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Acutely Ill Adult & High Dependency Nursing

– 6KNIA327 Level: 6

Credits: 30

Module leader: Carolyne Stewart

Tel: 02o 7848 3526

Email: carolyne.1.stewart@kcl.ac.uk

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This handbook must be read in conjunction with module information provided on KEATS, the King’s E-Learning And Teaching Service. You will be given access to KEATS on enrolment. Important information relating to assessment and related regulations can be found in the Undergraduate Programme Handbook, available on KEATS and via the Nightingale Student Hub. This handbook can also be provided in alternative formats (such as large print) upon request to asc@kcl.ac.uk.

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Contents

Module overview .............................................................................................................. 4

Module aim ................................................................................................................... 4

Learning outcomes ....................................................................................................... 4

Teaching arrangements ............................................................................................... 5

Formative assessment .................................................................................................. 5

Summative assessment ................................................................................................ 6

Dates for examinations .................................................................................................... 7

Results and resits for examinations ............................................................................ 7

Learning outcomes for sessions ...................................................................................... 7

Day 1 .................................................................................................................................. 7

Lecture 1 and 2—Introduction to the Course and Patient Assesment ..................... 7

Seminar 1 ...................................................................................................................... 8

Day 2 ................................................................................................................................. 8

Lecture 3— Airway and Breathing Assessment, Acid Base Balance ......................... 8

Lecture 4 — Advanced Respiratory Support .............................................................. 9

Lecture 5 — Tracheostomy Care.................................................................................. 9

Seminar 2 – Case Study: The patient requiring Non-invasive Ventilation (NIV) .. 9

Day 3 ................................................................................................................................. 11

Lecture 6 — Circulation Assessment & Cardiac Function ......................................... 11

Lecture 7 — Acute Coronary Syndromes .................................................................... 11

Lecture 8 — Haemodynamic Monitoring ................................................................... 12

Day 4 ................................................................................................................................. 12

Lecture 9 — Neurological Assessment ........................................................................ 12

Lecture 10— Management of the Patient with Stroke and Head Injury .................. 13

Lecture 11 — Patient with Delirium ............................................................................ 13

Seminar 4 Case Study: The patient with an altered level of Consciousness ............ 13

Day 5 ................................................................................................................................. 14

Lecture 12 — Renal Assessment .................................................................................. 14

Lecture 13 — Acute Kidney Injury ............................................................................... 14

Lecture 14 — Patients with Liver Disease ................................................................... 15

Seminar 5 — Case study: The patient with Acute Kidney Injury .............................. 15

Day 6 ................................................................................................................................. 16

Lecture 15 — Diabetic Emergencies ............................................................................ 16

Lecture 16 — Diabetes Workshop ............................................................................... 16

Day 7 ................................................................................................................................. 16

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Lecture 17 — The Deteriorating Patient ...................................................................... 16

Lecture 18 — The Management of Shock ................................................................... 17

Lecture 19 — The Management of Sepsis ................................................................... 17

Seminar 6 – Case study: The patient with sepsis ....................................................... 18

Day 8 ................................................................................................................................. 19

Mock exam .................................................................................................................... 19

Discussion of Summative Assessment ........................................................................ 19

Module evaluation ........................................................................................................... 19

Action from previous evaluations ............................................................................... 19

Timetable .......................................................................................................................... 20

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Module overview This module can be chosen as part of a programme. The module can also be taken as a freestanding module.

Module aim

To enable you to develop the necessary knowledge and skills to holistically assess and implement the care required to meet the specific needs of the acutely ill and high dependent patient.

To apply specialist knowledge and skills to meet the needs of the acutely ill and high dependent adult patient.

To enable the development of skills to effectively lead and manage change within an inter-professional context.

To reflect on the physiological, psychosocial, spiritual and cultural factors affecting the assessment and management of the acutely ill and high dependency patient.

To enhance awareness of the principles of evidence based practice specific to the care of acutely ill and high dependency patients and use these findings to promote changes in the delivery of care, where appropriate.

To instil a self-directed approach to learning by encouraging you to assess your own learning needs, identify sources of information and educational support, and evaluate your own learning.

Learning outcomes

The course contributes to all NHS Knowledge Skills Framework (KSF) core dimensions and a number of specific dimensions. These are highlighted alongside each learning outcome.

Competently assess, implement and critically evaluate evidence based care for the acutely ill and high dependency adult patient on a general hospital ward, identifying areas for further research. HWB1,2,4,5,6,7,8, IK1-3

Critically examine the decision-making processes involved in caring for the acutely ill and highly dependent adult patient including in complex and unpredictable situations. HWB5,6,7, G1,2,6

Critically analyse the contribution of the nurse in caring for acutely ill and highly dependent adults and their significant others whilst maintaining patient autonomy. HWB3, IK1-3, G2,6

Evaluate the current evidence base for the care and management of acutely ill and high dependency patients. HWB1,2,4-8, IK1-3, G1,6

Debate appropriate communication techniques for working with acutely ill and highly dependent patients, their significant others and the interdisciplinary team. Examine the changing needs of the acutely ill patient through the care episode. HWB1-8,IK3

Examine the changing needs of the acutely ill and highly dependent patient through the care episode. HWB1-8, G1,2

Discuss the consequences for other patients, staff and general ward resources of caring for acutely ill and highly dependent patients for acutely ill patients.G1-4, 6

Analyse the implications of clinical governance and use of resources available and apply the principles to caring for the acutely ill and highly dependent adult. IK1-3, G1-3,6

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Teaching arrangements

For a 30 credit module it is expected that students will spend around 300 hours studying. The educational approach is adult student centred, which builds on your experience as qualified practcioners. You will experience various learning activities during the course;

Lectures,

E-learning

Group work and guided study

Case study exploration

Independent study Your active participation in presentations and discussions is encouraged in order to share your experience and learn from each other during the course. We hope that you will enjoy these activities which have been designed to enhance your learning.

Submitting coursework

Assessment criteria

1. Three hour scenario-based examination

Formative assessment

To help prepare you for the examination, you are required to take part in an online discussion of the evidence base for an identified area of acute care nursing practice. This will require you to:

1. Work in a group to prepare a model answer based on an exam type question 2. Contribute to an online group analysis of the evidence base for an identified area of acute

nursing care

You will be allocated to small study groups. A clinical scenario will be accessed through the KEATS site. You are expected to engage with your study group in an online discussion to produce a group answer to a specific question based on the scenario. Contributions should be collated and a final group answer posted on the discussion board by the deadline.

Contributions might include: reflections from practice, commentary on current evidence, reference to clinical guidelines, academic debate of peer contributions, novel ideas. Extensive reading of relevant literature is expected and all contributions must be free from plagiarism. Full Harvard referencing will not be required, however, the author and date must be cited in the text. You must use an appropriate academic style and adhere to appropriate professional conduct at all times.

The final group answer must not exceed 1,000 words. Words in excess of this limit will not be marked. The group answer will be assessed according to the level 6 Faculty assessment criteria contained in the post qualification handbook.

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Timetable for completion of formative assessment

Date Activity

01 May 2018 Introduction to online formative assessment.

Allocation of study groups

08 May 2018 Scenario open for viewing and contributions

25 June 2018 Scenario closed

NO FURTHER CONTRIBUTIONS WILL BE MARKED AFTER MIDNIGHT

03 July 2018 Online feedback

Summative assessment Examination

You are required to sit a three hour scenario based examination. Topics will be distributed four weeks prior to the date of the examination. The examination will comprise three scenarios with three related questions. You will be required to:

Answer all questions assigned to the three scenarios

Evaluate clinical data

Debate the contemporary research evidence base for practice

Demonstrate an in-depth knowledge of physiological, psychological and social aspects of acute nursing care

There will be opportunity to undertake and discuss practice scenarios within the module timetable.

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Dates for examinations You will be notified of dates for examination on the Student Records section of the King’s Intranet. The examination weeks run from the 6th August 2018 until the 17th August 2018. You will be notified of the confirmed date closer to the time.

Results and resits for examinations Unratified results from exams will be available on your KEATS module site 4 weeks from the date of the examination. Faculties are required from this academic year 2016/17 to make examination scripts available to any student who makes a request, free of charge. Any requests for examination scripts should still be managed in accordance with the Data Protection Act 1998. Students may request access to their exam paper at any time (after the Assessment Sub Board meeting) during their programme of study. This policy applies to all summative, unseen, written examinations. MCQs and OSCEs are exempt from this process.

If for any reason you are unable to sit the exam you must complete a Notification of Examination Absence form that you can find at this link: https://internal.kcl.ac.uk/nursing/Staff/About-the-Faculty/Faculty-Policy-Zone/M/MitigatingCircumstances/KingsCollegeLondonMitigatingCircumstancesForm.pdf. The external examiner for this module is Nicola Morrell-Scott, and please note that, students are not to make direct contact with external examiners, in particular regarding their individual performance in assessments. Re-sit dates will available on your KEATS module site. If you are unsuccessful, it is recommended that you contact the module leader before submitting your second attempt or re-sitting your examination.

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Learning outcomes for sessions

Day 1 01 May 2018

Lecture 1 and 2—Introduction to the Course and Patient Assesment By the end of the session students will be able to:

Confirm the course registration is correct

Overview of the course

Appraise local and national policies and guidelines affecting the care of the acutely ill adult patient in hospital.

Consider a sytems based approach to patient assessment

Indicative reading: Department of Health (2000) Comprehensive Critical Care – a review of adult critical care services. The Stationary Office, London. Creed F. & Spiers C. (2010) Care of the Acutely Ill Adult: An Essential Guide for Nurses, Chapter 2. Oxford University Press, Oxford. National Institute for Health and Clinical Excellence (2007) Acutely ill patients in hospital: recognition of and response to acute illness in adults in hospital. NICE, London. Moore T. & Woodrow P. (2009) High Dependency Nursing Care Observation, Intervention and Support for Level 2 Patients. Baillière Tindall Elsevier, Edinburgh.

Sheppard M. & Wright M. (2006) Principles and Practice of High Dependency Nursing. Baillière Tindall Elsevier, Edinburgh.

Cox C.L. (ed) (2004) Physical Assessment for Nurses. Blackwell Publishing, Oxford. McArthur-Rouse F. (2001) Critical care outreach services and early warning scoring systems: a review of the literature. Journal of Advanced Nursing. 36(5), 696-704. NPSA (2007). Recognising and responding appropriately to early signs of deterioration in hospitalised patients. London: NPSA. Institute for Innovation and Improvement (2010). SBAR tool. http://www.institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/sbar_-_situation_-_background_-_assessment_-_recommendation.html Intensive Care Society (2009). Levels of critical care for adult hospital patients: Standards and guidelines. Available at: http://www.sicsag.scot.nhs.uk/Levels_of_Care_Intensive_Care_Society_2009.pdf

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Seminar 1 You will work in your allocated formative groups and will be presented with a scenario. You will be asked to assess the patient using ABCDE assessment, calculate a NEWS score, provide immediate nursing interventions, decide on the next course of action, and use SBAR to report. By the end of the session the student will be able to:

Identified strengths and weaknesses in the assessment and treatment of an acutely Ill adult patient.

Identified learning needs and develop a personalized learning plan for the course.

Day 2 08 May 2018

Lecture 3— Airway and Breathing Assessment, Acid Base Balance By the end of the session students will be able to:

Identify the common causes of respiratory distress

Plan and prioritize evidence-based interventions to maintain adequate oxygenation.

Understand the role of medication to improve oxygenation

Evaluate the use of oxygen therapy and associated nursing care Indicative reading: British Thoracic Society (2017). BTS Guidelines for Emergency Oxygen Use Healthcare and Emergency settings. Available from: https://www.brit-thoracic.org.uk/document-library/clinical-information/oxygen/2017-emergency-oxygen-guideline/bts-guideline-for-oxygen-use-in-adults-in-healthcare-and-emergency-settings/ (Accessed 4th April 2018) BTS & SIGN (2016) British Guideline on the Management of Asthma. Available from: https://www.brit-thoracic.org.uk/document-library/clinical-information/asthma/btssign-asthma-guideline-2016/. (Accessed 4th April 2018) Cowley N. (2013) Interpreting arterial blood gas results. BMJ 346(f16), 1-7. NICE (2010) Guidelines on COPD. NICE, London. Woodrow P. (2004) Arterial blood gas analysis. Nursing Standard 18(21), 45-52. BMJ Best practice guideline (2018) Assessment of dyspnoea. BMJ. Available from: https://bestpractice.bmj.com/topics/en-gb/862/pdf/862.pdf. (Accessed 4th April 2018)

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Lecture 4 — Advanced Respiratory Support By the end of the session students will be able to:

Understand the appropriate nursing interventions for acute respiratory conditions

Understand modes of NIV delivery (IPAP CPAP)

Understand the physiological effects of NIV and effective assessment of its effectiveness

Indicative reading: Singer P ,Rattanachaiwong S (2018) To eat or to breathe? The answer is both! Nutritional management during non-invasive ventilation. Critical Care. 22/27 Esmond G and Mickelsons C (2009) Non-invasive respiratory support techniques: Oxygen therapy, non-invasive ventilation and CPAP. Blackwell, Chichester. Masip J, Peacock WF, Price S, Cullen L et al (2018) Indications and practical approach to non-invasive ventilation in acute heart failure. European Heart Journal. 39 pp 17-25. Rochwerg B, Brochard L, Elliot M, Hess D et al (2017) Official ERS/AS clinical practice guidelines: non-invasive ventilation for acute respiratory failure. European respiratory journal. 50 pp 2-19 NCEPOD (2017) Inspiring change: A review of the quality of care provided to patients receiving acute non-invasive ventilation. Available from: http://www.ncepod.org.uk/2017niv.html (Accessed 4th April 2018)

Lecture 5 — Tracheostomy Care By the end of the session students will be able to:

Understand the preparation of equipment and environment for tracheostomy

Understand observations and complications

Understand the safety checks that need to be undertaken Indicative reading McGrath B. A., Bates L., Atkinson D., & Moore J.A. (2012) Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies Anaesthesia 67(9), 1025-41. NCEPOD (2014) Tracheostomy Care: On the Right Trach? National Confidential Enquiry into Patient Outcome and Death, London. NTSP (2013) NTSP Manual 2013. UK National Tracheostomy Safety Project, Manchester http://tracheostomy.org.uk/

Seminar 2 – Case Study: The patient requiring Non-invasive Ventilation (NIV) During this session you will learn:

The evidence-base supporting use of NIV in the critically ill

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The nursing care of a patient requiring non-invasive respiratory support. Indicative Reading McNeill G. & Glossop A. (2012) Clinical applications of non-invasive ventilation in critical care. Contin Educ Anaesth Crit Care Pain (2012) 12(1), 33-37. Doi: 10.1093/bjaceaccp/mkr047

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Day 3 22 May 2018

Lecture 6 — Circulation Assessment & Cardiac Function By the end of the session students will be able to:

Discuss common causes of acute alterations in cardiovascular function.

Understand cardiac output and the assessment of cardiac function

Plan and prioritize evidence-based interventions to maintain adequate cardiac output / perfusion.

Indicative reading: Mehta M (2010) Assessing cardiovascular status. Nursing 2010 critical care. 5 pp 37-39 Society for Cardiological Science and Technology. (2014) Clinical guidelines by consensus: Recording a standard 12-lead electrocardiogram. London: Society for Cardiological Science and Technology. Sampson M (2015) Understanding the ECG. Part 1: Anatomy and physiology. British Journal of Cardiac Nursing. 10 pp 548- 553. Sampson M (2015) Continuous ECG monitoring in hospital: part 2, practical issues. British Journal of Cardiac Nursing.

Lecture 7 — Acute Coronary Syndromes By the end of the session students will be able to:

Evaluate nursing interventions for the patient with acute chest pain.

Appraise the role of medication to improve cardiovascular function.

Evaluate health education to improve cardiovascular function. Indicative reading: NICE (2018) Assessment and immediate management of suspected acute coronary syndrome. Available from: www.nice.org.uk (Accessed 4th April 2018) Laight S., Currie M., Davies N. (2006). Cardiac Care. In Sheppard M & Wright M Principles & Practice of High Dependency Nursing. 2nd ed. Bailliere Tindall, Edinburgh. SIGN (2016) Acute coronary syndrome – SIGN 148. Available from: http://www.sign.ac.uk (Accessed 4th April 2018)

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Lecture 8 — Haemodynamic Monitoring By the end of the session the student will be able to:

Understand the rationale and importance of haemodynamic monitoring

Understand the commonly used tools to measure cardiac output eg arterial blood pressure monitoring and CVP

Indicative reading: Fox F. (2009) Haemodynamic Monitoring and Manipulation: An Easy Learning Guide. M&K, London. The Association of Anaesthetists of Great Britain and Ireland 4th Ed (2007) Recommendations for standards of monitoring during anaesthesia and recovery. AAGBI, London. Alhashemi, et al. (2011) Cardiac output monitoring: an integrative perspective. Critical Care 15, 214. Perel P., Roberts I. & Ker K. (2013) Are colloids more effective than crystalloids in reducing death in people who are critically ill or injured? Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD000567. DOI: 10.1002/14651858.CD000567.pub6.

Day 4 05 June 2018

Lecture 9 — Neurological Assessment By the end of the session students will be able to:

Understand the process of neurological assessment

Recognise the signs of raised intracranial pressure during neurological assessment Indicative reading: Woodward S. & Mestecky A-M. (2011) Neuroscience Nursing: Evidence Based Practice. Wiley Blackwell, London.

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Lecture 10— Management of the Patient with Stroke and Head Injury By the end of the session students will be able to:

Identify appropriate management of the patient with raised ICP and the rationale for this

Recognise the neurological changes/deficits patients may experience following acute stroke

Understand the evidence-based nursing interventions for the patient with stroke

Demonstrate knowledge of strategic care delivery for patient with stroke in accordance with current national guidelines

Indicative reading: Carney N. et al. on behalf of the Brain Trauma Foundation (2016) Guidelines for the Management of Severe Traumatic brain injury. 4th ed www.braintrauma.org (Accessed 4th April 2018) NICE (2014) Head injury: assessment and early management. Available from: https://www.nice.org.uk/guidance/cg176. (Accessed April 4th 2018) NICE (2008) Stroke and transient ischaemic attack in over 16s:diagnosis and initial management. Available from: https://www.nice.org.uk/guidance/cg68 (Accessed 4th April 2018)

Lecture 11 — Patient with Delirium By the end of the session students will be able to:

Understand the importance of assessment tools such as those used for levels of sedation, pain and delirium

Consider the indications for and consequences of the use of restraint

Understand the policy and protocol for falls assessment and the management of injury following a fall

Indicative reading: NICE (2010) Delirium: Diagnosis, prevention and management of delirium. The Stationary Office, London. Schofield I., Tolson D. & Fleming V. (2012) How nurses understand and care for older people with delirium in the acute hospital: a critical discourse analysis. Nursing Inquiry. 19(2), 165-176.

Seminar 4 Case Study: The patient with an altered level of Consciousness During this session you will learn:

The evidence-base supporting care of the patients with an altered level of consciousness

The nursing care of a patient with a reduced Glasgow Coma Scale Indicative Reading BMJ (2017) Assessment of altered mental status. BMJ Best Practice. Available from: http://bestpractice.bmj.com/topics/en-gb/843. (Accessed 4t April 2018)

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Day 5 12 June 2018

Lecture 12 — Renal Assessment By the end of the session students will be able to:

Understand the importance of and mechanisms of fluid balance

Understand the importance of renal assessment. Indicative reading:

Think Kidneys (2015) recommended minimum requirements of a care bundle for patients with AKI in Hospital. Available from: https://www.thinkkidneys.nhs.uk/aki/resources/nurses/ (Accessed 4th April 2018) Large W. (2006) Fluid and electrolytes. In Sheppard M & Wright M Principles & Practice of High Dependency Nursing. Bailliere Tindall, Edinburgh. Thomas N. (Ed) (2007). Renal Nursing. 3rd ed. Mosby’s Elsevier, China.

Lecture 13 — Acute Kidney Injury By the end of the session students will be able to:

Discuss causes and clinical indications for the development of acute renal failure.

Evaluate nursing interventions required to maintain renal function.

Discuss the importance of fluid balance Indicative reading: Ftouh S. & Thomas M. (2013) Acute kidney injury: summary of NICE guidance. British Medical Journal; 347: f4930. The Renal Association (2011) Clinical Practice Guidelines; Acute Kidney Injury. Available from: https://www.thinkkidneys.nhs.uk/aki/resources/nurses/ (Accessed 4th April 2018)

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Lecture 14 — Patients with Liver Disease By the end of the session students will be able to:

To understand the common aetiologies of chronic liver disease in the UK

To recognise the stigmata of chronic liver disease

To understand liver biochemistry with regards to liver function, excretion and damage

To analyse the nursing and medical management of the common complications of chronic liver disease

To explore transplantation options and outcomes for this specific patient group Indicative reading: Sargent S. (2009) Liver Diseases An Essential Guide for Nurses and Health Care Professionals. Wiley-Blackwell, Iowa. European Association for the Study of Liver Disease (2010). Clinical practice guidelines for the management of ascites, spontaneous bacterial peritonitis and hepatorenal syndrome in cirrhosis. Journal of Hepatology 53, 397-417.

Seminar 5 — Case study: The patient with Acute Kidney Injury

During this session you will learn:

The evidence-base supporting care of the patients with AKI

The nursing considerations associated with caring for a patient with AKI Indicative Reading Think Kidneys (2015) recommended minimum requirements of a care bundle for patients with AKI in Hospital. Available from: https://www.thinkkidneys.nhs.uk/aki/resources/nurses/ (Accessed 4th April 2018

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Day 6 26 June 2018

Lecture 15 — Diabetic Emergencies By the end of the session students will be able to:

Accurately monitor and evaluate blood glucose levels.

Understand the causes and implications of altered blood glucose levels.

In conjunction with the patient plan and evaluate the care to improve blood glucose control.

Critically analyse appropriate responses in emergency situations.

Indicative reading:

NICE (2015) Type 1 diabetes in adults: diagnosis and management. Avaliable from: https://www.nice.org.uk/guidance/ng17. (Accessed 4th April 2018)

NICE (2015) Type 2 diabetes in adults: management. Avalaible from: https://www.nice.org.uk/guidance/ng28. (Accessed 4th April 2018) Joint British Diabetes Societies (2013) The management of diabetic ketoacidosis in adults. Available at: http://www.diabetes.org.uk/Documents/About%20Us/What%20we%20say/Management-of-DKA-241013.pdf [Accessed April 2018] Joint British Diabetes Societies (2013) The Hospital Management of Hypoglycaemia in Adults with Diabetes Mellitus. Available at: http://www.diabetologists-abcd.org.uk/subsite/JBDS_IP_Hypo_Adults_Revised.pdf [Accessed April 2018]

Lecture 16 — Diabetes Workshop

A series of case scenarios will be discussed.

Insulin safety will be reviewed

Day 7

Lecture 17 — The Deteriorating Patient By the end of the session students will be able to:

Evaluate the components of the decision-making process.

Appraise the role of the nurse in the co-ordination of interprofessional teams to provide effective care for individual patients.

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Indicative reading: Department of Health (2009) Competencies for Recognising and Responding to Acutely Ill patients in Hospital. The Stationary Office, London. Available at: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_096988.pdf Reason J. (2009) Human Error. University Press, Cambridge.

Lecture 18 — The Management of Shock By the end of the session students will be able to:

Compare hypovolaemic, cardiogenic, neurogenic, anaphylactic and septic shock.

Discuss the development of clinical indicators and implications for nursing care. Indicative reading: Jevon P. (2010) ‘Recognition and Treatment of Anaphylaxis in Hospital’ British Journal of Nursing 19(16), 1015-1020. Resuscitation Council UK (2008) Emergency Treatment of Anaphylactic Reactions: Guidelines for Healthcare Providers. Annane D., Siami S., Jaber S., Martin C., Elatrous S., Declere A.D et al (2013). ‘Effects of fluid Resuscitation with Crystalloids vs Colloids on Mortality in Critically Ill Patients presenting with Hypovolaemic Shock: The CRISTAL Randomised Trial’ JAMA 310(17), 1809-1817.

Lecture 19 — The Management of Sepsis By the end of the session students will be able to:

Accurately monitor body temperature and identify factors and conditions influencing temperature.

Discuss the clinical presentation of a patient with sepsis.

Critically evaluate evidence-based management of fever.

Discuss the role and safe administration of antibiotics and anti-pyretics. Indicative reading: Rhodes A., Evans L., Alhazzani W. et al. (2017) Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Medicine 43(3), 304-377. NCEPOD (2015) Just Say Sepsis! A review of the process of care received by patients with sepsis. National Confidential Enquiry into Patient Outcome and Death (NCEPOD). Available online at: http://www.ncepod.org.uk/2015report2/downloads/JustSaySepsis_FullReport.pdf (Accessed 4th April 2018). NICE (2016) Sepsis: recognition, diagnosis and early management (NG51). National Institute for health and care excellence (NICE). Available online at: https://www.nice.org.uk/guidance/ng51 (Accessed 4th April 2018).

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Seminar 6 – Case study: The patient with sepsis During this session you will learn:

The evidence-base supporting care of the patients with sepsis

The nursing considerations associated with caring for a patient with sepsis Indicative Reading Rhodes A., Evans L., Alhazzani W. et al. (2017) Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Medicine 43(3), 304-377.

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Day 8 10 July 2018

Mock exam A short r paper will be set as a mock exam in the morning as a formative session. This will then be reviewed and informally marked in the session to allow for discussion of the questions and answers.

Discussion of Summative Assessment Students will have the opportunity to discuss the summative exam topics Module evaluation At the end of the module you are requested to complete the short online evaluation which will be available on your module KEATS site. Student evaluations are very important to us and are required by Health Education England and the regional London Local Education and Training Boards.

Action from previous evaluations

Previous student evaluations of the course have found the course valuable and increased their confidence in looking after acutely ill and high dependency patients.

The following action has been introduced from verbal feedback from students- Increase in tutorial time.

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Timetable 6KNIA327 Acutely Ill Adult & High Dependency Nursing Teaching mode Date Type of Session Title Time Lecturer Room

Day 1 University based

study 01 May 2018 Lecture 1 Course Introduction 09.00-10.00

Carolyne Stewart

FWB 1.20

Lecture 2 Patient Assessment 10.30-12.00 Seminar 1 Formative Assessment &

Scenario (Groups will be allocated)

13.00-16.00

Day 2

University based study

08 May 2018 Lecture 3 Airway & Breathing Assessment

09.00-10.00 Tina Day

FWB 1.20

Lecture 4 Advanced Respiratory Support

10.30-12.00 Carolyne Stewart

Lecture 5 Tracheostomy Care 13.00-14.30 Seminar 2 Case study – The patient

requiring non-invasive ventilation

14.30-16.00 Carolyne Stewart/

Tina Day

Day 3 University based

study 22 May 2018 Lecture 6 Circulation Assessment &

Cardiac Function 09.00-10.00

Carolyne Stewart

FWB 1.20

Lecture 7 Acute Coronary Syndromes

10.30-12.00 Eshan Khan

Lecture 8 Haemodynamic Monitoring

13.00-14.00 Carolyne Stewart

Seminar 3 E-learning components on KEATs

14.30-16.00 Self-directed learning

Day 4 University based

study

05 June 2018 Lecture 9 Neurological Assessment 09.00-10.00 Carolyne Stewart

FWB 1.20

Lecture 10 Management of Stroke & Head Injury

10.30-12.00 Ann-Marie Mestecky

Lecture 11 Delirium 13.00-14.30 Carolyne Stewart Seminar 4 Case study – The patient

with an altered level of consciousness

15:00-16:00

Ann-Marie Mestecky

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Day 5

University based study

12 June 2018

Lecture 12 Renal Assessment 09.00-10.00 Roseline Agyekum

FWB 1.20

Lecture 13 Acute Kidney Injury 10.30-12.00 Lecture 14 Liver Disease 13.00-14.30 Adam Riedlinger Seminar 5 Case study – The patient

with Acute Kidney injury 14.30-16.00

Anya Benton

Day 6 University based

study 26 June 2018

Lecture 15 Diabetic emergencies 09.00-10.00

TBC JCMB B.16

Lecture 16 Diabetic Workshop 10.30-12.00 Formative assessment

scenario 14.00- 16.00

Self-directed learning

Day 7 University based

study 03 July 2018

Lecture 17 The Deteriorating patient 09.00-10.00

Carolyne Stewart

JCMB B.16

Lecture 18 The Management of shock

10.30-12.00

Lecture 19 The Management of sepsis

13.00-14.00

Seminar 6 Case study: The patient with sepsis

15:00-16:00

Day 8 University based

study 10 July 2018

Group Session Mock Examination 10.00-12.00 Carolyne Stewart

JCMB B.16

Discussion Discussion of Summative

Assessment 13.00-14.00

Discussion Module Evaluation 14.30-15.00 Self-directed study 15:00-16:00

Location key:

FWB – Franklin-Wilkins Building, Waterloo Campus

JCMB – James Clerk Maxwell Building, Waterloo Campus