20 credits at level HE5
Acutely ill patients present in all settings frequently, unfortunately though the signs and symptoms of acute illness are all too often undetected by health professionals. The reasons for this are likely to be multi-factorial, however evidence clearly indicates that delays in recognising those who are acutely ill leads to dramatically worse outcomes when considered in relation to those who receive more appropriate care. The aim of this module is then to facilitate the early detection of those who become acutely ill in order to facilitate the instigation of the most appropriate care.
Traditionally the education of health care professionals has focused on the recognition of late signs of acute illness as an indication to act. Coupled with this protocols directed at managing patients with trauma have complicated may have complicated practitioner understanding about to respond to patients with primarily medical conditions rather than traumatic ones.
In response to these issues this module will assist practitioners to identify early signs of acute illness and guide practitioners to deliver the most appropriate evidence based response to patients who exhibit signs of acute illness.
This module will specifically focus on developing practitioners awareness of the acutely ill adult. The physiological changes that occur at a time of acute illness will be explained. Principally the concepts and mechanisms of compensation, decompenstion and the acute on chronic phenomenon will be explained in detail so that students have a robust understanding of homeostasis across the parameters that are under homeostatic control. The potential challenges to homeostasis will also be explained including ways through which the body can precipitate cascades of increasing physiological disarrangement at time of acute illness.
This knowledge of homeostasis and the physiology of acute illness will then feed into assisting professionals with the ability to critically interpret patients vital signs in light of their presenting history. A disciplined systematic approach to the interpretation of vital signs will be provided as well as an explanation as to what each of the observations recorded adds to the clinical picture in terms of assessing homeostatic stability vs. disarrangement.
Students will then examine the evidence base that underpins the guidelines that are available to support the care of the acutely ill individual. Alongside this students will practice their clinical skills in simulated conditions providing an opportunity to integrate theory with practice.
Finally to support the above aspects of care that are organisational or relate to specific legal, ethical and professional issues surrounding acute care will be explained.
This module will be delivered in a blender learning manner. Students will be provided with directed reading and a range of web based and classroom resources. Participants will refresh current knowledge at the start of this module and then deepen this knowledge by examining the evidence base that underpins current practice guidelines. podcast lectures and face to face activities will guide students though the module and its content.
Students will then be exposed to a range of clinical scenarios in the University clinical skills laboratory using patient simulator technologies. Here students will put into practice their skills and specifically they will show an ability to integrate theory to practice through taking on a range of roles in response to a wide range of acutely ill patient scenarios.
The assessment of this module will then bring together theses components assessing both the students clinical leadership and decision making skills in a OSCE and clinical knowledge as has been deployed in practice via the submission of a written piece of work that requires the student to critically reflect in light of best evidence on a critical incident that they have encounters involving an acutely ill patient.
when you have successfully completed this module you will:
to demonstrate that you have achieved the learning outcome you will:
|1.||Analyse the Patho-physiological changes that occur during acute illness||
1.1 Describe the normal physiologic compensatory response to illness
1.2 Display a detailed knowledge of all types of shock and how this can be influenced by different factors.
1.3 Recognise Indicators of decomposition
1.4 Be able to state the normal values of physiologic markers that are used in monitoring of the acutely ill adult
|2.||Assess and monitor a patient evaluating stability and analysing potential for deterioration
Systematically assess and reassess patients at risk in light of interventions and evaluate their efficacy for a given patient
2.2 Demonstrate ability to synthesise the significance of changes in an individual patient with relation to their clinical circumstance and current therapeutics.
2.3 Decide on an appropriate management plan based on assessment and clinical circumstances
|3.||Demonstrate initial management and stabilisation of individuals
displaying deterioration in clinical condition.
3.1 Prepare equipment for the care of the acutely ill
3.2 React to deteriorations demonstrating appropriate clinical judgement
3.4 Undertake clinical activities with a view to supporting respiration and circulation.
3.5 Describe the main groups of pharmacological agents used in the management of acute illness demonstrating an understanding of dosage, delivery, indication, contra indication and side effects.
3.6 Continue care and monitoring plan
|4.||Demonstrate the coordinated management of a patient in a peri arrest and arrested states in accord with currently available best evidence ones own scope of practice||
4.1 Initiate resuscitation attempts where appropriate coordinating initial response
4.2 Secure patients airway and provide respiratory support using basic,
intermediate and advanced aids
4.3 Assess the need for and where appropriate defibrillate
patients using manual defibrillator.
|5.||Function professionally in collaboration with other members of the health care team in responding to the needs of an acutely ill individual in a legal and professional manner.||
Show a clear knowledge of the roles of individual who could be involved in the management of an acutely ill person and recognise the need and urgency of referral to an appropriate individual.
5.2 Analyse and reflect own practice in light of current evidence whist acknowledging personal limits of understanding and performance.
5.3 Demonstrate effective communication and leadership in the emergency / urgent care scenario that include the transfer and recording of complex information accurately.
5.4 Support those significant to the acutely ill individual demonstrating respect and sensitivity at times of stress or bereavement
5.5 Recognise situations where resuscitation may not be appropriate and take action to ensure that only appropriate care is delivered
5.6 Use strategies to manage your own stress associated with supporting the acutely ill
Your achievement of the learning outcomes for this module will be tested as follows:
|Description||2. 2500 word essay||2. 2500 word essay|
There are no prerequisites for this module.
No restrictions apply.
Aspects of this list will become out of date with the issue of the 2010 resuscitation guidelines which are forthcoming, students should refer to the 2010 guidelines when they are issued in October to ensure the accuracy of information contained in these texts. This list will be updated in accord with the change in guidelines.
Nolan, J. Baskett, P. (2005) European Resuscitation Council Guidelines for Resuscitation 2005. Resuscitation 67 Supplement 1.
Resuscitation Council UK (2005) Resuscitation Guidelines 2005. Resuscitation Council, London. [Available online at www.resus.org http://www.resus.org.uk/pages/guide.htm]
British Medical Association (2007) Withholding and withdrawing life prolonging medical treatment third edition. BMA & Blackwell Publishing, London.
British Medical Association, Resuscitation Council UK, Royal Collage of Nursing (2007) Decisions relating to cardiopulmonary resuscitation. British Medical Association, Resuscitation Council UK, Royal Collage of Nursing. London.
BTS & SIGN (2008) British Guideline on the Management of Asthma; A national clinical guideline. BTS, London. Available online at www.brit-thoracic.org.uk
Cooper, N. Forrest, K. Cramp, P. (2006) Essential Guide to Acute Care 2nd ed. Blackwell Publishing & BMJ Books, Oxford.
Dellinger, R.P. Levy, M.M. Carlet, J.M. et al (2008) Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008 [published correction appears in Crit Care Med 2008; 36:1394–1396]. Crit Care Med 2008; 36:296–327.
Franklin, C. Mathew, J. (1994) Developing Strategies to Prevent in-Hospital Cardiac Arrest: analyzing responses of physicians and nurses in the hours before the event. Crit Care Med 22:244-247.
Hampton, JR. (2003) The ECG Made Easy. Churchill Livingstone, London.
Hodgetts, TJ. Kenward, G. Vlackonikolis, I. Payne, S. Castle, N. Crouch, R. Ineson, N. Shaikh, L. (2002) Incidence, location and reasons for avoidable in-hospital cardiac arrest in a district general hospital. Resuscitation 54:115-123.
McQuillan, P. Pilkington, S. Allan, A. Taylor, B. Short, A. Morgan, G. Nielsen, M. Barrett, D. Smith, G. Collins, CH. (1998) Confidential inquiry into quality of care before admission to intensive care. BMJ 316:1853-1858.
National Confidential Enquiry Into Patient Outcome & Death (2005) An Acute Problem. A report of the National Confidential Enquiry into Patient Outcome and Death (2005). London, NCEPOD.
NICE (2007) Acutely Ill Patients in Hospital; Recognition of and response to Acute Illness in Adults in Hospital. London, National Institute of Health & Clinical Excellence.
O’Brien, E. Asmar, R. Beilin, L. Imai, Y. Mallion, J. Mancia, G. Mengden, T. Myers, M. Padfield, P. Palatini, P. Parati, G. Pickering, T. Redon, J. Staessen, J. Stergiou, G. Verdecchia, P. on behalf of the European Society of Hypertension Working Group on Blood Pressure Monitoring. (2003) European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. Journal of Hypertension 21:821–848.
O’Driscoll, B. Howard, L. Davison, A. on behalf of the British Thoracic Society Emergency Oxygen Guideline Development Group, a subgroup of the British Thoracic Society Standards of Care Committee. (2008) Guideline for emergency oxygen use in adult patients. Thorax; 63: Supplement VI.
Resuscitation Council (UK) and Intercollegiate Board for Training in Intensive Care Medicine (2005) Acute Care In Undergraduate Teaching (ACUTE) Initiative. London, Resuscitation Council UK.
Resuscitation Council UK (2008) Emergency treatment of anaphylactic reactions guidelines for healthcare providers. Resuscitation Council UK, London.
Royal College of Physicians (2008) Non-Invasive ventilation in chronic obstructive pulmonary disease: management of type 2 respiratory failure. Royal College of Physicians London.
Steane, A. (2007) Who Cares? One Family's Shocking Story of Care in Today's NHS. Original Book Co, Bournemouth.
Health Professions Council (2008) Standards of Conduct, Performance and Ethics. Health Professions Council, London.
|Host Subject Group:||Health Studies|
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