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Anaesthetic Nursing Two
6KNIC600 Level: 6
Credits: 15
Module leader Sheila Turner
Tel: 020 7848 3217
Email: [email protected]
The teaching team consists of Sheila Turner supported by guest speakers.
Please do not hesitate to discuss any aspect of your programme with your module leader. We are only too happy to help in any way we can.
We are very much aware of the pressures of working, studying and/or family commitments and we have, therefore, provided academic support and guidance throughout the module. The use of learning agreements jointly developed between your practice supervisor and you will encourage self-reliance and self-direction. It will enable you to negotiate the pace and depth of your work and facilitate the integration of theory and practice.
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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 Student Services Centre. This handbook can also be provided in alternative formats (such as large print) upon request to [email protected].
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Contents Module overview .............................................................................................................. 4
Module aim ................................................................................................................... 4
Learning outcomes ....................................................................................................... 4
Practice Outcomes ........................................................................................................ 5
Teaching arrangements ............................................................................................... 5
Submitting coursework ....................................................................................................... 6
Assessment Strategy .................................................................................................... 6
Rationale ....................................................................................................................... 6
Guidelines ..................................................................................................................... 6
Assessment criteria ...................................................................................................... 7
Summative guidelines .................................................................................................. 7
Formative Work ........................................................................................................... 9
PAD ................................................................................................................................... 10
Submission details ....................................................................................................... 10
Results and resubmissions for coursework ................................................................ 11
Learning resources............................................................................................................... 12
Day 1 .................................................................................................................................. 12
Session 1: Introduction ................................................................................................ 12
Session 2: Systemic Disease and Anaesthesia ............................................................ 12
Session 3: The ‘Complex Case’ Cardiac and Neuroanaesthesia ................................ 13
Session 4: Post-anaesthetic Recovery and Care of the Ventilated Patient in Recovery ...................................................................................................... 13
Day 2 ................................................................................................................................. 15
Session 1: Paediatric Anaesthesia, the Nurse Perspective & Session 2: Paediatric Anaesthesia, the significance of A&P .................................. 15
Session 3: Ethics and Professional Issues .................................................................. 16
Session 4: Care of the Patient with Diabetes .............................................................. 16
Session 5: Blood Gas Analysis ..................................................................................... 17
Session 6: Haemodynamic Monitoring ...................................................................... 17
Day 3 ................................................................................................................................. 18
Session 1: Non-technical skills and the Anaesthetic Nurse ....................................... 18
Session 2: Paediatric & Neonatal Anaesthesia ........................................................... 18
Session 3: Classroom ................................................................................................... 19
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Day 4 ................................................................................................................................. 20
Session 1: Venepuncture and Cannulation ................................................................. 20
Session 2: Introduction to Advanced Life Support .................................................... 20
Session 3: Post-anaesthetic Recovery ......................................................................... 21
Session 4: Recovery Scenarios .................................................................................... 21
Module evaluation ........................................................................................................... 22
Action from previous evaluations ............................................................................... 22
Timetable .............................................................................................................................. 23
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Module overview This module forms part of the BSc Clinical Practice. The module contributes to your programme of study by building upon what you have gained from 6KNIC601 Anaesthetic Nursing One. The module prepares you to work in more complex clinical scenarios, possibly caring for patients with challenging conditions, or in challenging circumstances; equipping you to respond effectively to rapid situational changes.
Module aim The aim of this module is:
To critically analyse and evaluate the practice of anaesthetic nursing.
To establish a basis of professional knowledge and competence in the anaesthetic nursing care of adult patients that promotes logical decision making in the planning and delivery of care.
To promote the use of reflective practice in developing expertise in care delivery.
To review the evidence underpinning anaesthetic nursing and evaluate implications for current and future practice.
Learning outcomes At the end of the module participants will be able to effectively manage the assessment, planning, implementation and evaluation of holistic anaesthetic nursing care. This will be indicated by the ability to:
Critically examine the evidence-base and research-based literature.
Utilise an approach to care that reflects the knowledge and skills required to deliver effective communication with the patient/client/family and members of the health care team.
Explore personal values, philosophy and the professional role with regard to the delivery of care to effectively meet the social, cultural, and spiritual needs of patients undergoing anaesthesia and surgery.
Contribute towards a culture in which diversity, with regards to both clients and colleagues, is respected and equality is evident.
Critically review and judge the evolving role of the anaesthetic nurse.
Appraise the need to adopt approaches that will enhance anaesthetic practice and might contribute towards service development.
Participate effectively in the nursing care and management of neonatal/paediatric patients undergoing anaesthesia.
Participate effectively in the nursing care and management of clients recovering from anaesthesia.
Evaluate the moral, legal, ethical and political implications of anaesthetic nursing practice.
Debate the strategies that may be employed to ensure effective and careful resourcing, whilst maintaining provision of top quality nursing care.
Analyse how competent leadership can facilitate positive and clear roles for professionals within anaesthetic nursing practice.
Facilitate learning with clients, students and colleagues.
Appraise the knowledge and skills required for inter-professional collaboration in anaesthetic care.
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Practice Outcomes Application of knowledge and skills to your clinical area and the development of critical thinking ability will be continuously assessed through completion of a clinical proficiency document (PAD). This specifies the competencies that need to be achieved to the identified standard by the date specified.
Teaching arrangements Teaching and learning in this course will be a dynamic process actively involving all nurses. This reflects adult learning, with the aim of building upon your experience as a qualified nurse.
We will be utilising a variety of educational approaches to facilitate development of creative and analytical thinking, self-awareness, problem solving and decision making skills.
Lectures and discussion
Practical sessions
Independent study
Seminars and tutorials Directed reading
Directed study activities
It is student participation and collaboration which enrich the taught component of any module. While you should not share work you intend to submit for assessment; you could share references, for example, if one of you finds an article particularly useful, you could post the details for the rest of the group on your discussion board.
During this module, your taught sessions are delivered 09.00-12.30, 13.30-17.00 you are expected to devote some of your own time to activities designed to further your understanding/improve your knowledge about anaesthetic nursing. You are also expected to invest a similar amount of time (i.e. as a minimum 2-3 hours) weekly (4-6 hours over two weeks) upon your own reading into/research about your specific role as an anaesthetic nurse caring for a diverse group of patients who present more challenging care requirements.
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Submitting coursework
For this module you are assessed by Sheila Turner through the submission of an essay and assessment of clinical practice (PAD).
Assessment Strategy The aim of this assignment is to allow you to integrate your knowledge from clinical experience with your assessment of proficiency in clinical practice (PAD document) and the theory which underpins nursing practice (References).
Rationale The role of the nurse in anaesthesia is diverse and complex. The responsibilities of the nurse in this role are wide-ranging, from the formation of an effective professional relationship with patients, parents/relatives/carers and colleagues through to evaluation of the nursing care provided to the patient on some occasions in complex/challenging situations. The assessment approach therefore provides an opportunity to consider the domains of this role in relation to the practice setting.
Guidelines Proficiency document submitted manually It is a requirement of the course that you pass an assessment of clinical competence in a practice setting relevant to anaesthetic nursing. Assessment of clinical practice is continuous throughout the course. Format: The assessment of clinical practice related to competencies identified for this module, Anaesthetic Nursing Two, requires successful completion of a competency document (PAD). Mentor(s) must be identified in your clinical area. Your primary mentor must be an experienced nurse or ODP with a Mentorship qualification or equivalent (for example, ENB 998 or C&G 730). An initial interview should take place within the first few weeks of the course. It is your responsibility to arrange this with identified mentor(s).
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Assessment criteria
Written assignment - submitted electronically
ESSAY TITLE: The anaesthetic nursing care of a patient with complex needs- a critical incident analysis
This essay focus must be the anaesthetic nursing care of a patient with complex needs.
Essay word length: 2,000 words
The essay will be closely based upon the module outcomes, for example,
At the end of the module participants will be able to effectively manage the assessment, planning, implementation and evaluation of holistic anaesthetic nursing care. This will be indicated by the ability to:
Critically examine the evidence-base and research-based literature.
Utilise an approach to care that reflects the knowledge and skills required to deliver effective communication with the patient/client/family and members of the health care team.
Appraise the knowledge and skills required for inter-professional collaboration in anaesthetic care.
You are strongly advised to seek tutorial guidance from the module leader. This should be undertaken a minimum of 4 weeks before the submission date for assignments.
Aim
The aim of this assignment is to enable you to analyse in-depth a critical incident in which you have been involved. The reflection should focus on your nursing role related to patient care.
The incident might involve a specific issue, for example, conflict, patient anxiety, debriefing, everyday events, audit or near miss/errors.
What is most important is your interpretation/analysis of the event and learning for future practice (possibly demonstrated in an action plan).
Summative guidelines The main focus of the essay should be on the analysis of the incident with recommendations for future practice. The description of your incident should comprise no more than (200 words) 10% of the total word count.
The essay must address the following areas:
A description of a practice-based critical incident. This must have taken place within your current area of clinical practice and be a recent incident.
A rationale for your choice of incident in line with current definitions of a critical incident.
Analysis rather than description.
A framework of structured reflection to explore the critical incident.
An awareness of the context in which the incident took place
An analysis of the professional and clinical implications for practice. If your incident identifies an aspect of practice, which was potentially unsafe, you must ensure you demonstrate how this practice was rectified.
Recommendations for future practice
Reference to appropriate literature.
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Benner (1984) provides a definition of critical incidents which is stated below; for the purposes of this assignment you may find it easier to choose one of the first three statements.
An incident in which you feel your intervention really made a difference in patient outcome, either directly or indirectly.
An incident that went unusually well.
An incident in which there was a breakdown i.e. things did not go as planned.
An incident that is very ordinary and typical.
An incident, which you think, captures the quintessence of what nursing is all about.
An incident that was particularly demanding.
So the ‘incident’ does not have to be overly dramatic or representative of a situation in which things went wrong.
Please note that any issue regarded as unsafe practice will constitute an automatic fail. Essay notes:
What might ‘complex needs’ be?
- An emergency scenario (for example: aortic aneurysm repair)
- A neonate/infant
- A patient with concurrent disease
- A patient undergoing complex or protracted surgery (for example: cardiac, neuro, and transplant, major max-fax or vascular)
You must justify your choice of scenario. Please do not choose a topic and try to make that fit a ‘critical incident analysis’.
Consider what ‘reflection’ requires: ‘Reflection’ suggests looking back over events; you may think ‘why did that happen?’ Equally you might consider ‘why do we do that?’ Or, even, ‘is there a better way we might do that?’ It is a very personal process, so you present your thinking in the first person (me, my, I) because you are central to that process. Inevitably reflection can lead to an exploration of how you ‘feel’ about things and whether your feelings influence your actions. In your analysis you should try to develop a deep understanding about what you have chosen, this might involve looking at conflicting arguments about specific approaches to care or it might involve you considering alternate viewpoints. Ultimately your reflection should lead to you looking forward and considering how what you have learnt from your analysis might be used/applied to your practice. Reflection is, therefore an active process and is ongoing.
You are advised to choose a model to structure your reflection. The model you use must be apparent in its entirety; you cannot cherry-pick and use parts of the model. Popular models (listed in accordance with their complexity) have been designed by Driscoll (2007), Gibbs (1988) and Johns (2000).
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In your essay:
You must consider your role/performance, not that of colleagues.
You must support your writing with reference, using a critical approach, to relevant contemporaneous literature.
You must produce a comprehensive reference list which details (using the Harvard system, guidance about this is available on the KEATS module page) all the sources to which you refer in the essay.
Work must be within the word limit. The word limit specified in module handbooks is the maximum number of words permissible and any excess will not be read or marked. The work that comes within the word limit will be assessed according to the guidelines. Therefore, if important parts of the assignment fall outside the word limit you are likely to fail the assignment. Appendices must be used appropriately and essential information placed within the text. Appendices, reference lists, tables and figures are not included in the word count.
Formative Work You are required to participate in a group assignment tutorial on Day 3, so please bring your essay plan and some thoughts about how you will approach the essay with you, following the group tutorial you must prepare and submit 250 words of your assignment as a formative draft by e-mail to Sheila before Thursday 1st March, so that Sheila can provide feedback during Day 4 on Thursday 8th March.
All students have the opportunity to make tutorial appointments, dates/times available on KEATS, to discuss their formative and preparation for summative assessment.
If you require an e-tutorial please state this in the e-mail when you send Sheila your draft. For example:
‘Please find my essay draft attached, I would like to book a 1-2-1 tutorial/I have booked a 1-2-1 tutorial on date/I have booked a small group tutorial on date/ I would like an e-tutorial’.
Whichever form of tutorial support you choose your formative draft will be returned to you during electronic, 1-2-1 or small group tutorials.
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PAD
The document contains comprehensive user instructions; you and your mentor must read and become acquainted with what is required to complete your assessment in practice. An example of a completed PAD page appears as the final page of the document; please read this with your supervisor so that you both understand what is required.
The PAD must be complete, with the minimum standard attained in every aspect.
Please note: You must ‘pass’ both the essay and your assessment in clinical practice: it is possible to ‘fail’ the module if your PAD is incomplete or if your mentor has erroneously graded you below the minimum required standard, for example. If your mentor expresses concern about your clinical competence; s/he must discuss those concerns with Sheila, as soon as they arise, and before you submit the PAD. If you are unaware about any concerns, you must ensure that your PAD is complete before you submit.
Submission details Coursework submission details are provided on the module KEATS site. It is essential that you use your candidate number on all assignments/examinations. Your candidate number, which will begin with Y for the academic year 2017/18, will be available via Student Records on the King’s Intranet approximately one month after you enrol. If you are unable to submit your work by the deadline, please refer to the information in your programme handbook on “mitigating circumstances”. If you require further support in these circumstances, you are advised to contact KCLSU. Summary of essay (electronic) submission:
Guidance for electronic assignment submission will be published on KEATS . Your submission must contain:
As the first page the post-registration cover sheet (which you paste into your essay as page 1).
The second page will be the introduction to your essay, followed by the essay.
Please ensure your candidate number appears on every page of your essay (as a footnote).
At the end of the essay your reference list will be submitted beginning on a separate page (your cover sheet, reference list and the PAD are not included in the 2000-word count but all other work is).
Please submit all these elements as one document.
A marking rubric is provided on KEATS, this outlines what the markers look for when marking/grading your work.
Submission date for coursework: Tuesday 10 April 2018, no later than 11.59am
Late submissions will be accepted for 24 hours following the submission date. All work submitted late will be marked as normal but will be capped at the pass mark for the module.
ASSIGNMENT UPLOAD MIGHT TAKE 60 MINUTES, SO AIM TO COMPLETE UPLOAD BY 10.00AM.
Summary of PAD (manual) submission:
The first page will be the post-registration cover sheet
The PAD must be included with this manual submission
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Remember the PAD must be submitted manually
Submission date for PAD: Tuesday 24 April 2018, no later than 11.59am
Your PAD is submitted manually (as a hard copy). When you get to the submission room, please ensure you date stamp it (the machines sit on top of the submission boxes) and submit it into one of the boxes. The submission room is G15 James Clerk Maxwell Building, which is open between 07.00-22.00 Monday-Friday and 09.00-19.00 Saturday and Sunday.
Essay submission is electronically via TurnItIn on the module KEATS site and information about how to submit is provided on KEATS module sites under ‘assessment information’. Please ensure you use a coversheet containing your candidate number and double-check you have submitted the correct file.
The external examiner for this module is Darren Brand. Students are not to make direct contact with external examiners, in particular regarding their individual performance in assessments.
The College and its Examination Boards in the ten Faculties (Institutes/Schools, King's Learning Institute and the Association of King's College (AKC), work with over 500 external examiners to ensure the quality and standard of our taught awards. Find the latest report on the External Examiners Report page, navigate to the Faculty of Nursing and Midwifery section.
Results and resubmissions for coursework Essay available for download: Wednesday 9 May 2018 PAD available for collection: Tuesday 22 May 2018 Students will receive a provisional (unratified) mark for their coursework 4 weeks following submission. According to the method of submission as detailed on your KEATS site, if your work was submitted online you will be able to download marked coursework from KEATS; alternatively, if you completed a hard copy submission you can collect your coursework and feedback from the Student Services Centre. To collect a hard copy assignment, you must provide your candidate number. Alternatively, you may send a stamped addressed (signed for) envelope to the Student Services Centre ensuring that this is large enough to accommodate your PAD and that you have applied sufficient postage. Hard copy assignments will be retained for four weeks; if you have not collected your assignment by then, it will be destroyed. Feedback upon your essay will include the award of a numerical grade which remains provisional until ratified by the examination boards. The dates for the examination boards are available on KEATS. Ratified marks can be viewed via Student Records on the King’s Intranet, the Monday following the relevant examination board. The marking criteria by which your work is judged are provided in full in your programme handbook. Please also refer to the section in your programme handbook on plagiarism and how to avoid it. If you have a query about how to refer to a specific piece of work please ask your module leader, your group leader or a member of library staff for guidance or please use King’s Libguides site. The feedback you receive on your assignment will guide you towards how to do better next time or how to maintain your existing high standard! If you do not understand your mark or the feedback you receive please contact Sheila Turner. If you are unsuccessful, it is recommended that you contact Sheila Turner before submitting your second attempt. This will enable her to provide you with an appropriate level of support as you prepare to resubmit your work.
Resubmission date Essay/PAD: Tuesday 17 July 2018 Resubmitted work available for download/collection: Tuesday 14 August 2018
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Learning resources
Day 1
Session 1: Introduction Introduction to the module and the module assignment.
Session 2: Systemic Disease and Anaesthesia The session will include the anaesthetic issues relevant to a number of disorders, including: Sickle cell disease, Hypertension, Renal and Hepatic disease
By the end of the session students will be able to: Recognise the implications of systemic disease for the management of an anaesthetic
Describe the conditions of concern
Identify the specific management required by patients with:
o Sickle cell disease
o Hypertension
o Hypotension
o Hepatic/Renal disease
Indicative reading Beattie C. & Gillies M.A. (2015) Anaesthesia and intensive care for adult liver transplantation. Anaesthesia and Intensive Care Medicine. 16(7), 339-343.
Griffiths C.A. (2000) Prevention of occupational transmission of blood borne diseases in clinical nurse anaesthesia practice. CRNA: The Clinical Forum for Nurse Anaesthetists 11(1), 2-7.
Homa D.G. & Palfreyman M.A. (2000) Infectious diseases in the operating room. CRNA: The Clinical Forum for Nurse Anaesthetists 11(1), 8-14.
Oullette S.M. (1999) Anaesthetic management of the patient with ischaemic heart disease. Current Reviews for Nurse Anaesthetists 21(25), 231-238.
Oullette S.M. (1999) Perioperative management of the hypertensive patient. Current Reviews for Nurse Anaesthetists 22(7), 65-76.
Reide P.J. & Yentis S.M. (2010) Anaesthesia for the Obstetric Patient with (non-obstetric) systemic disease. Best Practice and Research Clinical Obstetrics and Gynaecology 24(3), 313-326.
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Session 3: The ‘Complex Case’ Cardiac and Neuroanaesthesia By the end of the session students will have a greater understanding about anaesthesia for surgical specialties which offer particular challenges to the anaesthetic team. Indicative reading Alexander D. (2015) Principles of cardiac anaesthesia. Anaesthesia and Intensive Care Medicine. 16(10), 479-483.
Chaytor A. (2015) Control of cardiac function: an overview. Anaesthesia and Intensive Care Medicine. 16(10), 479-483.
Donnelly L. (2017) The brain: Functional divisions. Anaesthesia and Intensive Care Medicine. 18(5), 264-269.
Herr C. & Roscoe D. (2015) Transoesophageal cardiography in cardiac anaesthesia. Anaesthesia and Intensive Care Medicine 16(10), 491-497.
Hett D.A. (2006) Anaesthesia for off-pump coronary artery surgery. Continuing Education in Anaesthesia, Critical Care and Pain 6(2), 60-62.
Mishra L.D., Rajkumar N. & Hancock S.M. (2006) Current controversies in neuroanaesthesia, head injury management and neuro critical care. Continuing Education in Anaesthesia, Critical Care and Pain 6(2), 79-82.
Myles P.S. & McIlroy D. (2005) Fast-Track Anaesthesia: Choice of Anaesthetic Agents and Techniques. Seminars in Cardiothoracic and Vascular Anaesthesia 9(1), 5-16.
Serfontein L. (2010) Awareness in cardiac anesthesia. Current Opinion in Anaesthesiology 23(1), 103-108.
Session 4: Post-anaesthetic Recovery and Care of the Ventilated Patient in Recovery By the end of the day students will be able to:
Provide advanced post anaesthesia nursing care.
Outline the indications for, and nursing management of, patients requiring short term ventilation and inotropic support.
Identify effective care documentation.
Indicative reading Bailey P.L. (1997) Opioid-induced respiratory depression. Current Reviews for Nurse Anaesthetists 20(10), 87-96.
Garrett N. & McShane F. (1999) The pathophysiology of pain. AANA Journal 67(4), 349-357.
Macca R.S. (1999) Postoperative hypocarbia. Current Reviews for Nurse Anaesthetists 22(2), 10-19.
Marley R.A. (1998) Continuing education. Postoperative oxygen therapy. Journal of Perianaesthesia Nursing 13(6), 393-412.
McConachie I. (2009) Anesthesia for the High-Risk Patient. 2nd ed. Cambridge University Press, Cambridge.
Preston N. & Gregory M. (2012) Patient recovery and postanaesthesia care unit (PACU). Anaesthesia and Intensive Care Medicine. 13(12), 591-593
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Prowse M.A. & Lyne P.A. (2000) Clinical effectiveness in the post-anaesthesia care unit: how nursing knowledge contributes to achieving intended patient outcomes. Journal of Advanced Nursing 31(5), 1115-1124.
I appreciate some of the above references are ‘elderly’, but they offer useful information, which is no ‘out-of-date’ in respect of contemporary practice.
Homework Begin reading for the essay, prepare an essay plan and initial reading list.
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Day 2
Session 1: Paediatric Anaesthesia, the Nurse Perspective & Session 2: Paediatric Anaesthesia, the significance of A&P By the end of the session students will be able to:
Outline the specific challenges and nursing care needs of the neonatal patient
Define the specific care needs of the paediatric patient
Identify the equipment required and state why it is different to that used in adult anaesthesia
Outline the specific risks associated with paediatric anaesthesia
Consider the parents of the neonate/infant/child undergoing anaesthesia
Indicative reading
Alkalay A.L. & Sola A. (2000) Special report: ethics and pain. Analgesia and local anaesthesia for non-ritual circumcision in stable healthy newborns. Neonatal Intensive Care 13(2), 19-22.
Anderson B.J. (2107) Neonatal pharmacology. Anaesthesia and Intensive Care Medicine. 18(2) 68-74.
Howard R.F. (2005) Acute pain management in the neonate. Anaesthesia and Intensive Care Medicine. 6(4), 122-124.
Leslie D., Froome S. & Gilderslieve C. (2015) Equipment and monitoring for paediatric anaesthesia. Anaesthesia and Intensive Care Medicine. 16(8), 389-394.
Long J., Sawardekar A. & Suresh S. (2016) Neuraxial anaesthesia in paediatrics. Anaesthesia and Intensive Care Medicine. 17(6), 293-298.
McGregor K. (2017) Principles of anaesthesia for term neonates. Anaesthesia and Intensive Care Medicine. 18(2) 75-78.
Mildenhall L.F.J. (2017) Resuscitation of the newborn. Anaesthesia and Intensive Care Medicine. 18(2), 99-105.
Nolan J.A. (2106) Principles of paediatric anaesthesia. Anaesthesia and Intensive Care Medicine. 17(6), 265-269.
Peiris K. & Fell D. (2009) The prematurely born infant and anaesthesia. Continuing Education in Anaesthesia, Critical Care and Pain 9(3), 73-77.
Roberts S. & Cowan R. (2016) Peripheral and local techniques for paediatric surgery. Anaesthesia and Intensive Care Medicine. 17(6), 286-292.
Short J.A. & Gordon J.K. (2015) Preoperative assessment and preparation for anaesthesia in children. Anaesthesia and Intensive Care Medicine. 16(8), 381-388.
Welborn L.G. (1997) Perioperative complications in the former preterm infant. Current Reviews for Perianaesthesia Nurses 19(2), 14-24.
Williams G. (2017) Acute pain management in the neonate. Anaesthesia and Intensive Care Medicine. 18(2) 84-89.
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Electronic resources: Anaesthesia UK Neonatal physiology http://www.frca.co.uk/article.aspx?articleid=100980 (Last accessed 28.11.2017).
Anaesthesia UK article about paediatric anaesthesia
http://www.frca.co.uk/article.aspx?articleid=100706 (Last accessed 28 Nov 2017).
Session 3: Ethics and Professional Issues
By the end of the session students will be able to:
Debate issues which may offer ethical challenges to the anaesthetic and recovery nurse.
Consider the medico legal/professional implications of the anaesthetic nurse role. Indicative reading Cozens-Firth J. (1995) Tackling risk by changing behaviour. Quality in Health Care 4, 97-101.
Draper H. & Scott W.E. (2003) Ethics in Anaesthesia and Intensive Care. 2nd ed. Butterworth-Heinemann, London.
Thompson I.E., Melia K.M., Boyd K.M. & Horsburgh D. (2006) Nursing Ethics. 5th ed. Churchill Livingstone, London.
White S.M. & Baldwin T.J. (2004) Legal and Ethical aspects of Anaesthesia, Critical Care and Perioperative Medicine. Cambridge University Press, Cambridge.
Electronic resources: Patient safety; learning from litigation http://www1.imperial.ac.uk/resources/CF95F112-9A71-4905-A130-0062518224EC/learningfromlitigation.pdf (last accessed 28 Nov 2017).
Systems analysis of clinical incidents, the London Protocol: http://www1.imperial.ac.uk/resources/C85B6574-7E28-4BE6-BE61-E94C3F6243CE/londonprotocol_e.pdf (last accessed 28 Nov 2017).
http://www.frca.co.uk/page.aspx?id=124 (last accessed 28 Nov 2017).
Session 4: Care of the Patient with Diabetes
By the end of the session students will be able to: Identify the specific care needs of the patient with Diabetes
Indicative reading
Will be provided by the session facilitator.
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Session 5: Blood Gas Analysis
By the end of the session the students should be able to: Explain the physiology of acid-base balance and its significance to anaesthesia.
Indicative reading Nice straightforward Patient.co.uk explanation of ABG http://www.patient.co.uk/doctor/Arterial-Blood-Gases-Indications-and-Interpretation.htm (last accessed 28 Nov 2017).
Cowley N J, Owen A and Bion J F (2013) Interpreting blood gas results. British Medical Journal online at: http://www.bmj.com/content/346/bmj.f16.pdf%2Bhtml (last accessed 28 Nov 2017).
Session 6: Haemodynamic Monitoring
By the end of the session students will be able to: Evaluate the methods and approaches for obtaining accurate haemodynamic assessment of
the patient undergoing anaesthesia.
Indicative reading Asian M.C. (1990) Blood pressure Measurement: An Evaluation of Direct and Indirect Methods. Intensive Care Nursing 6(3), 111-117.
Darovic G.O. (2008) Hemodynamic Monitoring: Invasive and Non-invasive Clinical Application. 4th ed. Elsevier Saunders, Edinburgh.
Jevon P. & Ewens B. (2012) Monitoring the Critically Ill Patient (Essential clinical skills for nurses), 3rd ed. Wiley Blackwell, Oxford.
Metheny N.M. (2010) Fluid and Electrolyte Balance. 5th ed. Jones & Bartlett Learning International, Philadelphia.
Thomas G. & Duffin-Jones V. (2015) Monitoring arterial blood pressure. Anaesthesia and Intensive Care Medicine. 16(3), 124-127.
Homework Continue preparation of your essay plan and reference list in readiness for an in-class exercise during day 3. Before day 3 please watch and make notes upon the following video clips: https://www.youtube.com/watch?v=JzlvgtPIof4 Just a routine operation https://www.youtube.com/watch?v=jZPvVwvX_Nc Emergency plane landing in Hudson River
To err is human video, watch the first 18 minutes: https://www.youtube.com/watch?v=oNCObzqSMa0
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Day 3 Please bring your revised essay plans and expanded reading lists for an in-class formative exercise today.
Session 1: Non-technical skills and the Anaesthetic Nurse
By the end of the session students will be able to:
Recognise the NTS employed by members of the perioperative team
Recognise the need to call for help
Respond appropriately during situational changes Work collegiately
Indicative reading
Fletcher G., Flin R., McGeorge P., Glavin R., Maran N. & Patey R. (2003) Anaesthetists’ Non‐Technical Skills (ANTS): evaluation of a behavioural marker system. British Journal of Anaesthesia 90(5), 580-588.
Flin R., Glavin R., Patey R. & Maran N. (2010) Anaesthetists non-technical skills. British Journal of Anaesthesia 105(1), 38-44.
McCulloch P., Mishra A., Handa A., Dale T., Hirst G. & Catchpole K. (2009) Qual. Saf. Health Care 18, 109-115.
Session 2: Paediatric & Neonatal Anaesthesia
By the end of the session students will be able to: Outline the specific challenges and anaesthetic care needs of the neonatal patient
Define the specific care needs of the paediatric client
Identify the equipment required and state why it is different to that used in adult anaesthesia
Outline the specific risks associated with paediatric anaesthesia
Consider the parents of the neonate/infant/child undergoing anaesthesia
Indicative reading
Alkalay A.L. & Sola A. (2000) Special report: ethics and pain. Analgesia and local anaesthesia for non-ritual circumcision in stable healthy newborns. Neonatal Intensive Care 13(2), 19-22.
Anderson B.J. (2107) Neonatal pharmacology. Anaesthesia and Intensive Care Medicine. 18(2), 68-74.
Howard R.F. (2005) Acute pain management in the neonate. Anaesthesia and Intensive Care Medicine. 6(4), 122-124.
Leslie D., Froome S. & Gilderslieve C. (2015) Equipment and monitoring for paediatric anaesthesia. Anaesthesia and Intensive Care Medicine. 16(8), 389-394.
Long J., Sawardekar A. & Suresh S. (2016) Neuraxial anaesthesia in paediatrics. Anaesthesia and Intensive Care Medicine. 17(6), 293-298.
McGregor K. (2017) Principles of anaesthesia for term neonates. Anaesthesia and Intensive Care Medicine. 18(2) 75-78.
Mildenhall L.F.J. (2017) Resuscitation of the newborn. Anaesthesia and Intensive Care Medicine. 18(2), 99-105.
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Nolan J.A. (2106) Principles of paediatric anaesthesia. Anaesthesia and Intensive Care Medicine. 17(6), 265-269.
Peiris K. & Fell D. (2009) The prematurely born infant and anaesthesia. Continuing Education in Anaesthesia, Critical Care and Pain 9(3), 73-77.
Roberts S. & Cowan R. (2016) Peripheral and local techniques for paediatric surgery. Anaesthesia and Intensive Care Medicine. 17(6), 286-292.
Short J.A. & Gordon J.K. (2015) Preoperative assessment and preparation for anaesthesia in children. Anaesthesia and Intensive Care Medicine. 16(8), 381-388.
Welborn L.G. (1997) Perioperative complications in the former preterm infant. Current Reviews for Perianaesthesia Nurses 19(2), 14-24.
Williams G. (2017) Acute pain management in the neonate. Anaesthesia and Intensive Care Medicine. 18(2) 84-89.
Anaesthesia UK Neonatal physiology http://www.frca.co.uk/article.aspx?articleid=100980 (Last accessed 28 Nov 2017).
Anaesthesia UK article about paediatric anaesthesia
http://www.frca.co.uk/article.aspx?articleid=100706 (Last accessed 28 Nov 2017).
Session 3: Classroom Formative Exercise
Student-led activities related to essay preparation. Homework: Consolidate plans for the essay using the information/references discussed in the group tutorial and email the first 250-word draft of your essay by 1st March; so that she can provide feedback during study day 4 on Thursday 8th March.
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Day 4 1.6 Chantler SaIL Centre (09.30-14.00) Shepherd’s House Guy’s campus
Session 1: Venepuncture and Cannulation
By the end of the session students will be able to:
Identify the professional issues associated with developing this skill
Prepare for a period of supervised practice in venepuncture and cannulation
Identify the correct sites for venepuncture and cannulation
Define an accessible ('good') vein
Use the correct aids to successfully cannulate or take blood from a patient
Identify the challenging scenario (e.g. elderly, child, needle phobic patients) and present approaches to manage each situation
Identify the infection control risks associated with an invasive technique
Adopt the correct skin cleansing technique
Apply a tourniquet for phlebotomy or cannulation
Take blood from a mannequin Cannulate a mannequin
Indicative reading Brooks N. (2014) Venepuncture and Cannulation: A Practical Guide. M&K Publishing, Cumbria.
Ernst D.J. & Ernst C. (2002) Phlebotomy Tools of the Trade. Home Healthcare Nurse 20(3), 151-153.
Ernst D.J. & Ernst C. (2003) Phlebotomy Tools of the Trade: Part 2: Surveying the antecubital area. Home Healthcare Nurse 20(6), 402-403.
Ernst D.J. & Ernst C. (2002) Phlebotomy Tools of the Trade: Part 3: Alternative sites for Drawing Blood. Home Healthcare Nurse 21(3), 156-158.
Ernst D.J. & Ernst C. (2003) Phlebotomy Tools of the Trade: Part 4: Proper Handling and Storage of Blood specimens. Home Healthcare Nurse 21(4), 266-270.
Session 2: Introduction to Advanced Life Support
Please read the ALS guidelines on the Resuscitation Council website before the session. Introduction to Advanced Life Support. This session has been designed to challenge your thinking beyond Basic Life Support. You will also have the opportunity to practice different airway management techniques.
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Session 3: Post-anaesthetic Recovery Classroom 4 NHH Guy’s campus
By the end of the day students will be able to: Provide advanced post anaesthesia nursing care.
Outline the indications for, and nursing management of, patients requiring short term
ventilation and inotropic support.
Identify effective care documentation.
Participate in a variety of clinical scenarios necessitating safe and effective patient care post-
anaesthesia.
Indicative reading Bailey P.L. (1997) Opioid-induced respiratory depression. Current Reviews for Nurse Anaesthetists 20(10), 87-96.
Blackburn J. & Spencer R. (2015) Postoperative nausea and vomiting. Anaesthesia and Intensive Care Medicine. 16(9), 452-456.
Chapman J.L.R. & Lalkhen A.D. (2016) Postoperative analgesia. Anaesthesia and Intensive Care Medicine. 17(3), 144-150.
Garrett N. & McShane F. (1999) The pathophysiology of pain. AANA Journal 67(4), 349-357.
Macca R.S. (1999) Postoperative hypocarbia. Current Reviews for Nurse Anaesthetists 22(2), 10-19.
Marley R.A. (1998) Continuing education. Postoperative oxygen therapy. Journal of Perianaesthesia Nursing 13(6), 393-412.
McConachie I. (2009) Anesthesia for the High-Risk Patient. 2nd ed. Cambridge University Press, Cambridge.
Preston N. & Gregory M. (2015) Patient recovery and postanaesthesia care unit (PACU). Anaesthesia and Intensive Care Medicine. 16(9), 443-445.
Prowse M.A. & Lyne P.A. (2000) Clinical effectiveness in the post-anaesthesia care unit: how nursing knowledge contributes to achieving intended patient outcomes. Current Reviews for Nurse Anaesthetists 31(5), 1115-1124.
Session 4: Recovery Scenarios Classroom 4 NHH Guy’s campus This session involves recovery scenarios and linking theory with practice. By the end of the session students will have a greater understanding about the wider issues associated with the post anaesthetic care of patients, including the environment and the need to prioritise when faced with minimal facilities. The day finishes with a module evaluation and discussion about further experience/study. Homework: Continue essay preparation for submission on 10 April 2018. Because of Easter and the fact that draft work is not review within less than one week of the submission date, if planning to attend/participate in tutorial activities, please contact Sheila by 12 March 2018 to agree date/time. As the submission date approaches, while unable to review draft work, Sheila will be able to respond to email (sent using your KCL email account) queries about the essay.
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Module evaluation As part of the university’s Student Voice Strategy, King’s uses an electronic module evaluation system known as EvaSys. This provides an opportunity for you to feedback on different aspects of the module through a series of pre-set questions and qualitative comments. At the end of the module you will receive an automated invitation via your KCL email account to complete your evaluation online.
Please take the time to complete as your feedback is important. It informs ongoing developments to individual modules to ensure that the learning needs and expectations of the Faculty’s student community are met to a high standard.
To strengthen the feedback cycle, a report summarizing the quantitative results for the module as a whole and the module lead’s reflections on your feedback will be sent to you after the online evaluation survey has closed.
Action from previous evaluations The most recent evaluations were largely very positive, 15 out of 36 participants responded. One issue raised related to the classrooms; while it is relatively beyond module leader control, Sheila intends to immediately register any concerns about rooms as they arise so that they can be speedily rectified.
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Timetable
6KNIC600 Anaesthetic Nursing Two
Teaching mode
Date Type of Session Title Time Lecturer Room
Day 1
University based study
18 January 2018
Introduction Welcome to the module and the module assignment
09.00 - 10.00
Sheila Turner
FWB 2.40 Seminar, group discussion
Systemic disease and anaesthesia 10.30-12.30
Lecture The ‘complex’ anaesthetic scenario 13.30-14.30
JCMB B17 Lecture, discussion
Post anaesthetic Recovery and care of the ventilated patient in recovery 14.30-16.45
Day 2
University based study
8 February 2018
Lecture
Paediatric anaesthesia, the nurse perspective
09.00-10.00
Cheryl Green Senior Anaesthetic RN Evalina
FWB 2.40 Paediatric anaesthesia, the significance of A&P
10.00-11.00 Sheila Turner
Ethics and professional issues 11.30-12.30
Care of the Patient with Diabetes 13.30-14.30 TBC
JCMB B17 Blood Gas Analysis 14.30-15.30 Sheila Turner
Haemodynamic Monitoring 15.45-16.45
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Day 3
University based study
22 February
2018*
Seminar/Lecture and discussion
Non-technical skills and the Anaesthetic nurse
09.00-12.00 Sheila Turner FWB 2.40
Lecture
Paediatric anaesthesia, the anaesthetist perspective
13.30-14.30
Dr Cathie Hill Consultant Paediatric Anaesthetist King’s College Hospital
Classroom 3 WEC
Seminar and discussion
Assignment formative exercise, Student-led discussion
14.30-16.30 Sheila Turner
Day 4
University based study
8 March 2018
Lecture/ simulated practice
Venepuncture and Cannulation 09.00-12.30
Sheila Turner
1.6 CSC
Airway management/intubation practise Group split into two, half lunch (12.30-13.15), then practise (13.15-14.00), half practise (12.30-13.15), then lunch (13.125-14.00).
12.30-14.00
Scenarios/ discussion
Post anaesthetic recovery 14.30-16.15 Room 4 NHH
Discussion Module evaluation 16.15-16.45
*22 February 2017 Formative PAD submission to Sheila, please hand your PAD to Sheila when you arrive, it will be returned during the afternoon. Location key:
CSC – Chantler SaIL Centre, Shepherd’s House, Guy’s Campus FWB – Franklin-Wilkins Building, Waterloo Campus JCMB – James Clerk Maxwell Building, Waterloo Campus NHH- New Hunts House, Guy’s campus WBW – Waterloo Bridge Wing, Waterloo Campus WEC – Weston Education Centre; Denmark Hill
