The acuity of patients nursed in general ward areas has increased significantly over recent years. This is due to a number of factors; advancements in surgical and clinical procedures, the ageing population and policy drivers which led to a removal of some barriers relating to critical care provision, with patients now receiving care in general areas who would have traditionally been admitted to high dependency and intensive care units.
Faced with this, nursing staff are now required to look after groups of patients who are more highly dependent and who have the potential to deteriorate rapidly. There is also a blurring of the roles between nursing and medical staff with nurses now often required to make decisions regarding a patient's management which would previously been the remit of medical colleagues.
Suboptimal care frequently relates to the poor management of simple aspects of acute care, for example the management of a patient's airway, breathing and circulation, oxygen therapy and fluid administration. Other contributory factors include a lack of organisation, poor communication skills and failure to appreciate the urgency of the situation often due to a lack of knowledge. Equipping nursing staff with these essential skills enables them to identify and intervene quickly with patients who are at risk of clinical deterioration with a concomitant reduction in patient mortality.
This module explores the nursing care of the acute/critically ill patient across the lifespan with primarily medical conditions. The module takes a 'whole systems' approach, and encompasses the needs of those at risk of acute/critical illness, the needs of the patients during the illness, and the needs of those who have recovered from such illness.
Module learning outcomes
At the end of this module, students will be able to:
Demonstrate an in depth understanding of the impact of acute illness across the lifespan on individuals, families and the wider society.
Identify effective inter-professional working patterns to enhance integrated care across care setting boundaries.
Critically appraise current political imperatives that inform the contemporary pattern of nursing care delivery in primary care, outreach services, in-patient and day unit settings.
Demonstrate an in depth knowledge of the pathophysiology, treatment and care needs of acutely ill individuals across the lifespan with a range of acute conditions including those requiring critical or technologically dependent care.
Based on appraisals of current evidence select and justify appropriate therapeutic interventions for people with acute care needs.
Effectively evaluate the evidence underpinning the factors which signal the physiological deterioration of adults across a range of different healthcare environments.
Consider the degree to which quality can be achieved in acute care based on professional initiatives.
Critically reflect on the specific ethical and legal issues/dilemmas that might arise in the delivery of acute care.
Demonstrate proficiency in the use of a structured clinical assessment tool and document clinical findings appropriately.
Assessment
Task
Length
% of module mark
Closed/in-person Exam (Centrally scheduled) Supporting the Individual with Acute & Complex Care Needs
2 hours
100
Special assessment rules
Non-compensatable
Reassessment
Task
Length
% of module mark
Closed/in-person Exam (Centrally scheduled) Supporting the Individual with Acute & Complex Care Needs
2 hours
100
Module feedback
Formative feedback from the facilitator and peers within practical work which may contribute to revision for the summative assessment.
Students are provided with collective exam feedback relating to their cohort, within the timescale specified in the programme handbook.
Indicative reading
Textbooks:
Carr, C. (2012). Unlocking Medical Law and Ethics. Oxon: Hodder Education.
Mulryan, C. (2011) Acute Illness Management. London: Sage Publications.
Thompson, C. and Dowding, D. (Eds.). (2009). Essential Decision Making and Clinical Judgement for Nurses. London: Churchill Livingstone.
Woodrow, P. (2015) Nursing Acutely Ill Adults. London: Routledge Publications.
Clinical Guidelines:
National Confidential Enquiry into Patients Outcomes and Deaths (2012). Time to Intervene? A review of patients who underwent cardiopulmonary resuscitation as a result of an in-hospital cardiorespiratory arrest. NCEPOD. [Online]. Available at: http://www.ncepod.org.uk/2012report1/downloads/CAP_fullreport.pdf
NICE (2006) CG32: Nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition
NICE (2007) CG50: Acute illness in adults in hospital: recognising and responding to deterioration
NICE (2010) CG94: Unstable angina and NSTEMI: early management
NICE (2011) CG130: Hyperglycaemia in acute coronary syndromes: management
NICE (2012) CG138: Patient experience in adult NHS services: improving the experience of care for people using adult NHS services
NICE (2013) CG167: Myocardial infarction with ST-segment elevation: acute management
NICE (2013) CG169: Acute kidney injury: prevention, detection and management
NICE (2014) CG191: Pneumonia in adults: diagnosis and management
NICE (2014) CG176: Head injury: assessment and early management
SIGN (2014) CG141: British guideline on the management of asthma