Forelesningsplan - Lecture and Curriculum Avansert geriatrisk sykepleie I / Advanced Geriatric Nursing I (GERSYK4101) (10 sp)

Spring 2013

Course coordinator: Ellen Karine Grov, Desiree Madah-Amiri Email, Course coordinator: [email protected] , [email protected]

Location: 201 in NU9, clinical training space Time: Week 7 February 12-15: lecture and practice Week 11 March 11-15: lecture and practice Week 15 April 8-12: supervised clinical study Week 16 April 15-19: supervised clinical study Week 18 Exam Schedule: 09:15-15:00 Monday-Friday for lectures and practice Etter gjennomført emne skal studenten:  utføre omfattende kartlegginger og vurderinger av helsebehovet hos friske eldre og eldre med kronisk sykdom, funksjonsog helsesvikt, med utgangspunkt i fysiologiske og psykososiale endringer i den gamles livsløp  beslutte, planlegge, iverksette og evaluere relevante tiltak  kommunisere med den eldre og hans pårørende på en kunnskapsrik, respektfull og hensiktsmessig måte  samhandle med den eldre og hans pårørende i kartlegging, planlegging og tilrettelegging av helsehjelp på en måte som bidrar til å opprettholde og styrke den eldres ressurser og medvirkning  konsultere og samhandle med andre relevante medisinske og helsefaglige profesjoner på en hensiktsmessig måte Forelesningsplan 26.02.2013

 gjennomføre sentrale prosedyrer og anvende relevante kartleggingsverktøy, tekniske hjelpemidler med mer anvende teorier og prinsipper for helsefremming, forebygging, deltakelse og medvirkning

Upon completion of this course the student should:  Conduct a comprehensive geriatric history and physical exam  Understand appropriate documentation and patient presentation skills  Perform an advanced assessment based on patient’s clinical presentation  Communicate with the elder and their family in a knowledgeable, respectful, and appropriate manner  Interact with the elder and their relatives in the assessment of health in a way that helps to maintain and enhance the elderly’s resources and participation  Utilize appropriate assessment tools  Communicate effectively with the elder and their family  Consult and cooperate with other relevant medical and health professionals as appropriate  Identify abnormal results and red flags during assessments  Consider differential diagnoses based on exam findings  Understand the geriatric patient holistically; consider various aspects of the elder’s life and how that plays a role in health and wellness

Hovedtema:  Rollen som avansert klinisk sykepleier Forelesningsplan 26.02.2013

     

Avansert klinisk vurdering av helsetilstand i relasjon til grunnleggende behov Beslutninger om og gjennomføring av tiltak/behandling, utarbeidelse av tiltaksplan Kommunikasjon og samhandling med eldre og deres familier Makt, deltakelse og medvirkning Helsefremming og forebygging Å leve med kronisk helsesvikt

Focus:     

The role of the advanced geriatric nurse practitioner History taking, documention, and interviewing skills Advanced clinical assessment for each body system Potential differential diagnosis and common abnormal findings Communication and interaction with seniors and their family

Teaching methods:  Lectures, case studies, documentation practice, oral presentation skills, clinical training practice, and clinical studies  120 hours of clinical studies in nursing home and home care nursing facility, including 30 hours clinical training. The student will evaluate healthy, acutely, and chronically ill elderly patients.

Requirements/Assessment:    

The student must participate in at least 80% of seminars and student participation and in-class assignments The student must present an oral patient presentation on March 14 The student must prove adequate ability of skills prior to clinical studies; observation of skills on March 15 Clinical requirements: o At least 80% participation in clinical studies o Submit 8-10 completed different assessment tools

Forelesningsplan 26.02.2013

o Electronically submit: 1 comprehensive assessments, including discussion and plan. These assessments must include an in-depth system evaluation of at least 1 system with extensive review of system and physical exam. For example, a patient with a headache would have a complete neurological review of system and complete neurological exam (in addition to a regular exam). o Students should record their patient encounters on the clinical record forms and deliver 5  Examination: The home exam will be delivered in Fronter kl 0900 on Monday April 29 and must be delivered by Friday May 3 at 1400. The exam must also be delivered in paper version, 3 examples, to the student consultant by Friday 3. Students who live far from Oslo may send by post, but it must be postmarked on Friday May 3. Eksamen:  Emnet blir vurdert i form av en individuell hjemmeeksamen. Med utgangspunkt i en erfart pasientsituasjon skal studenten gjøre rede for framgangsmåten og innhold i kartlegging og utredning av pasientens helsetilstand, samt gjøre rede for tiltaksplan ut fra ett helsefremmende perspektiv. Det leveres en individuell skriftlig oppgave på 1500 ord (+/- 10 %) ekskludert referanseliste. Det gis gradert karakter.

Important dates:      

Exam registration: 01.02.13 Lecture dates February 12-15, March 11-15 Clinical studies: April 8-12, April 15-19 Patient oral presentation March 14 Clinical assessment skills observation March 15 Exam April 26-May 3

Tid

Tema

Uke 7 Mondag 11.02.13

Pharmacology Exam

Forelesningsplan 26.02.2013

Lecturer

Readings & In-Class Assignments

Tirsdag 12.02.13 Session 1 9:15-10:00

Review, questions, comments from Ellen Karine Grov, Desiree Madah-Amiri previous clinical experience

10:00-11:30 Classroom

History, Interviewing, Review of Systems, & Documentation

Lunch 11:30-12:15 Session 2 12:15-15:00 Practice Room

Review and clairfication from previous assessment skills

Cox, C. (2009). Physical assessment for nurses. (2nd ed., pp. 620). John Wiley & Sons. Retrieved from http://books.google.com/books/about/Physical_Assessment_for _Nurses.html?id=3YR8aRzdyHQC In-class assignments: Critical thinking case study, HPI practice Evaluation of the Elderly Patient handout Ellen Karine Grov, Desiree Madah-Amiri Oral presentation template Patient-centered interview example Review of systems check list

Onsdag 13.02.13 Session 1 9:15-11:00 Classroom

At home: Musculoskeletal Assessment

Desiree Madah-Amiri

Lunch 11:00-11:45 Session 2 11:45-14:30 Classroom

At-home: Smith, R.C. (2002). Patient-Centered Interviewing: an EvidenceBased Approach, 2nd Ed. Lippincott Williams & Wilkins, Chapter 3

Abdominal Assessment

Forelesningsplan 26.02.2013

Desiree Madah-Amiri

Barr, K. P. (2007). Review of upper and lower extremity musculoskeletal pain problems. Physical medicine & rehabilitation clinics of north america, 747-760. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17967363 Cox, C. (2009). Physical assessment for nurses. (2nd ed., pp. 204-229). John Wiley & Sons. Retrieved from http://books.google.com/books/about/Physical_Assessment_for _Nurses.html?id=3YR8aRzdyHQC

Cox, C. (2009). Physical assessment for nurses. (2nd ed., pp. 101-112). John Wiley & Sons. Retrieved from http://books.google.com/books/about/Physical_Assessment_for _Nurses.html?id=3YR8aRzdyHQC

Discussion 14:30-15:00

Organ fill-in-the-blank Skeletal fill-in-the-blank In-class: Case study Musculoskeletal symptom analysis Torsdag 14.02.13 Session 1 9:15-11 Classroom

At home: Neurological Assessment

Desiree Madah-Amiri

Lunch 11:00-11:45 Session 2 12:00-15:00 Practice room

Musculoskeletal, Abdominal, and Neurological practice time

Desiree Madah-Amiri

Fure, B. (2011). Clinical neurological examination of the geriatric patient. Tdsskr nor laegeforen, 131(11), 1080-3. Retrieved from http://tidsskriftet.no/article/2107651 Cox, C. (2009). Physical assessment for nurses. (2nd ed., pp. 181-203). John Wiley & Sons. Retrieved from http://books.google.com/books/about/Physical_Assessment_for _Nurses.html?id=3YR8aRzdyHQC In-class: Cranial nerve handout Practice room check-off Optional: Neurological Assessment of the Older Adult

Fredag 15.02.13 Session 1 9:15-10:00

At home: Pulmonary Assessment

Forelesningsplan 26.02.2013

Desiree Madah-Amiri

Blanchette, C. M., & Berry, S. R. (2011). Advances in chronic obstructive pulmonary disease among older adults. Current opionions in pulmonary medicine, 17(2), 84-89. Retrieved from

Classroom 10:00-11:00

http://www.medscape.com/viewarticle/738112 Cardiovascular Assessment

Desiree Madah-Amiri

Pulmonary and Cardiovascular practice; practice review from entire week

Desiree Madah-Amiri

Lunch 11:00-11:45 Session 2 12:00-15:00 Practice room

Fried, T.R., Vaz Fragoso, C.A., Rabow, M.W. (2012). Caring for the older person with chronic obstructive pulmonary disease. The journal of the american medical association, 308(12). Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=1361999#P erspectives

Cox, C. (2009). Physical assessment for nurses. (2nd ed., pp. 83-100). John Wiley & Sons. Retrieved from http://books.google.com/books/about/Physical_Assessment_for _Nurses.html?id=3YR8aRzdyHQC Handout: Cardiovascular Function and Disease in the Elderly http://www.galter.northwestern.edu/geriatrics/chapters/cardio vascular_function_disease.cfm

Cox, C. (2009). Physical assessment for nurses. (2nd ed., pp. 54-82). John Wiley & Sons. Retrieved from http://books.google.com/books/about/Physical_Assessment_for _Nurses.html?id=3YR8aRzdyHQC In-class: Pulmonary practice sheet Uke 11 Mondag 11.03.13 Session 1 9:15-11:00 Classroom

At home: Jaul, E. (2010). Assessment and management of pressure ulcers in the elderly: current strategies. Drugs Aging. 27(4) 312-325. Dermatology assessment Wounds Pressure ulcers

Lunch Forelesningsplan 26.02.2013

Desiree Madah-Amiri

Gist, S., Tio-Matos, I., Falzgraf, S., Cameron, S., Beebe, M. (2009). Wound care in the geriatric client. Clinical Interventions in Aging 2009:4 269-287.

11:00-11:45 Session 2 12:00-1500 Practice room

Dermatology assessment Wounds Pressure ulcers Review

Desiree Madah-Amiri

Yalçın, B., Tamer, E., Toy, G. G., Öztaş, P., Hayran, M. and Allı, N. (2006), The prevalence of skin diseases in the elderly: analysis of 4099 geriatric patients. International Journal of Dermatology, 45: 672–676. doi: 10.1111/j.1365-4632.2005.02607.x. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.13654632.2005.02607.x/abstract Dermatology Case-Study In class: Best practice statement activity Documentation of pressure ulcers Sample documentation exercise Practice room with images At home: Comprehensive Elderly Exam handout

Tirsdag 12.03.13 Session 1 9:15-11:00 Classroom

Elderly Considerations, Mental Health, & Non-specific Symptoms

Desiree Madah-Amiri

Assessment Tools

Desiree Madah-Amiri

Lunch 11:00-11:45 Session 2 12:00-15:00 Practice room

Gagliardi, J. P. (2008). Differentiating among depression, delerium, and dementia in elderly patients. American medical association journal of ethics , 10(6), 383-388. Retrieved from http://virtualmentor.ama-assn.org/2008/06/cprl1-0806.html with questions Helvik, A.s., Engedal, K., Krokstad, S., Stordal, E., Selbæk, G. (2012), A comparison of depressive symptoms in elderly medical inpatients and the elderly in a population-based health study (the Nord-Trøndelag Health Study 3). Nord J Psychiatry, 6(3) 189-197. Solhaug, H.I., Romuld, E.B., Romlid, U., Stordal, E. (2012). Increased prevalence of depression in cohorts of the elderly: an 11-year follow-up in the general population- the HUNT study. International Psychogeriatrics 24:1 (151-158).

Forelesningsplan 26.02.2013

Onsdag 13.03.13 Session 1 9:15-11:00 Classroom

Head, ears, eyes, nose, & throat (HEENT) assessment

Desiree Madah-Amiri

HEENT parctice

Desiree Madah-Amiri

Lunch 11:00-11:45 Session 2 12:00-15:00 Practice room

At home: Eisenstadt, E.S. (2010), Dysphagia and aspiration pneumonia in older adults. Journal of the American Academy of Nurse Practitioners, 22: 17–22. doi: 10.1111/j.1745-7599.2009.00470.x. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.17457599.2009.00470.x/abstract?deniedAccessCustomisedMessage= &userIsAuthenticated=false Harkin, H. (2005). A nurse-led ear care clinic: sharing knowledge and improving patient care. British Journal of Nursing. 14(5) 250254. In class: HEENT Assessment http://my.ilstu.edu/~ddwilso2/nur431/HEENT_class.htm HEENT practice sheet

Torsdag 14.03.13 Session 1 9:15-11 Practice room

At home: Handout: Comprehensive elderly exam Review in practice room from entire week Prepare for oral presentation/ check-offs

Desiree Madah-Amiri

Oral Presentations

Ellen Karine Grov Desiree Madah-Amiri

Lunch 11:00-11:45 Session 2 12:00-15:00 Practice room

Forelesningsplan 26.02.2013

Prepare oral patient presentation of choice

Fredag 15.03.13 Session 1 9:15-11:00 Practice room

Prepare for clinical skills observation Physical exam skills check-offs

Desiree Madah-Amiri

Session 2 11:45- 15:00 Practice room Uke 15

Physical exam skills check-offs

Desiree Madah-Amiri

Uke 16

Clinical studies

Uke 18

Exam

Lunch 11:00-11:45

Clinical studies

Forelesningsplan 26.02.2013