Enhancing Clinical Judgement and Decision Making in Adult Nursing
| Module title | Enhancing Clinical Judgement and Decision Making in Adult Nursing |
|---|---|
| Module code | NURM113 |
| Academic year | 2023/4 |
| Credits | 30 |
| Module staff | Mr Enrico De Luca () Dr Susan Clompus () |
| Duration: Term | 1 | 2 | 3 |
|---|---|---|---|
| Duration: Weeks | 8 | 0 | 0 |
| Number students taking module (anticipated) | 14 |
|---|
Module description
This module is designed to enhance your knowledge and skills related to the care, assessment and management of the adults and older person. You will learn the assessment, diagnosis and management of the unwell adult or older person (critically or acutely ill, or who have long term conditions) with a specific focus on systems such as cardiovascular and respiratory, and relevant issues such as ageing, infection, wound healing, diabetes and long-term conditions. You will continue to work within Exeter’s seven pillars. Your module will explore epidemiology, policy, assessment, diagnostic management and evaluation of the adult person. You will also focus on the evidence for nursing and managing care.
Module aims - intentions of the module
The module aims for you to:
- Enhance your adult nursing knowledge and skills of assessment and examination to support your clinical judgement and decision making
- Use person-centred approaches to taking an individual’s detailed history and examine body systems to help you make a potential diagnosis.
- Develop your understanding of epidemiology, pathophysiology, pharmacology, policy, assessment, diagnostic management and evaluation of the adult person.
You will fully integrate Exeter’s seven pillars of nursing into your academic practice as indicated below:
Fundamental essentials of nursing care: you will consider the legal, ethical and accountability issues involved with prescribing and develop knowledge around pharmacodynamics and pharmacokinetics to prepare you for future prescribing practice. The focus will be, enhancing patient safety and provision of excellent quality care. You will learn to manage, supervise and evaluate the fundamentals of nursing care delivery and enabling effective self-management. F
Patient and public involvement: you will apply the principle of “nothing about us without us” and demonstrate the ability to accurately assess a person’s capacity to make sound decisions about their own care and to give or withhold consent. This pillar becomes increasingly sophisticated and integrated with evidence for practice during this module and includes the impact of policy. PPI
Evidence for practice: as an Exeter nurse you will start to produce evidence for practice, you will consider the contribution of quality improvement models, tools and strategies to enhancing patient safety and the provision of quality care. You will make strong conceptual links with the development, testing, evaluation and implementation of complex nursing and other healthcare interventions and appreciate the centrality of public involvement in service improvement and health services research. E
No health without mental health: this pillar enables you to consider decision making in challenging situations while providing holistic care by involving and advocating for individuals, families and carers. You will provide and support evidence based low intensity interventions for common mental health conditions. MH
Leadership and management: you will be leading on care management, supervising and delegating care, teaching and providing feedback to others. You will be able to debate the leadership challenges involved in partnership working with service users, carers’ families and agencies with complex multi-faceted needs. Leadership is a critical focus as you develop your professional capabilities and achieve an understanding of the operationalisation of health services, including developing a business case underpinned by an application of financial management processes. You will engage in relationship management to include performance management and resource management. LM
Global health: this pillar will enable you to appraise and apply information about health outcomes when supporting people and families to manage their healthcare needs and make important health choices. You will understand the evidence for behavioural change and public health initiatives whilst enabling people to make their own informed personal decisions. GH
Ethics and Professionalism: The Exeter Nurse will demonstrate commitment to professional values - including social justice - and to the flourishing of individuals, families and communities. The Exeter Nurse aspires always to do the right thing and to be of good character (E & P)
Intended Learning Outcomes (ILOs)
ILO: Module-specific skills
On successfully completing the module you will be able to...
- 1. Critically discuss both the demographics of adults accessing health care and common physical presentations (illnesses) amongst the client group pertinent to your area of clinical practice.(E)
- 2. Develop an enhanced comprehensive knowledge of human anatomy and physiology, understanding of disease progression and altered physiology and the diagnostic process for common conditions in your healthcare setting. (F;E)
ILO: Discipline-specific skills
On successfully completing the module you will be able to...
- 3. Critically reflect on your sphere of competence in managing, physiological and psychosocial needs of patients, identifying and facilitating suitable pathways of care.(PPI;MH;F;E;L&M, E&P)
- 4. Develop enhanced history taking, holistic patient assessment and diagnostic skills to examine body systems in order to make effective decisions regarding your client group's specific health care needs.(F;E;L&M, E&P)
- 5. Critically evaluate and synthesize history and assessment findings to draw conclusions about possible diagnosis, offer health care treatments and produce person centred care plans. Focus on patient autonomy, reduce risk, admission avoidance and early facilitated discharge as appropriate.(F;E;PPI;GH;MH;L&M, E&P)
- 6. Critically justify your clinical reasoning and decision making skills, including pharmacological aspects of nursing care including knowledge of legal, ethical and profession accountability in relation to prescribing practice.(L&M;E; E&P)
- 7. Identify relevant high quality evidence to underpin and support decisions about care and treatment.(E, E&P)
ILO: Personal and key skills
On successfully completing the module you will be able to...
- 8. Develop problem solving and decision making skills in relation to managing patients.(F;E;L&M, E&P)
- 9. Critically discuss methods for clearly communicating clinical assessment and care decisions with other health and social care professionals.(L&M;E;F)
- 10. Develop an understanding of community and or acute care pathways for adults with healthcare needs.(E;F;L&M)
Syllabus plan
Whilst the module’s precise content may vary from year to year, an example of an overall structure is as follows:
This module runs across the academic year and is in conjunction with your clinical adult traineeship.
Body systems & Pathophysiology
Communication and examination skills
Policy, regulation and legal and ethical frameworks
Common conditions
Decision making
Evidence base for practice
Pharmacology
Common interventions and tests
Health promotion, disease prevention and behavioural change
Learning activities and teaching methods (given in hours of study time)
| Scheduled Learning and Teaching Activities | Guided independent study | Placement / study abroad |
|---|---|---|
| 100 | 200 | 0 |
Details of learning activities and teaching methods
| Category | Hours of study time | Description |
|---|---|---|
| Scheduled teaching | 20 | Lectures |
| Scheduled teaching | 20 | PBL (complex scenarios) |
| Scheduled teaching | 50 | Simulation Communication, examination and assessment skills |
| Scheduled teaching | 10 | Professional tutorials |
| Guided independent study | 100 | Skills development for assessments |
| Guided independent study | 100 | Reading and preparing for sessions |
Formative assessment
| Form of assessment | Size of the assessment (eg length / duration) | ILOs assessed | Feedback method |
|---|---|---|---|
| Debate on application of evidence to improve quality in specialist adult health care | 2 hour session in class activity | 1-10 | Peer written and staff verbal feedback |
| Pharmacology examination preparation (in-class activities) | n/a | 6 | Verbal feedback |
Summative assessment (% of credit)
| Coursework | Written exams | Practical exams |
|---|---|---|
| 70 | 30 | 0 |
Details of summative assessment
| Form of assessment | % of credit | Size of the assessment (eg length / duration) | ILOs assessed | Feedback method |
|---|---|---|---|---|
| Pharmacology examination | 30 | 2 hour exam | 6 | Written feedback |
| Critical analysis essay | 70 | 3000 words | 1-10 | Written and verbal feedback |
Details of re-assessment (where required by referral or deferral)
| Original form of assessment | Form of re-assessment | ILOs re-assessed | Timescale for re-assessment |
|---|---|---|---|
| Critical analysis Essay (70%) | Critical analysis Essay 3000 words | 1-10 | Up to 4 weeks following result |
| Pharmacology examination (30%) | Pharmacology 2 hour exam | 6 | Up to 4 weeks following result |
Re-assessment notes
Students must pass all items of assessment.
Indicative learning resources - Basic reading
Arnold, E.A and Boggs. K.U. (2011) Interpersonal Relationships: Professional Communication Skills for Nurses (7th ed.) Elsevier.
Alligood, M.A. (2018) Nursing Theorists And Their Work, Elsevier.
Ashelford, S., Raynsford, J., and Taylor, V. (2016) Pathophysiology & Pharmacology for Nursing Students, Sage.
Bickley, L.S (2017) Bate’s Guide to Physical Examination and History Taking. Wolters Kluwer.
Bickley, L.S (2017) Bate’s Pocket Guide to Physical Examination and History Taking. Wolters Kluwer.
Blank, R.H., Burau, V., & Kuhlmann, E. (2017) Comparative Health Policy (5th ed.) Macmillan International.
Bradshaw, T., and Mairs, H. (eds.) (2017) Health Promotion and Wellbeing in people with Mental Health problems, Sage publications.
Benner, P. (1984) From Novice to Expert. Excellence and Power in Clinical Nursing. Addison Wesley.
Brooker, C., & Nicol, M. (2015) Alexander’s Nursing Practice 4th ed. Churchill Livingstone.
Cody, W. (ed.) Philosophical and Theoretical Perspectives: for Advanced Nursing Practice (5th ed.), Jones and Bartlett.
Edelman, C.L., & Kudzman, E.C. (2018) Health Promotion Across the Life span, Elsevier.
Giger, J.N., (2017) Transcultural Nursing; Assessment and Intervention (7th ed.), Elsevier.
Gould, D., & Brooker, C. (2008) Infection Prevention and Control; Applied Microbiology for Healthcare (2nd ed.) Palgrave Macmillan.
Griffith, R., & Tengath, C. (2017) Law and Professional Issues in Nursing: Transforming Nursing Practice, Sage.
Hubert, R.J., and Van Meter, K.C. (2018) Gould’s Pathophysiology for the Health Professions, Elsevier.
Innes, J.A., Dover. A.R., & Fairhurst, K. (eds.) (2018) Macleod’s Clinical Examination (14th ed.), Elsevier.
Johns, C., Freshwater D. (2005) Transforming Nursing Through Reflective Practice, (2nded.) Wiley Blackwell.
Naidoo, J., and Wills, J. (2016) Foundations for Health Promotion, Elsevier.
Polit, D.F., and Back, C.H. (2017) Essential of Nursing Research: Appraising Evidence for Nursing Practice. Wolters Kluwer.
Papadopoulos, I. (ed) (2006) Transcultural Health and Social Care; Development of Culturally Competent Practitioners, Butterworth Heinemann.
Richards, D.A., and Hallberg, I.R. (eds) (2015) Complex Interventions in Health. Routledge.
Sethia, B., and Kumar, P. (eds) (2019) Essentials of Global Health Elsevier.
Stanley, D. (ed) (2017) Clinical Leadership in nursing and Healthcare: Values into Action,(2nd ed) John Wiley& Sons, available at https://onlinelibrary.wiley.com/doi/book/10.1002/9781119253785
Schon, D.A. (2006) the Reflective Practitioner: How Professionals Think in Action. Ashgate.
Stein-Parbury, J. (2018) Patient & Person: Interpersonal Skills in Nursing, Elsevier.
Tashiro, J., Shimpuku, Y., Naruse, K. et. al., (2013) Concept analysis of reflection in nursing professional development. Japan Journal of Nursing Science 10(2):170-179 available at: https://www.evidence.nhs.uk/Search?q=nursing+reflection&sp=on
Tortora, G.J., Derrickson, B (2017) Principles of Anatomy and Physiology. Wiley.
Toughy, T.A., Jett, K. (2018) Ebersoles and Hess’ Gerontological Nursing and Healthy Ageing. Elsevier.
Waller, D.G., Sampson, A.P et., al. (2014) Medical Pharmacology & Therapeutics, Saunders, Elsevier.
Watson, C. (2018) The Language of Kindness: A Nurse’s Story. Chatto & Windus
West, M.A., Armit, K., Loewenthal, L., Eckert, R., West, T., and Lee, A. (2015) Leadership and Leadership development in healthcare: The Evidence base. The King’s fund/CCL. Available at
https://www.kingsfund.org.uk/publications/leadership-and-leadership-development-health-care
Wright, K.M., and McKeown, M. (2018) Essentials of Mental Health Nursing, Sage Publications
Indicative learning resources - Web based and electronic resources
Web based and electronic resources:
Nursing and Midwifery Council: www.nmc.org.uk
Royal College of Nursing: www.rcn.org.uk
Department of Health: www.gov.uk/government/organisations/department-of-health-and-social-care
National Institute of Health and Clinical Excellence: www.nice.org.uk
World Health Organisation: www.who.int
Healthtalk online: www.healthtalk.org
WeNurses (@WeNurses) · Twitter: https://twitter.com/WeNurses
https://intlearningcollab.org/mission/the-fundamentals-of-care/
https://www.elsevierclinicalskills.co.uk/
https://www.clinicalskills.net/
Indicative learning resources - Other resources
Journals:
American Journal of Nursing
British Journal of Community Nursing
British Journal of Nursing
Evidence-based Nursing
International Journal of Nursing Studies
Journal of Advanced Nursing
Journal of Clinical Nursing
Journal of Psychiatric and Mental Health Nursing
Nursing Ethics
Nursing Management
Nursing Older People
Worldviews on Evidence Based Nursing
| Credit value | 30 |
|---|---|
| Module ECTS | 15 |
| Module pre-requisites | NUR1000, NUR1100, NUR2000, NUR2100, NUR3000, NUR3600, NUR3109 HPDM105N |
| Module co-requisites | Clinical Specialist Internship |
| NQF level (module) | 7 |
| Available as distance learning? | No |
| Origin date | 18/05/2022 |
| Last revision date | 28/06/2023 |
