphasis on effective critical reasoning and sound judgement. The focus of learning is on the nursing management of adults admitted to acute care facilities with medical–surgical conditions. Students analyse and apply their knowledge and problem-solving skills in clinical case scenarios based on commonly encountered medical–surgical problems. Nursing competencies previously achieved are reinforced and relevant nursing skills strengthened and extended including: vital signs and neurological observations; infection control; administration of parenteral medications; person-centred nursing care; complex wound care; pain assessment and management; and fluid and electrolyte replacement. Students are exposed to simulated and scenario-based emergency situations, and guided to develop appropriate evidence-based, patient-focused responses. All learning experiences focus on providing safe and effective care to individuals and families drawing on the National Safety and Quality Health Service Standards (ACSQHC 2011) and the Essentials of Care Program (NSW Health: Nursing and Midwifery Office 2014).

Subject learning objectives (SLOs)

Upon successful completion of this subject students should be able to:
A. Incorporate pathophysiology, symptomatology and interdisciplinary management into clinical judgements about the care of individuals experiencing acute and chronic conditions (RN Standards for Practice 1, 2 & 5).
B. Apply information technologies knowledge to the application of skills in assessment, planning, implementation and evaluation of nursing care (RN Standards for Practice 1, 2, 5).
C. Develop person centred, evidence based plans of care in adherence with relevant policies and clinical practice guidelines (RN Standards for Practice 1, 2, 3, 5, 7).
D. Discuss socio-cultural issues, health promotion and disease prevention in medical-surgical nursing contexts (RN Standards for Practice 1, 2).
E. Identify, appraise and apply research evidence to inform clinical nursing practice (RN Standards for Practice 1, 3, 6).
F. Demonstrate a capability to translate academic learning and clinical judgement to nursing actions that can meet identified patient outcomes (RN Standards for Practice 1, 3, 4, 5, 6, 7).
G. Critically reflect on clinical experience and performance and identify strategies to improve future professional practice (RN Standards for Practice 1, 3).
H. Demonstrate appropriate nursing practice in accordance with the Registered Nurse Standards for Practice including the ability to communicate in English with patients and staff in the clinical environment (RN Standards for Practice 1 - 7).

Teaching and learning strategies

In this subject, you will participate in a range of teaching and learning strategies that are designed to encourage you to engage with the nursing care of patients admitted to acute care facilities with acute medical-surgical conditions.

UTSOnline Learning Modules and MSN workbook
To assist students with study time management they will complete the pre-class activities outlined in the learning modules available on UTSOnline. Access to websites, online videos and professional literature contribute to this learning strategy.

A MSN lab workbook will be utilised by students to complete their lab activities. Students express that they prefer a workbook as it becomes a useful rescource for their learning.

Case Scenarios
Cases are used to help students explore health related scenarios. Students will participate in tutorial sessions using scenarios that depict patients and their families in clinical situations. Students use these scenarios to learn concepts, interpret information, form clinical judgements and develop appropriate person-centred solutions. Critical thinking is developed through analysis, interpretation of and reflection on issues or situations. Students will be provided with feedback from their tutors and peers throughout the scenarios.

Clinical skills, communication and simulation
Students participate in clinical laboratory sessions that focus on integration of key concepts and skills. In these sessions, students are introduced to and practice a range of nursing skills, including assessment and interventions and simulation activities. Simulation activities are practical collaborative learning experiences designed to give students exposure to a comprehensive range of scenarios that may be encountered in practice. Activities include the use of audio-visual aids, interactive-computer programs and clinical equipment set-ups with mannequins, teaching staff or students as pretend patients. Students learn and practice clinical and interpersonal skills with case scenarios in the laboratories. These practice scenarios incorporate the development of effective communication skills including professional, interprofessional and therapeutic communication, which are required for safe nursing practice. The needs of students for whom English is an additional language will be taken into account. Students’ development of clinical skills is assessed through an Objective Skills Clinical Examination (OSCE) in preparation for clinical placement.

Clinical Placement
Students who commenced prior to 2018 complete 80 clinical placement hours; Students commenced from 2018 complete 120 clinical placement hours.

Placements are provided in a range of acute care hospitals in mostly metropolitan locations. Students provide nursing care within interprofessional teams to develop and consolidate their knowledge, skills and attributes relevant to the clinical field.

As part of this subject, an opportunity may arise for students to complete a placement in a speciality area including Paediatrics, Mental Health or in Rural and Remote Areas. Students will be notified of the speciality areas available at the beginning of session and are invited to make an Expression of Interest (EOI) prior to the allocation of placements. Placements will be allocated based on the quality of the EOI and academic merit. The submission of an EOI does not guarantee a placement in a speciality area. For further information, students should refer to the EOI application form in myPlacement.

Information Technologies
Information technologies will be used by students to access relevant evidence based literature to inform clinical practice.

Lectures
There are 3 x 1hr face to face / online lectures delivered in this subject. Online lectures allow students flexibility in where and when they learn and the option of accessing materials repeatedly.

Content (topics)

Person-centred care: Content included - critical thinking in health assessment and care planning; clinical reasoning;
cultural competence; quality use of medicines; therapeutic communication; inter-professional communication;
teamwork and patient safety.

Care of the person requiring medical, and surgical care: Content included - fluid management and electrolyte imbalance; acute pain; diabetes; respiratory conditions; acute coronary syndromes; neurological injury; recognition and management of 'the deteriorating patient’.

Clinical-based laboratories and simulation: Content included - quality use of medications (oral, parenteral and inhalers); establishment and management of intravenous (IV) therapy including peripheral cannula care; patient assessment using the A-G algorithm; oxygen therapy and management; basic airway management and suctioning; nursing management of chest pain; basic cardiac rhythm recognition; basic life support; neurological assessment; infection control including additional precautions and wound swabbing; introduction to interpretation of pathology results; pain assessment and management; planning care for 2 or more patients; discharge planning.

Skills addressed in the subject

Clinical communication and documentation:

  • Clinical handover
  • Recording vital signs
  • Recording fluid intake/output
  • Using and maintaining patient records
  • Interprofessional communication
  • Negotiating care with patient/client and families

Clinical assessment and monitoring:

  • A - G physical assessment
  • Pain assessment
  • Respiratory assessment
  • Cardiovascular assessment
  • Basic cardiac rhythm recognition
  • Cardiac monitoring: lead attachment and performing an ECG
  • Neurological assessment
  • Assessment of fluid balance
  • Blood glucose monitoring
  • Haematological results
  • Recognition and responding to the deteriorating patient

Clinical interventions and management:

  • Basic life support
  • Wound care: care of drains
  • Wound care: swabbing for culture
  • Oxygen therapy
  • Airway management: suctioning

Privacy and dignity:

  • Respectful care
  • Confidentiality
  • Cultural and transcultural care

Risk and safety:

  • Hand hygiene
  • Infection control

Medications, intravenous therapy:

  • Safe checking, administration, documentation and disposal of medications
  • Medication calculations
  • Oral medication administration
  • Other non-parenteral medications
  • Intramuscular injections
  • Subcutaneous injections
  • Intravenous therapy calculations
  • Intravenous therapy

Assessment

Assessment task 1: In-class medical-surgical nursing quizzes

Intent:

This assessment enables students to demonstrate clinical reasoning skills at second year level. Effective clinical reasoning skills have a positive effect on patient outcomes. They are essential for patient safety, the provision of best practice care, early detection of deterioration, appropriate management of risks and the prevention of adverse outcomes for patient.

Type: Quiz/test
Groupwork: Individual
Weight: 20%
Length:

Quiz 1: 20 questions in 20 minutes

Quiz 2: 20 questions in 20 minutes

Assessment task 2: Objective Structured Clinical Examination (OSCE)

Intent:

This assessment provides students with the opportunity to demonstrate application of knowledge and clinical reasoning skills gained during laboratory preparation and simulated clinical scenarios participation to simulated clinical situations.

Type: Examination
Groupwork: Individual
Weight: 35%
Length:

60 minutes

Assessment task 3: Concept map

Intent:

The purpose of this assessment item is to provide students with the opportunity to demonstrate their development of critical thinking, clinical judgment and clinical decision-making skills.

Groupwork: Individual
Weight: 30%
Length:

60 minutes 1 x A3 sheet

Assessment task 4: Reflection Paper

Intent:

This assessment is designed to develop students reflective practice to improve their self-awareness and professional competence through critically thinking. This guided critical reflection can evaluate students’ ability to critically think and inform their future clinical practice.

Type: Reflection
Groupwork: Individual
Weight: 15%
Length:

1000 words

Assessment task 5: Clinical placement

Groupwork: Individual
Length:
  • Students who commenced prior to 2018 complete 80 clinical placement hours
  • Students commenced from 2018 complete 120 clinical placement hours

Required texts

Brown, D., Edwards, H., Seaton, L., & Buckley, T. (eds) 2015, Lewis’s medical-surgical nursing: assessment and management of clinical problems, 4th edn, Elsevier Australia, Chatswood, NSW.

Berman, A., Snyder, S., Levett-Jones, T., Burton, P. & Harvey, N. (eds) 2016, Skills in clinical nursing, Pearson Australia, Melbourne, VIC.

Levett-Jones, T. (ed.) 2018, Clinical reasoning: learning to think like a nurse, 2nd edn, Pearson Australia, Melbourne, VIC.

Recommended texts

Tiziani, A. 2013, Havard’s nursing guide to drugs 9th edn, Elsevier Australia, Chatswood, NSW

References

Refer to UTSOnline for access to up to date references for this subject.
Links to references are provided on UTSOnline.

Other resources

UTS Student Centre
Building 10
Monday to Friday: 9am - 5pm
Tel: 1300 ASK UTS (1300 275 887)

Details for student centres: www.uts.edu.au/current-students/contacts/general-contacts
For other resources/information refer to the Faculty of Health website (www.uts.edu.au/about/faculty-health), the Health Student Guide (www.uts.edu.au/sites/default/files/uts-health-student-guide.pdf) and UTSOnline at: https://online.uts.edu.au/webapps/login/

UTS Library
The Library has a wide range of resources, facilities and services to support you including textbooks, subject readings, old exam papers, academic writing guides, health literature databases, workshops, a gaming room and bookable group study rooms. There is also a team of librarians to help you with all your questions.
W: lib.uts.edu.au, Facebook: utslibrary, Twitter: @utslibrary Tel: (02) 9514 3666

Improve your academic and English language skills
Marks for all assessment tasks such as assignments and examinations are given not only for what you write but also for how you write. If you would like the opportunity to improve your academic and English language skills, make an appointment with the HELPS (Higher Education Language & Presentation Support) Service in Student Services.

HELPS (Higher Education Language & Presentation Support)
HELPS provides assistance with English language proficiency and academic language. Students who need to develop their written and/or spoken English should make use of the free services offered by HELPS, including academic language workshops, vacation intensive courses, drop-in consultations, individual appointments and Conversations@UTS (www.ssu.uts.edu.au/helps). HELPS staff are also available for drop-in consultations at the UTS Library. Phone (02) 9514 9733

Please see www.uts.edu.au for additional information on other resources provided to students by UTS.