Overview
This unit examines clinical assessment and diagnostic reasoning to recognise and respond to a patient's deteriorating condition with appropriate and timely actions. This unit will enhance your knowledge of serious adverse events such as unexpected death and cardiac arrest which often follow observable deterioration in the patient’s condition. You will develop knowledge and skills in the early identification of deterioration, the initiation of prompt and effective action to minimise serious consequences, improve outcomes and lessen the level of intervention required to stabilise patients. The unit will focus on the underlying pathology of the patient's deteriorating condition and the interpretation of clinical manifestations to implement safe and effective nursing care.
Details
Pre-requisites or Co-requisites
Students must be enrolled in CL22 Master of Clinical Nursing or CL16 Graduate Certificate in Clinical Nursing to undertake this unit.
Important note: Students enrolled in a subsequent unit who failed their pre-requisite unit, should drop the subsequent unit before the census date or within 10 working days of Fail grade notification. Students who do not drop the unit in this timeframe cannot later drop the unit without academic and financial liability. See details in the Assessment Policy and Procedure (Higher Education Coursework).
Offerings For Term 1 - 2021
Attendance Requirements
All on-campus students are expected to attend scheduled classes – in some units, these classes are identified as a mandatory (pass/fail) component and attendance is compulsory. International students, on a student visa, must maintain a full time study load and meet both attendance and academic progress requirements in each study period (satisfactory attendance for International students is defined as maintaining at least an 80% attendance record).
Recommended Student Time Commitment
Each 6-credit Postgraduate unit at CQUniversity requires an overall time commitment of an average of 12.5 hours of study per week, making a total of 150 hours for the unit.
Class Timetable
Assessment Overview
Assessment Grading
This is a pass/fail (non-graded) unit. To pass the unit, you must pass all of the individual assessment tasks shown in the table above.
All University policies are available on the CQUniversity Policy site.
You may wish to view these policies:
- Grades and Results Policy
- Assessment Policy and Procedure (Higher Education Coursework)
- Review of Grade Procedure
- Student Academic Integrity Policy and Procedure
- Monitoring Academic Progress (MAP) Policy and Procedure – Domestic Students
- Monitoring Academic Progress (MAP) Policy and Procedure – International Students
- Student Refund and Credit Balance Policy and Procedure
- Student Feedback – Compliments and Complaints Policy and Procedure
- Information and Communications Technology Acceptable Use Policy and Procedure
This list is not an exhaustive list of all University policies. The full list of University policies are available on the CQUniversity Policy site.
- Explain clinical parameters that indicate a patient is deteriorating
- Monitor and interpret physiological and psychosocial data to assess a patient's clinical deterioration
- Communicate effectively with health team and family members to ensure the accurate transfer and escalation of critical information
- Initiate interventions based on diagnostic results of clinical assessment tools and evaluate your nursing actions
- Critically examine everyday nursing practices and the ready use of tools related to the deteriorating patient.
NA
Alignment of Assessment Tasks to Learning Outcomes
| Assessment Tasks | Learning Outcomes | ||||
|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | |
| 1 - Practical Assessment - 0% | |||||
| 2 - Presentation - 0% | |||||
Alignment of Graduate Attributes to Learning Outcomes
| Graduate Attributes | Learning Outcomes | ||||
|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | |
| 1 - Knowledge | |||||
| 2 - Communication | |||||
| 3 - Cognitive, technical and creative skills | |||||
| 4 - Research | |||||
| 5 - Self-management | |||||
| 6 - Ethical and Professional Responsibility | |||||
| 7 - Leadership | |||||
| 8 - Aboriginal and Torres Strait Islander Cultures | |||||
Alignment of Assessment Tasks to Graduate Attributes
| Assessment Tasks | Graduate Attributes | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | |
| 1 - Practical Assessment - 0% | ||||||||
| 2 - Presentation - 0% | ||||||||
Textbooks
There are no required textbooks.
IT Resources
- CQUniversity Student Email
- Internet
- Unit Website (Moodle)
- CQUniversity library literature search tools
- CQUniversity Library website
- CQUniversity Library Nursing Resources
All submissions for this unit must use the referencing style: American Psychological Association 7th Edition (APA 7th edition)
For further information, see the Assessment Tasks.
j.m.shaw@cqu.edu.au
Module/Topic
Welcome to the Unit
Self-directed Learning
Moodle site
Student Support
Something about the Unit.
- clinical judgement
- the deteriorating patient
Chapter
Check out the Moodle site and click on all the links.
Assessment?
How do I find the Library?
What is the Academic Learning Centre?
Events and Submissions/Topic
Zoom - Monday 5pm
Activity – Access the General Discussion page and introduce yourself to your colleaguesby providing your name:
1. Name
2. What you are looking forward to as a Registered Nurse
Module/Topic
Research related to the deteriorating patient.
- exploration of literature
- evidence and practice
Observations as data.
Chapter
Readings and activities in Moodle
Events and Submissions/Topic
Zoom - Monday 5pm
Activity – Access the General Discussion. Identify the most difficult aspect that you have experienced when caring for a deteriorating patient.
Module/Topic
Physiological observations pertinent to the deteriorating patient.
Detailed examination of various observations.
Chapter
Readings and activities in Moodle
Events and Submissions/Topic
Zoom - Monday 5pm
Activity – Access the General Discussion.
Detail what you have learnt about assessing physiological observations correctly.
Module/Topic
Physiological observations pertinent to the deteriorating patient.
- temperature
- blood pressure
Detailed examination of various observations.
Chapter
Readings and activities in Moodle
Events and Submissions/Topic
Zoom - Monday 5pm
Activity – Access the General Discussion
Explain the impotance of temperature assessment of the older person.
Module/Topic
Family centred care (FCC) and the deteriorating patient.
- principles of FCC
- Families as legitimate partners
Application of principles of FCC in critical situations.
Chapter
Readings and activities in Moodle
Events and Submissions/Topic
Zoom - Monday 5pm
Activity – Access the General Discussion
Describe what you consider to be your family. Would all of these people be recognised as family.
Module/Topic
Chapter
Events and Submissions/Topic
Module/Topic
Interruption and distraction in the clinical setting.
Situational awareness.
Contribution of these concerns to the deteriorating patient.
Chapter
Readings and activities in Moodle
Events and Submissions/Topic
Zoom - Monday 5pm
Activity – Access the General Discussion
Provide an example of being distracted in the clinical setting.
Module/Topic
Effective clinical communication for prevention of deterioration.
- practice principles and their application in the clinical setting.
- strategies, issues and concerns.
Chapter
Readings and activities in Moodle
Events and Submissions/Topic
Zoom - Monday 5pm
Activity – Access the General Discussion
What is effective communication?
Module/Topic
Clinical communication in critical situations
- principles
Application of principles in practice
- examples
Chapter
Readings and activities in Moodle
Events and Submissions/Topic
Zoom - Monday 5pm
Module/Topic
Advanced clinical decision making.
Nursing care analysis.
The initiation of nursing actions based on advanced clinical decisions.
Chapter
Readings and activities in Moodle
Events and Submissions/Topic
Zoom - Monday 5pm
Activity – Access the General Discussion
What do you use to guide your clinical decison making?
Module/Topic
Advanced clinical decisions in review.
- Complexity, time-pressures and evaluation.
The evaluation of nursing actions based on advanced clinical decisions.
- Evaluation and new learning.
Chapter
Readings and activities in Moodle
Events and Submissions/Topic
Zoom - Monday 5pm
Activity – Access the General Discussion
Module/Topic
Critical analysis on the run.
- Speed and safety in the clinical environment.
Systems and strategies for critical analysis.
- Critiquing complexity.
Chapter
Readings and activities in Moodle
Events and Submissions/Topic
Zoom - Monday 5pm
Activity – Access the General Discussion
Any questions?
Module/Topic
The invisibility of everyday nursing practices.
Unmasking and legitimating the invisible.
An examination of cultural influences on nursing practice.
Say little, do much.
Chapter
Readings and activities in Moodle
Events and Submissions/Topic
Zoom - Monday 5pm
Activity – Access the General Discussion
Say goodbye.
Module/Topic
Chapter
Events and Submissions/Topic
Assessment 1 & 2 are coordinated by the Graduate Coordinator at the health setting and are to be completed by Friday 11th June, 2021.
Practical assessment of the simulated deteriorating patient Due: Review/Exam Week Friday (11 June 2021) 5:00 pm AEST
Presentation Due: Review/Exam Week Friday (11 June 2021) 5:00 pm AEST
Module/Topic
Chapter
Events and Submissions/Topic
1 Practical Assessment
Students undertaking this assessment will be either in:
-
i) A Partnered Graduate Program
-
ii) NOT in a Partnered Graduate Program
Type: Practical assessment
Due date:
-
i) The Graduate Coordinator will advise students in a partnered Graduate Program of the due date.
-
ii) Obtain a signed agreement from one of your unit nursing leaders (NUM, CNC, Nurse Educator) indicating that they will assess you in this task on an agreed due date. Provide the Unit Coordinator with a copy by the end of Week 2.
Weighting: PASS/FAIL
Unit Coordinator: Dr Julie Shaw
Learning Outcome Assessed
-
Explain clinical parameters that indicate a patient is deteriorating.
-
Monitor and interpret physiological and psychosocial data to assess a patient's clinical deterioration.
-
Communicate effectively with health team and family members to ensure the accurate transfer and escalation of critical information.
Aim
This clinical assessment evaluates your knowledge and skills in the early identification of a patient's deteriorating condition and the initiation of prompt and effective action to minimise serious consequences, improve outcomes and lessen the level of intervention required to stabilise patients. The assessment will also assess your knowledge of the pathology of the patient's deteriorating condition, your ability to interpret clinical manifestations and effectively communicate these changes in health to team members including the patient.
Task Description
You are required to demonstrate the safe care of a deteriorating patient in a clinical simulation setting. This assessment is undertaken at three skill stations (this structure may vary across different partnered Health Services).
You will be required to rotate between three skill stations. At each station a scenario relating to a deteriorating patient will be presented. During the first stage you will have the opportunity to practice skills to recognise and respond to a deteriorating patient. During the next stage, you will be assessed on your ability to safely perform these skills: These skills include:
-
initial nursing management
-
verbalising a targeted systematic assessment approach (look, listen and feel ABCDEFG) [this worksheet is available on the Moodle site]
-
recording vital signs
-
verbalising escalation concerns using ISBAR
-
managing basic airway manoeuvres, adjuncts and oxygen therapy delivery devices
-
identifying further clinical risk factors and additional investigations that may be required
-
selecting and inserting naso/oropharyngeal airway
-
demonstrating chin lift, head tilt and manual ventilation techniques
-
demonstrating and instructing on the use of nasal prongs, Hudson mask, non-rebreather masks and the HFNP Air Viva
Task Instructions
Step 1. Familiarise yourself with the relevant policies, procedures and legislation available on the unit Moodle site
Step 2. Familiarise yourself with Standard 8, Recognising and responding to acute deterioration standard (The Australian Commission on Safety and Quality in Health Care, [ACSQH] 2017).
Step 3. Stage 1- practice your skills in recognising and responding to deteriorating patients rotating through three skill stations.
Step 4. Stage 2 – demonstrate your ability to recognise and respond to the deteriorating patient including:
- initial nursing management
- verbalising a targeted systematic assessment approach (look, listen and feel ABCDEFG) [this worksheet is available on the Moodle site]
- recording vital signs
- verbalising escalation concerns using ISBAR
- managing basic airway manoeuvres, adjuncts and oxygen therapy delivery device
- identifying further clinical risk factors and additional investigations that may be required
- selecting and inserting naso/oropharyngeal airway
- demonstrating chin lift, head tilt and manual ventilation techniques
- demonstrating and instructing on the use of nasal prongs, Hudson mask, non-rebreather masks and the HFNP Air Viva
Step 5. The assessors will forward the results of the assessment to the Unit coordinator.
Marking Criteria
Refer to the marking rubric below for more detail on how marks will be assigned.
Review/Exam Week Friday (11 June 2021) 5:00 pm AEST
Assessment due date will be negotiated and undertaken in the clinical setting where you work
Exam Week Friday (18 June 2021)
Return of assessment will be negotiated and undertaken in the clinical setting where you work
Student name: __________________________
Students must pass each criterion in each skill/topic to be successful in this assessment
Students may have a second attempt if unsuccessful at the first attempt.
| Skill / Topic | Pass | FAIL | |
| Skill station: Patient deterioration |
|
||
| Oxygen Therapy |
|
||
| Basic Airway Management |
|
||
| Knowledge of polices and guidelines |
|
- Explain clinical parameters that indicate a patient is deteriorating
- Monitor and interpret physiological and psychosocial data to assess a patient's clinical deterioration
- Communicate effectively with health team and family members to ensure the accurate transfer and escalation of critical information
- Knowledge
- Communication
- Cognitive, technical and creative skills
- Self-management
- Ethical and Professional Responsibility
2 Presentation
Students undertaking this assessment will be either in:
-
i) A Partnered Graduate Program
-
ii) NOT in a Partnered Graduate Program
Type: Presentation
Due date:
-
i) The Graduate Coordinator will advise students in a partnered Graduate Program of the due date.
-
ii) Students not in a partnered Graduate Program must obtain a signed agreement from one of your unit nursing leaders (NUM, CNC, Nr Educator) indicating that they will assess you in this task on an agreed due date. Provide the Unit Coordinator with a copy by the end of Week 2
-
.
Weighting: Pass/Fail
Length: No more than 10 minutes
Unit Coordinator: Dr Julie Shaw
Learning Outcome Assessed
-
Initiate interventions based on diagnostic results of clinical assessment tools and evaluate your nursing actions.
-
Critically examine everyday nursing practices and the ready use of tools related to the deteriorating patient.
Aim
The aim of this assessment is to provide you with an opportunity to demonstrate your knowledge and understanding of using reflection to self-assess your clinical practice.
Instructions
You are providing an oral report on your participation in your simulation assessment.
Your target audience for your presentation may include your workplace colleagues, peers or unit nursing leaders.
Please follow the steps below to complete your assessment task:
Step 1. Access the Gibbs’ Reflective Model (1988) to reflect on your simulated patient deterioration activity – Assessment 1.
- Gibbs’ steps to reflective practice are:
- Description – what happened (situation/experience)?
- Feelings – What are you thinking or feeling about this?
- Evaluation – What was good and what was bad about the experience?
- Analysis - What can you learn from this experience?
- Conclusion – What could you have done differently?
- Action – If you faced this situation again, how would you act differently (Gibbs, 1988)
Step 2. Structure your presentation in a manner that is logical, and the patient experience and your experience is presented systematically.
Step 3. Present your reflection in an objective manner to your audience that may include peers, educators and other unit nursing leaders.
Resources
-
Decision-making framework (DMF) (NMBA, 2020)
-
Nursing and Midwifery Board of Australia (NMBA) registered nurse standards for practice (2016).
-
National Safety and Quality Health Service (NSQHS) Standards (2017)
-
Patient Safety Competency Framework for Nursing Students (PSCF) (Levett-Jones et al., 2017)
-
You can use unit provided materials and other credible sources (e.g. journal articles, books) to reference your argument. The quality and credibility of your sources are important.
-
For information on academic communication please go to the Academic Learning Centre Moodle site. The Academic Communication section has many helpful resources including information for students with English as a second language. There are also Oral Presentation resources.
Submission
No submission required as this assessment is undertaken in the workplace.
The assessor will forward the results of the assessment to the Unit coordinator.
Marking Criteria
Refer to the marking rubric on the Moodle site and below for more detail on how marks will be assigned.
Review/Exam Week Friday (11 June 2021) 5:00 pm AEST
Presentation due dates will be negotiated at the local clinical setting
Review/Exam Week Friday (11 June 2021)
Provided by your Graduate Coordinator at your employing health service.
Student name: __________________________
Students must pass each criterion in each skill/topic to be successful in this assessment
Students may have a second attempt if unsuccessful at the first attempt.
| Skill / Topic | Content covered | PASS | FAIL |
| Patient Deterioration | Debrief after each scenario and provides constructive feedback on:
|
Demonstrates cognitive and technical skills:
|
Does not demonstrate cognitive and technical skills:
|
| Debrief | Following each scenario, the teams are asked to provide constructive feedback on:
|
|
|
| Presentation |
|
Communication
|
Communication
|
PASS/FAIL Assessor Name____________________________ Signature ________________________________ Date_____________
- Initiate interventions based on diagnostic results of clinical assessment tools and evaluate your nursing actions
- Critically examine everyday nursing practices and the ready use of tools related to the deteriorating patient.
- Knowledge
- Communication
- Cognitive, technical and creative skills
- Research
- Self-management
- Ethical and Professional Responsibility
As a CQUniversity student you are expected to act honestly in all aspects of your academic work.
Any assessable work undertaken or submitted for review or assessment must be your own work. Assessable work is any type of work you do to meet the assessment requirements in the unit, including draft work submitted for review and feedback and final work to be assessed.
When you use the ideas, words or data of others in your assessment, you must thoroughly and clearly acknowledge the source of this information by using the correct referencing style for your unit. Using others’ work without proper acknowledgement may be considered a form of intellectual dishonesty.
Participating honestly, respectfully, responsibly, and fairly in your university study ensures the CQUniversity qualification you earn will be valued as a true indication of your individual academic achievement and will continue to receive the respect and recognition it deserves.
As a student, you are responsible for reading and following CQUniversity’s policies, including the Student Academic Integrity Policy and Procedure. This policy sets out CQUniversity’s expectations of you to act with integrity, examples of academic integrity breaches to avoid, the processes used to address alleged breaches of academic integrity, and potential penalties.
What is a breach of academic integrity?
A breach of academic integrity includes but is not limited to plagiarism, self-plagiarism, collusion, cheating, contract cheating, and academic misconduct. The Student Academic Integrity Policy and Procedure defines what these terms mean and gives examples.
Why is academic integrity important?
A breach of academic integrity may result in one or more penalties, including suspension or even expulsion from the University. It can also have negative implications for student visas and future enrolment at CQUniversity or elsewhere. Students who engage in contract cheating also risk being blackmailed by contract cheating services.
Where can I get assistance?
For academic advice and guidance, the Academic Learning Centre (ALC) can support you in becoming confident in completing assessments with integrity and of high standard.
What can you do to act with integrity?
