Acute Medical Care
Run by School of Medical and Health Sciences
20.000 Credits or 10.000 ECTS Credits
Organiser: Mrs Heather Bloodworth
Overall aims and purpose
Recent and somewhat radical changes in the provision of health care have resulted in an emergent group of patients with complex needs who, following initial specialized care in units such as ED's, ITU, emergency assessment units are then receiving continuation of their care in general hospital wards while they remain acutely unwell with a multiplicity of needs. These patients present challenges that transcend the traditional medical/surgical divide.
This module has been designed to prepare all health care professionals working in the acute care setting to manage such acutely unwell patients through the processes of assessment, diagnosis, care management and on-going evaluation in an environment which has thus become very challenging due to the acceleration in throughput of patients
This module will be of particular use to such health care professionals who will be working as Advanced Nurse Practitioners, and indeed all other practitioners dealing with patients in the acute care settings including Acute Medical/Surgical Assessment Units, within North Wales specifically and more widely within the region.
Homeostasis and electrolyte imbalance
Review the respiratory system
Care of patients on CPAP & Non invasive ventilation
Review of acute kidney injury
Monitoring of acutely ill patients using:
• the early warning score
Pain management in acutely ill adults Review of cardiovascular system • Acute chest pain • ECG interpretation Review of endocrine system • diabetic ketoacidosis • pancreatitis Shock Review of gastro intestinal tract • Gastric bleed Nutritional needs of acutely ill adults Infection control Brain Attack Haematology and Biochemistry
• Knowledge of key areas/principles only • Weaknesses in understanding of main areas • Limited evidence of background study • Answer only poorly focussed on question and with some irrelevant material and poor structure • Arguments presented but lack coherence • Several factual/computational errors • No original interpretation • Only major links between topics are described • Limited problem solving • Many weaknesses in presentation and accuracy
C- to C+
• Good knowledge of key areas/principles • Understands main areas • Limited evidence of background study • Answer focussed on question but also with some irrelevant material and weaknesses in structure • Arguments presented but lack coherence • Has several factual/computational errors • No original interpretation • Only major links between topics are described • Limited problem solving • Some weaknesses in presentation and accuracy
Excellent knowledge • Detailed understanding • Extensive background study • Highly focussed answer and well structured • Logically presented and defended arguments • No factual/computational errors • Original interpretation • New links between topics are developed • New approach to a problem • Excellent presentation with very accurate communication
• Very good knowledge • Detailed understanding • Extensive background study • Highly focussed answer and well structured • Logically presented and defended arguments • No factual/computational errors • Original interpretation • New links between topics are developed • New approach to a problem • Very good presentation with very accurate communication
- Develop an understanding of the pathophysiology of a wide range of acute presentations
- Develop an understanding of a systematic approach to the acutely ill patient
- Enhancing and updating the practitioner’s knowledge and understanding of a range of common acute medical/surgical conditions
- Demonstrate a sound understanding of the principles of a range of clinical presentations such as fluid management, management of sepsis and dealing with shock etc.
- Demonstrate a critical knowledge and understanding of the biomedical paradigm, including the early warning scoring .ALERT and ILS etc.
- Critically evaluate the causes of acute illness and its management in the acute hospital environment and to manage these patients competently.
|CLINICAL PRACTICAL ASSESSMENT||Clinical Competencies||
Successful completion of all competencies signed off by a clinical mentor.
Case study which will include an anonymised case profile, the student should select a pertinant topic from the case to discuss and analyse.
Teaching and Learning Strategy
Clinical & complete clinical competencies - 100 hours
Lectures and practical demonstrations - hours (7hours x7 days)
E learning - including workbooks
- Literacy - Proficiency in reading and writing through a variety of media
- Computer Literacy - Proficiency in using a varied range of computer software
- Self-Management - Able to work unsupervised in an efficient, punctual and structured manner. To examine the outcomes of tasks and events, and judge levels of quality and importance
- Exploring - Able to investigate, research and consider alternatives
- Information retrieval - Able to access different and multiple sources of information
- Inter-personal - Able to question, actively listen, examine given answers and interact sensitevely with others
- Critical analysis & Problem Solving - Able to deconstruct and analyse problems or complex situations. To find solutions to problems through analyses and exploration of all possibilities using appropriate methods, rescources and creativity.
- Safety-Consciousness - Having an awareness of your immediate environment, and confidence in adhering to health and safety regulations
- Presentation - Able to clearly present information and explanations to an audience. Through the written or oral mode of communication accurately and concisely.
- Teamwork - Able to constructively cooperate with others on a common task, and/or be part of a day-to-day working team
- Mentoring - Able to support, help, guide, inspire and/or coach others
- Caring - Showing concern for others; caring for children, people with disabilities and/or the elderly
- Management - Able to utilise, coordinate and control resources (human, physical and/or financial)
- Argument - Able to put forward, debate and justify an opinion or a course of action, with an individual or in a wider group setting
- Self-awareness & Reflectivity - Having an awareness of your own strengths, weaknesses, aims and objectives. Able to regularly review, evaluate and reflect upon the performance of yourself and others
- Leadership - Able to lead and manage, develop action plans and objectives, offer guidance and direction to others, and cope with the related pressures such authority can result in
Resource implications for students
Talis Reading listhttp://readinglists.bangor.ac.uk/modules/nhs-3155.html
Creed, F. Spiers, C (2016) Care of the Acutely Ill Adult: An essential guide for nurses. Oxford University Press.
Djillali, A., Shidasp, S., Samir, J. (2013). Effects of fluid resuscitation with colloids vs crystalloids on mortality in critically Ill patients presenting with hypovolemic shock the CRISTAL randomized trial. JAMA, http://jamanetwork.com/journals/jama/fullarticle/1752245
Gossage, J. Modarai B. Sahari, A. Worth, R. (2008). 100 cases in surgery. Hodder Arnold: London.
Health Improvement Scotland (2016). Asthma guidelines. Retrieved from https://www.brit-thoracic.org.uk/document-library/clinical-information/asthma/btssign-asthma-guideline-2016/
Joint British Diabetes Societies Inpatient Care Group (2013) the management of diabetic ketoacidosis in adults. Retrieved from http://www.diabetologists-abcd.org.uk/JBDS/JBDS_IP_DKA_Adults_Revised.pdf
Ketchell, A., Clarke, D. (2016) Nursing the acutely ill adult. Palgrave: London
Kumar, P. Clark, M. (2016) Kumar and Clarks Clinical Medicine. Saunders Elsevier: London
Liakos, A. Hill, M. (2010) Assess and progress, clinical medicine. Oxford University Press.
Longmore, M. Wilkinson, I. Davidson, E. Foulkes, A. (2010) Oxford Handbook of Clinical Medicine 8th ed. Oxford University Press.
McLatchie, G. Borley, N. Chikwe, J. (2014). Oxford handbook of clinical surgery 3rd ed. Oxford University Press: Oxford
Nair, M. Peate, I. (2009). Fundamentals of applied pathophysiology; an essential guide for nursing students. John Wiley and Sons. National Institute of Health and Care Excellence (2007) Acutely ill adults in hospital: recognising and responding to deterioration National Institute of Health and Care Excellence (2016). Type 1 diabetes in adults: diagnosis and management. Retrieved from https://www.nice.org.uk/guidance/ng17/ifp/chapter/diabetic-ketoacidosis
National Institute of Health and Care Excellence (2016). Sepsis: recognition, diagnosis and early management. Retrieved from https://www.nice.org.uk/guidance/ng51
Provan, D. (2010). Oxford handbook of clinical and laboratory investigation 3rd ed. Oxford University Press: Oxford
Tait, D. James, J. (2020) Acute and Critical Care in Adult Nursing (Transforming Nursing Practice Series) Woodrow, P. (2015). Nursing acutely ill adult. Routledge.