Year
2024Credit points
10Campus offering
Prerequisites
NRSG524 Advanced Pathophysiology for Specialty Nursing Practice AND NRSG525 Evidence-based, Person-centred Family Care in Specialty Nursing Practice
Unit rationale, description and aim
The brain is a most specialised and complex organ that consists of the forebrain, midbrain and hindbrain. Within these sections there are various other structures such as lobes, various nervous systems, neural pathways and ventricles that are all involved in a complex interplay to regulate voluntary and involuntary physiologic processes. It is therefore critical that neuroscience nurses are equipped with the specialty knowledge and skills to effectively care for patients with neurological conditions requiring surgical procedures through application of evidence-based practice.
Selection of content is based on the requirement to have a robust understanding of how the brain functions to facilitate early identification and escalation of deterioration in neuroscience patients. Neuroscience patients require complex, holistic and family/carer centred nursing care in alignment with the recent advances in neuroscience nursing. Key concepts related to the structure and function of the brain, cerebral circulation, protection and support of the brain, comprehensive neurological assessment, cerebral oedema, intracranial hypertension and cerebral protective strategies will be detailed. Various signs and symptoms, diagnostics, medical and nursing management, and the nursing care of the neuroscience patient requiring cerebral protective strategies will be explored to assist students with skills in analysis, evaluation, and application of person-centred care in the neuroscience setting.
The aim of this unit is to support students to evaluate the complexity of neuroscience nursing care while developing knowledge and skills to critically appraise and evaluate evidence to ensure neuroscience patients are delivered high quality and safe care, that is respectful and promotes health and wellbeing. Students will develop neurological assessment skills that will assist them in identifying early signs of neurological deterioration.
Learning outcomes
To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.
Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.
Explore the graduate capabilities.
| Learning Outcome Number | Learning Outcome Description | Relevant Graduate Capabilities |
|---|---|---|
| LO1 | Analyse specialist clinical nursing knowledge and skills, interprofessional communication and teamwork in the specialist clinical setting | GC1, GC2, GC7, GC9, GC11, GC12 |
| LO2 | Analyse the factors that affect Cerebral Perfusion Pressure (CPP) in neuroscience patients and conclude how nurses can prioritise the delivery of nursing care | GC1, GC2, GC3, GC7, GC8, GC11 |
| LO3 | Appraise and apply the evidence underpinning how implementation of a consistent management approach for neuroscience patients including preventative, curative and rehabilitative approaches to care for surgical patients | GC1, GC2, GC7, GC8, GC11, GC12 |
| LO4 | Examine the impact and goals of care required when caring for a neuroscience patient that has Intracranial Hypertension whilst critically reflecting upon the key pathophysiological concepts that contribute to complex care trajectories | GC1, GC2, GC6, GC11, GC12 |
| LO5 | Discuss the ethical perspectives of providing holistic care to patients undergoing life altering neuroscience procedures, and evaluate how they influence the patient’s health and wellbeing | GC2, GC3, GC5, GC7, GC8, GC11 |
Content
Topics will include:
- Brain anatomy & physiology review
- Forebrain, midbrain & hindbrain
- Cerebrum
- Lobes
- Diencephalon
- Brainstem
- Cranial nerves
- Structure and function of neurons
- Neurons and glial cells
- Cerebellum
- Pituitary gland
- Cerebral circulation
- Blood supply to the brain
- Circle of Willis
- Regulation of Cerebral Blood Flow (CBF)
- Intrinsic & extrinsic factors affecting CBF
- Protection & support of the brain
- Cerebrospinal Fluid (CSF)
- Meninges
- Meningitis
- Encephalitis
- Blood Brain Barrier (BBB)
- The ventricular system
- Comprehensive neurological assessment
- Physical exam
- Assessment of the injured brain
- Diagnostics
- Brain imaging
- Monitoring
- Cerebral oxygenation
- Behaviours of Concern (BOC)
- Altered sensory abilities
- Managing and supporting patients with impaired learning, memory and attention
- Behaviour and personality changes
- Exploring communication challenges
- Self-awareness and self-management
- Identification of triggers for BOC and minimisation, intervention and management of BOC
- Escalation and communication (patient, staff, family and carers)
- Intracranial hypertension
- Intracranial compliance
- Neurological therapeutic management
- Optimising cerebral perfusion
- Surgical interventions
- Nursing management & neurosurgery nursing care
- Post-operative management and management of complications
- Compliance and elastance
- Volume pressure curve
- Dynamics of ICP and the Monroe-Kellie Hypothesis
- Cerebral oedema & treatments
- Types of Hydrocephalus
- Clinical manifestations
- Treatment options
- Intracranial hypertension from acute disorders of brain function
- Pathophysiology
- Autoregulation and compensation
- Complications including herniation
- Extra-ventricular drain and ventriculoperitoneal shunt and catheter placement
- Postoperative nursing management
- Lumbar drains
- Types of cerebral oedema
- Cerebral protective strategies
- Airway patency
- Oxygen supplementation
- PaCo2 control
- Maintenance of cerebral perfusion pressure
- Fluids
- Patient positioning
- Sedation & analgesia
- Seizure and glucose control
- Neuroprotective measures
Learning and teaching strategy and rationale
This unit is offered in online mode and uses an active and collaborative learning approach to support students to analyse and critically evaluate approaches to providing evidence-based, ethical nursing care within neuroscience setting. Students will engage in readings and reflections, e-Learning activities and opportunities to collaborate with peers in an online environment. This can involve, but is not limited to, online discussion forums, chat rooms, guided reading and webinar sessions. In addition, e-Learning and links to electronic readings will be provided to guide students’ reading and extend other aspects of online learning.
Through an online learning platform, students will have the opportunity to reflect on the complexity of delivering person-centred care to patients in neuroscience settings. Online learning in this unit will be supported by the provision of opportunities for students to attend online webinar sessions that allow synchronous exchange of information and facilitate responses to queries generated by students in relation to unit content. For those unable to participate in synchronous webinar sessions, recordings will be available.
Students are required to complete online activities and assessments to demonstrate the application of knowledge. The learning and teaching strategy used in this unit allows flexibility for students while ensuring they have expert support. These modes of delivery assist students in linking knowledge and skills to the neuroscience nursing context, and to develop shared meanings through online experiential reflections and discussions.
Assessment strategy and rationale
In order to successfully complete this unit, a minimum combined total grade of all assessment tasks of 50% is required to pass this unit.
The assessment strategy used in this unit encourages depth of learning and provides the students the opportunity to develop their capacity to interpret, translate, apply and evaluate evidence-based care provision in neuroscience settings. In order to develop neuroscience nursing knowledge and skills required to achieve the learning outcomes and graduate attributes, students first demonstrate the ability to participate in peer review and create an e-Poster presentation on a common neuroscience condition that causes cerebral oedema. Knowledge and skills gained in this assessment task are then further developed in the final assessment. In the final assessment students will undertake a case study review on a neuroscience patient with intracranial hypertension. Students will need to demonstrate the interplay between anatomical, pathophysiological and the physiological conditions that lead to the complex post operative care requirements. The pre and post operative considerations of the patient’s condition, diagnostics, signs and symptoms, the medical and nursing management required, complications that may be encountered and the comprehensive care of the neuroscience patient in relation to the provision of holistic care for the patient’s health and wellbeing. Through the application of learned knowledge, critical thinking skills, analysis and synthesis of evidence, students will develop a comprehensive plan of care that addresses risk management, treatment and prevention strategies that promote physical and psychosocial health and well-being for patients undergoing neuroscience interventions.
Overview of assessments
| Brief Description of Kind and Purpose of Assessment Tasks | Weighting | Learning Outcomes |
|---|---|---|
e-Poster Presentation with Peer Review Enables students to create an e-Poster presentation that demonstrates an ability to research evidence related to a common acute, chronic or degenerative neuroscience condition that causes cerebral oedema. Students will examine how the effects of cerebral circulation, cerebrospinal fluid pressure, comprehensive neurological assessment, the protection & support of the brain and autoregulation affects the delivery of nursing care. (This assessment task is divided into Part A and Part B and involves collaboration and peer review of other students’ presentations to promote critical thinking and facilitate interpretation, critique and feedback skills). | 50% | LO1, LO2, LO3 |
Case Study Enables students to undertake a case study review of a neuroscience patient with Intracranial Hypertension. Students will explore evidence-based literature in relation to treatments, diagnostics, neurological assessment, behaviours of concern, prevention strategies and planning nursing patient centred care throughout the pre and post operative neurosurgical trajectory. | 50% | LO1, LO2, LO3, LO4, LO5 |
Representative texts and references
Abraham, J., Gulley, J. & Allegra, C, J. (2019). The Bethesda handbook of clinical oncology (5th ed.). Wolters Kluwer. https://ebookcentral.proquest.com/lib/acu/detail.action?docID=5762697
Barash, P.(ed). (2017). Clinical anesthesia (8th ed.). Wolters Kluwer. https://acu-edu- primo.hosted.exlibrisgroup.com/permalink/f/7pr622/61ACU_ALMA51122808060002352
Brown, D., Edwards, H., Buckley, T., & Aitken, R. (2020). Lewis’s Medical-Surgical Nursing ANZ. Elsevier Australia. https://www.clinicalkey.com/student/nursing/content/toc/3-s2.0-C20170033220
Clarke, S., & Santy-Tomlinson, J. (2014). Orthopaedic and trauma nursing: An evidence-based approach to musculoskeletal care. Wiley Blackwell. Retrieved from https://ebookcentral.proquest.com/lib/acu/detail.action?docID=1740751
Hamlin, L., Richardon-Tench, M., Davies, M., & Gillespie, B. M. (2015). Perioperative nursing: an introductory text (2nd ed). Mosby Elsevier. https://ebookcentral.proquest.com/lib/acu/detail.action?docID=1722309
Hickey, J. (2020). The clinical practice of neurological and neurosurgical nursing (8th ed.). Wolters Kluwer, Philadelphia. https://ebookcentral.proquest.com/lib/acu/detail.action?pq-origsite=primo&docID=6372346
Hoffmann, T., Bennett, S., & Del Mar, C. (2017). Evidence-based practice across the health professions (3rd ed.). Elsevier https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/13lm7d8/alma991013272647302352
Odom-Forren, J. (2018). Drain’s Perianesthesia nursing: A critical care approach (7th ed.). Elsevier. https://www.clinicalkey.com.au/nursing/#!/browse/book/3-s2.0-C20190055070
Patton, K., & Thibodeau, G. (2019). Anatomy & physiology (10th ed.). https://www.clinicalkey.com.au/nursing/#!/browse/book/3-s2.0-C20181027031
Rothrock, J., & McEwen, D. (2019). Alexander’s care of the patient in surgery (16th ed.). Elsevier. https://www.sciencedirect.com/science/article/pii/S0001209211000421
Ryan, D. (2019). Handbook of neuroscience nursing: Care of the adult neurosurgical patient. Thieme Medical Publishers, USA. https://ebookcentral.proquest.com/lib/acu/detail.action?pq-origsite=primo&docID=5788745
Thorne, C. H. M., Gurtner, G. C., Chung, K. C., Gosain, A., Mehrara, B. J., Rubin, P., & Spear, S. L. (2014). Grabb & Smith’s plastic surgery (7th ed.). Wolters Kluwer. Retrieved from https://ebookcentral.proquest.com/lib/acu/detail.action?docID=3418274