92464 Nursing Care of the Older Person
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Credit points: 6 cp
Subject level:
Undergraduate
Result type: Grade and marksRequisite(s): 92449 Health Assessment and Nursing Therapeutics
There are course requisites for this subject. See access conditions.
Description
In this subject students explore the foundational principles and practice of person-centred nursing care of the older person in a variety of health care contexts. Students explore the normal ageing process and the diseases and dysfunctions that can occur in older age. The provision of quality care to the older person with multiple physical, social and psychological co-morbidities is emphasised. Students gain skills in undertaking comprehensive health assessments of older persons and gain an understanding of interprofessional approaches to care. Students continue to develop nursing skills specifically in relation to wound care, continence and bowel management, enteral supports, and end-of-life care. Through the provision of interactive online modules, collaborative laboratory activities and lectures provided by industry experts, this subject encourages students to engage with this important area of health care.
Subject learning objectives (SLOs)
| A. | Determine the processes of and supports for healthy ageing in contemporary Australian society using a health promotion framework (RN Standards for Practice 1, 2, 4, 6 & 7). |
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| B. | Undertake comprehensive person-centred social and health assessments, care planning and interventions for the older person based on foundational gerontological knowledge and skills (RN Standards for Practice 3, 4, 5 & 7). |
| C. | Identify the implications of chronic and/or life limiting illness for the older person and their family, the impact of multiple co-morbidities and the role of the nurse in enabling optimal care (RN Standards for Practice 1, 2, 4, 5, 6 & 7). |
| D. | Explain the nature and scope of a multidisciplinary and interdisciplinary approach to the continuity of care of the older person, across varied healthcare contexts (RN Standards for Practice 2, 5 & 7). |
| E. | Develop and demonstrate nursing knowledge through reading, questioning and synthesising relevant professional and scholarly evidence, including government legislation and policies and apply such evidence to nursing practice, writing in a style appropriate to purpose and context (RN Standards for Practice 1, 3 & 6). |
| F. | Practice appropriate NMBA clinical competencies including the ability to communicate in English with patients and staff in the clinical placement environment (RN Standards for Practice 2, 3 & 7). |
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
Personal care:
Assisted ambulation
Hygiene: bed making
Hygiene: shower/bath
Hygiene: bed bath
Hygiene: oral care
Skin integrity: positioning
Skin integrity: assessment
Skin integrity: pressure area care
Nutrition and feeding
Feeding a dependent patient
Enteral feeding
Elimination: continence management
Elimination: indwelling catheter care
Elimination: supra-pubic catheter care
Elimination: bowel care
Clinical communication and documentation:
Therapeutic and 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
Clinical assessment and monitoring:
Vital signs: TPR & BP
Physical assessment
Pain assessment
Respiratory assessment
Pulse oximetry
Using a stethoscope
Cardiovascular assessment
Cardiac monitoring: lead attachment
Blood glucose monitoring
Neurological assessment
Neurovascular assessment
Abdominal assessment
Nutritional assessment
Cognitive assessment
Assessment of fluid balance
Psychosocial assessment
Comprehensive health assessment
Venous ulcer assessment
Clinical interventions and management:
Wound care: aseptic non-touch technique
Wound care: packing wounds
Wound care: non-healing wounds
Oxygen therapy
Nasogastric tube insertion
Urinary catheterisation
Care of dying/deceased person
Privacy and dignity:
Respectful care
Confidentiality
Cultural and transcultural care
Care of the dying/deceased person
Promoting self-management:
Discharge planning
Heath education & health promotion
Risk and safety:
Hand hygiene
Hand washing for invasive procedures
Infection control
Manual handling
Falls prevention
Risk assessment
Safe use of physical and chemical restraints
Dealing with challenging behaviour
Medications, intravenous therapy and blood products:
Safe checking, administration, documentation and disposal of medications
Medication calculations
Oral medication administration
Other non-parenteral medications
Subcutaneous infusions
Promoting self-management of medications
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 nursing care of older persons.
Case scenarios
In laboratories, you will be introduced to a range of case scenarios based on older people with different conditions in a range of contexts for care or healthy ageing. Cases are used to help students explore health related scenarios for older people. Cases depict older persons and their families in clinical or community 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 relevant to older people.
Clinical placement
In this subject you will complete 80 hours of clinical placement experience in a range of clinical contexts inclusive of high level care facilities, dementia specific care facilities and acute aged care assessment units. In the placement, students explore and engage the practice of person centred care for older people, consider approaches to nursing care that recognise the nature of normal ageing, disease and dysfunction that can manifest in older age and work within inter-professional teams to develop and consolidate their knowledge, skills and attributes relevant to care of the older person.
Information Technologies
Information technologies will be used by students to access relevant evidence based guidelines related to health assessment and health promotion in addition to resources suitable for encouraging patient participation in health management.
Lectures and online learning materials
In this subject this benefits from both the real time delivery of content and access to online resources including podcasts, videos and learning modules. Face to face lectures enable students to quickly clarify complex descriptions and terminology, and engage with sensitive and confronting topics such as advance care planning and end of life care. Using scenario-based learning software, problem-based progressive case studies unfold at the student's pace and instant feedback is provided to develop students' judgement.
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 a range of 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. Students learn and practice clinical and inter-personal skills with older person case scenarios in nursing laboratories, designed to replicate the clinical environment. Simulation 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/consumers. These activities are designed to support student preparation for assessment items, scaffolding learning across the domains of nursing assessment and intervention, and by giving group formative feedback from peers and teaching staff on planning of nursing care. Teaching and learning strategies incorporate the development of professional communication skills including professional and therapeutic communication required for nursing practice. The needs of students for whom English is an additional language will be taken into account.
Structured Decision Making Activities
Working in small teams students engage in real-time, shared decision-making activities. This assists students to engage with policies and utilise knowledge to formulate responses to patient and family situations, under time pressure, as would be expected within a clinical practice setting. Together, students learn to quickly achieve consensus for decisions. Feedback for decision outcomes is also provided in real-time allowing students to assess and reflect on their decision making choices and indeed the impact of these on older patients and their families.
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.
Content (topics)
Healthy ageing in a range of contexts within Australian society including: Aboriginal and Torres Strait Islander people’s health, transition through health, illness and death; advance care planning/directives; achieving quality of life; poly-pharmacy in health maintenance; carer support; mental health issues.
Healthy ageing and ill health including: normal ageing processes; alteration to functional health patterns; continence; cognitive dysfunction; dementia, delirium and depression; co-morbidity and chronicity; disease and disability.
Comprehensive, person centred, social and health assessment using strengths based approach for care planning including: comprehensive history taking; functional assessments; person centred care planning, nursing intervention and care delivery.
Interprofessional approaches to the continuity of care within varied health care contexts including: collaborative care across the health professions, community care, transitional care, acute care, rehabilitation, differing levels residential aged care, accommodating different ethnic groups and cultural expectations in residential aged care.
Assessment
Assessment task 1: Person-centred care planning study: Essay
| Intent: | The intent of this assignment is for students to demonstrate their ability to identify and describe issues of concern for an older person, access and critically analyse the literature, select appropriate articles and prepare a critical analysis of the topic area. This will enable students to adopt and incorporate evidence based interventions in future practice. In addition, students will be able to demonstrate their ability to write clearly and succinctly to reflect their understanding of the topic. Students will receive feedback as per the marking criteria and within the paper. |
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| Objective(s): | This assessment task addresses subject learning objective(s): A, B, C and E This assessment task contributes to the development of graduate attribute(s): 2.0, 3.0 and 4.0 |
| Weight: | 45% |
| Length: | 1500 words (Literature table and discussion summary not included in word count). |
Assessment task 2: Quizzes
| Intent: | The intent of the assessment is for students to make decisions for some key clinical scenarios utilising knowledge and information sources they would access in clinical practice (policies and guidelines). |
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| Objective(s): | This assessment task addresses subject learning objective(s): E This assessment task contributes to the development of graduate attribute(s): 5.0 |
| Type: | Quiz/test |
| Weight: | 10% |
| Length: | 2 X 5 questions |
Assessment task 3: Examination
| Intent: | The intent of this assessment is for students to utilise the knowledge gained in this subject to answer questions for a number of case scenarios for each domain of nursing care of an older person-health ageing, chronic disease, care of a deteriorating older person and palliation. |
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| Objective(s): | This assessment task addresses subject learning objective(s): A, C and D This assessment task contributes to the development of graduate attribute(s): 2.0 and 5.0 |
| Weight: | 45% |
| Length: | 100 MCQ in 2 hours |
Assessment task 4: Clinical placement
| Objective(s): | This assessment task addresses subject learning objective(s): A, B, C, D and F This assessment task contributes to the development of graduate attribute(s): 1.0, 2.0, 3.0, 4.0 and 5.0 |
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| Weight: | Mandatory task that does not contribute to subject mark |
| Length: | 80 hours |
References
Australian Institute of Health and Welfare. (2013). National health priority areas, http://www.aihw.gov.au/national-health-priority-areas/
Brown, D., Edwards, H., Buckley, t. & Atiken, R. (eds) (2019). Lewis’ medical-surgical nursing: Assessment and management of clinical problems, 5rd edn, Elsevier/Mosby, Sydney.
Cohen J, Deliens, Luc (Eds). (2012) A Public Health Perspective on End of Life Care. Oxford: Oxford University Press.
Crisp, J., Douglas, C. Reberio, G & Waters, D. (eds) (2016). Potter and Perry’s fundamentals of nursing, 5th edn, Mosby/Elsevier, Sydney.
Forsgren S, Christensen T, Hedemalm A. Evaluation of the case method in nursing education. Nurse Educ Pract. 2014 Mar;14(2):164-9. doi: 10.1016/j.nepr.2013.08.003.
Garner, K. K., Goodwin, J. A., McSweeney, J. C., & Kirchner, J. E. (2013). Nurse executives' perceptions of end-of-life care provided in hospitals. Journal of pain and symptom management, 45(2), 235–243. https://doi.org/10.1016/j.jpainsymman.2012.02.021
Gott M, Ingleton C, Bennett MI, Gardiner C. Transitions to palliative care in acute hospitals in England: qualitative study. BMJ Support Palliat Care. (2011 Jun;1) (1):42-8. doi: 10.1136/bmj.d1773. PMID: 24653048.
Hillman KM. End-of-life care in acute hospitals (2011). Australian Health Review. Vol; 35: 176-7.
Nursing and Midwifery Board of Australia. (2016). Registered nurse standards for practice. http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx
Price A, Price B. Role modelling practice with students on clinical placements. Nurs Stand. 2009 Nov 18-24;24(11):51-6; quiz 58. doi: 10.7748/ns2009.11.24.11.51.c7391.Other resources
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