92445 Integrated Nursing Practice
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Credit points: 6 cp
Subject level:
Undergraduate
Result type: Grade and marksRequisite(s): (90 credit points of completed study in spk(s): C10122 Bachelor of Nursing OR 90 credit points of completed study in spk(s): C10123 Bachelor of Nursing Bachelor of International Studies OR 90 credit points of completed study in spk(s): C10351 Bachelor of Nursing Bachelor of Creative Intelligence and Innovation) AND (92442 Complex Nursing Care: Medical Surgical OR 92330 Complex Nursing Care: Medical Surgical)
Description
This subject enables students to consolidate and embody clinical practice in a number of ways. Specified patient case studies are explored using online resources as preparation for hands-on laboratory sessions. Using a community-of-practice framework, guided simulation scenarios are enacted in university clinical practice laboratories where post-simulation debriefing and reflection assists and informs students for their subsequent practice. The central focus of the subject is planning and coordination of care for patients with complex health issues commonly encountered in acute hospital settings. In preparation for entering the workforce, students explore concepts of leadership, socialisation in the workplace and clinical management strategies to assist with their new graduate year.
Subject learning objectives (SLOs)
| A. | Prioritise the care needs for patients with complex health issues, incorporating both physical and psychosocial aspects (RN Standards for Practice 1.3, 1.6, 2.1, 4.1, 6.1). |
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| B. | Justify beginning nursing management and leadership in the coordination of patient care (RN Standards for Practice 1.1, 1.6, 5.1, 5.2, 6.3, 6.4 & 7.1). |
| C. | Simulate and reflect on effective nursing assessment and responses to patients, relatives and team members in relation to relevant case scenarios and contexts (RN Standards for Practice 1.2, 1.3, 2.1, 2.2, 4.2, 5.1, 6.1, 7.1, 7.3). |
| D. | Select and apply relevant literature and health policies to justify clinical practices within subject assessments (RN Standards for Practice 1.1, 1.4, 3.3, 3.5). |
| E. | Demonstrate clinical reasoning, decision making and judgements in relation to patient case studies (RN Standards for Practice 1.4, 1.5, 2.6, 5.1, 5.2, 6.1). |
Course intended learning outcomes (CILOs)
This subject also contributes specifically to the following graduate attributes:
- Embody a professional disposition committed to excellence, equity and sustainability (1.0)
- Engage in person-centred care that is appropriately sensitive to the needs of individuals, families and communities (2.0)
- Communicate and collaborate effectively and respectfully with diverse groups (3.0)
- Inquire critically to assess a body of evidence to inform practice (4.0)
- Competently apply knowledge and skills to ensure safe and effective nursing practice (5.0)
Contribution to the development of graduate attributes
Students will find and evaluate research evidence and apply such evidence to complex nursing care of selected patients writing in ways that are appropriate for different purposes and contexts. Students will be required to present an in-service session or presentation session in their clinical setting.
Personal care:
Hygiene: oral care
Skin integrity: positioning
Skin integrity: pressure area care
Clinical communication and documentation:
Therapeutic communication
Admission
Clinical handover
Care planning
Recording vital signs
Recording fluid intake/output
Using and maintaining patient records
Communicating clinical reasoning
Interprofessional communication
Negotiating care with patient/client and families
Discharge planning
Delegation of nursing care
Clinical assessment and monitoring:
Vital signs: TPR & BP
Physical assessment
Pain assessment
Respiratory assessment
Pulse oximetry
Using a stethoscope
Cardiovascular assessment
Basic cardiac rhythm recognition
Cardiac monitoring: lead attachment
Cardiac monitoring: 12 lead ECG
Blood glucose monitoring
Haematological results
Arterial blood gas interpretation
Neurological assessment
Neurovascular assessment
Cognitive assessment
Recognition of the deteriorating patient
Assessment of fluid balance
Clinical interventions and management:
Basic life support
Wound care: aseptic non-touch technique
Wound care: dry dressing technique
Oxygen therapy
Care of the dying/deceased person
Privacy and dignity:
Respectful care
Confidentiality
Cultural and transcultural care
Care of the dying/deceased person
Promoting self-management
Risk and safety:
Hand hygiene
Gowning and gloving
Infection control
Falls prevention
Medications, intravenous therapy and blood products:
Safe checking, administration, documentation and disposal of medications
Medication calculations
Oral medication administration
Other non-parenteral medications
Subcutaneous injections
Intravenous therapy calculation
Intravenous therapy
Intravenous injections
Promoting self-management of medications
Teaching and learning strategies
In this subject, students will participate in a range of teaching and learning strategies that are designed to encourage students to engage with the nursing care of adults admitted to tertiary-care facilities focusing on planning and coordination of care for patients with complex health issues. Preparatory activities will be available on Canvas for every lab session and it is expected that students complete the activities prior to each lab session so that they can participate in full and experience the most from these clinical case scenarios.
Case Scenarios
Cases are used to help students explore health related scenarios. Cases depict patients and their families in clinical situations. Students use these scenarios to learn concepts, interpret information, form clinical judgements and develop creative solutions. Critical thinking is developed through analysis, interpretation of and reflection on issues or situations.
Clinical skills, communication and simulation
Students participate in clinical laboratory sessions that focus on integration of key concepts and skills. In these sessions, students learn more advanced skills and develop mastery of a range of previously taught nursing skills, including assessment and interventions and simulation activities. Simulation activities are practical 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 practice clinical and interpersonal skills with case scenarios in the laboratories and will engage in interdisciplinary simulations in collaboration with other nursing students. These practice scenarios incorporate the development of professional communication skills including professional and therapeutic communication required for nursing practice.There will be a debriefing session after the completion of each simulation. During the debriefing session students will participate in collaborative discussion where they will have the opportunity to receive feedback from questions raised during the debriefing session and reflect upon their practice during the simulation.
Academic Writing
Demonstrating information literacy and technology skills, students search and synthesise the professional literature to answer an essay question. Students comply with academic writing practices and use information ethically, legally and respectfully.
Lectures
Lectures in this subject are designed to engage students and enable them to clarify complex descriptions and terminology. This subject benefits from access to online resources including videos and learning modules. Lectures enable students to quickly clarify complex descriptions and terminology, and engage with sensitive or confronting topics.
Content (topics)
- Prioritisation and clinical decision-making relating to patients who have complex health issues.
- Discussion and implementation of practice which is based on evidence to enhance critical thinking, clinical reasoning and judgements.
- Rehearsing communication strategies including clinical handover (oral and written), ISBAR, and engagement with patients and their families.
- Recognition, effective assessment and implementation of appropriate care for deteriorating patients.
- Working in a nursing team and interprofessional team.
- Leadership and management in contemporary healthcare practice, including delegation and supervision.
Assessment
Assessment task 1: Group in-service presentation
| Intent: | The purpose of this assessment is to enable students to work together in groups to provide an inservice presentation to their peers about the investigation of a coroners case. Students will discuss preventative measures that form part of best practice through evaluation and synthesis of current research. |
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| Objective(s): | This assessment task addresses subject learning objective(s): B, C and D This assessment task contributes to the development of graduate attribute(s): 1.0, 3.0, 4.0 and 5.0 |
| Weight: | 30% |
| Length: | 15 minute presentation |
Assessment task 2: Complex health issues case study
| Intent: | The purpose of this assignment is to enable students to apply clinical reasoning and critical thinking to justify appropriate rationales when prioritising patient health issues. This will prepare students for the real world decisions they will be making as newly graduated nurses. |
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| Objective(s): | This assessment task addresses subject learning objective(s): A, B, C, D and E This assessment task contributes to the development of graduate attribute(s): 2.0, 4.0 and 5.0 |
| Weight: | 40% |
| Length: | 1500 words |
Assessment task 3: Final Quiz
| Intent: | The purpose of this assessment is for students to use critical thinking and clinical judgement to select the most appropriate response in relation to complex patient care. |
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| Objective(s): | This assessment task addresses subject learning objective(s): A and E This assessment task contributes to the development of graduate attribute(s): 2.0 and 4.0 |
| Weight: | 30% |
| Length: | 60 minutes. |
Recommended texts
LeMone, P., Bauldoff, G., Gubrud-Howe, P., Carno, M., Levett-Jones, T., Dwyer, T., Moxham, L., Reid-Searl, K., Berry, K., Carville, K., Hales, M., Knox, N. & Stanley, D. (2019). LeMone and Burke'sMedical-Surgical Nursing Critical Thinking for Person-Centred Care. (4th edn). Pearson, Sydney Australia.
Berman, A., Synder, S., Levett-Jones, T., Burton, T. & Harvey, N. (2017). Skills in clinical nursing. (1st edn). Pearson, Melbourne.
Levett-Jones, T. (2023). Clinical reasoning : learning to think like a nurse (T. Levett-Jones, Ed.; 3e. ed.). Pearson Australia.
Levett-Jones, T. (2020). Critical conversations for patient safety. (2nd edn). Pearson, Melbourne.
Tizani, A. (2013). Harvard’s nursing guide to drugs. (9th edn). Elsevier, Sydney.
References
Australian Institute of Health and Welfare (2021). Chronic disease. Retrieved from https://www.aihw.gov.au/reports-data/health-conditions-disability-deaths/chronic-disease/overview
Australian Institute of Health and Welfare (2019). Australian Burden of Disease Study: impact and causes of illness and death in Australia 2015. Australian Burden of Disease series no. 19. Cat. no.BOD 22. Canberra: AIHW.
Australian Commission on Safety and Quality in Healthcare (ACSQHC) (2017). National Safety and Quality Health Service Standards 2nd edn, ACSQHC, Sydney.
Australian Government. (2019). National Palliative Care Strategy 2018. Reterieved from https://www.health.gov.au/resources/publications/the-national-palliative-care-strategy-2018
Australian Health Ministers’ Advisory Council. (2017). National Strategic Framework for Chronic Conditions. Australian Government. Canberra. Retrieved from https://www.health.gov.au/resources/publications/national-strategic-framework-for-chronic-conditions?utm_source=health.gov.au&utm_medium=callout-auto-custom&utm_campaign=digital_transformation
Australian Institute of Health and Welfare. (2016). Nursing and midwifery workforce 2015. Retrieved from https://www.aihw.gov.au/reports/workforce/nursing-and-midwifery-workforce-2015
Australian Institute of Health and Welfare (AIHW) (2017). The burden of chronic respiratory conditions in Australia: a detailed analysis of the Australian Burden of Disease Study 2011. Australian Burden of Disease Study series no. 14. BOD 15. Canberra: AIHW.
NSW Health. (2019). Integrated care for patients with chronic conditions. Retrieved from https://www.health.nsw.gov.au/integratedcare/Pages/chronic-conditions.aspx
Nursing and Midwifery Board of Australia (2016). Registered nurses standards for practice, Melbourne, Victoria.
Nursing and Midwifery Board of Australia (2018). Code of conduct for nurses, Melbourne, Victoria.
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