Intensive Care Nursing - 6KNIC306 Level: 6

Credits: 30

Module leader: Dr Suzanne Bench

Tel: 020 7848 3550

Email: Suzanne.bench@kcl.ac.uk

Module deputy: Dr Andreas Xyrichis

Tel: 020 7848 3649

Email: andreas.xyrichis@kcl.ac.uk

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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 asc@kcl.ac.uk.

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Contents

Module overview .......................................................................................................... 4

Module aim ............................................................................................................... 4

Learning outcomes ................................................................................................... 4 Teaching arrangements ............................................................................................ 5

Submitting coursework ................................................................................................ 6

Assessment criteria ................................................................................................... 6

Formative assessment .............................................................................................. 6 Summative assessment............................................................................................. 7

Results and resubmissions for coursework: ............................................................. 8

Dates for examinations ................................................................................................ 8

Results and resits for examinations ......................................................................... 8

Learning resources ....................................................................................................... 8

Lecture 1 – Introduction to Module and Assessments ............................................. 8

Lecture 2 – Assessing Oxygenation and Ventilation ................................................ 8 Lecture 3 – Invasive Mechanical Ventilation .......................................................... 8

Lecture 4 & Seminar 1 – Acute Respiratory Distress Syndrome (ARDS) ................ 10

Lecture 5 – Positioning the Critically Ill Person ...................................................... 10

Lecture 6 – The Critically ill Obstetric Patient ......................................................... 10

Lecture 7 – Weaning from Ventilation ..................................................................... 11

Seminar 2 – Non-invasive Ventilation (NIV) ........................................................... 11 Lecture 8 – Pain, Sedation and Delirium ................................................................. 11

Lecture 9 – Nutrition in the Critically Ill ................................................................. 12

Lecture 10 & Seminar 3 – Advanced Haemodynamic Assessment and Management ...................................................................................................... 12

Simulation session – Rhythm Recognition, Resuscitation and Pacing ................... 13

Lecture 11 – Advanced Cardiac Support................................................................... 13

Lecture 12 – Acute Brain injury................................................................................ 13 Lecture 13 – Transfer of the Critically Ill ................................................................. 14

Seminar 4 – Elderly and Bariatric Patients .............................................................. 14

Lecture 15 – End of Life Care ................................................................................... 15

Lecture 16 – Severe Acute Pancreatitis .................................................................... 15

Lecture 17 – Renal Replacement Therapies (RRT) .................................................. 15

Seminar 6 – Acute Kidney Injury ............................................................................. 16 Lecture 18 – Rehabilitation after Critical Illness ..................................................... 16

Lecture 19 – The Service User Perspective ............................................................... 16

Lecture 20: A – Acute Hepatic Disorders................................................................. 17

Lecture 20: B – Cancer Therapies and Haemo-oncology ........................................ 17

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Lecture 21: A – Organ Donation/Brain Stem Death Testing ................................... 17

Lecture 21: B – Trauma ............................................................................................ 18

Seminar 7 – Exam Preparation ................................................................................ 18

Module evaluation ........................................................................................................ 19

Action from previous evaluations ............................................................................. 19

Timetable...................................................................................................................... 20

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Module overview This module forms part of the BSc Clinical Practice. The module contributes to your programme of study. It enables you to apply the knowledge from core modules specifically to intensive care nursing practice. The module covers the core elements of knowledge required to underpin completion of the national critical care nursing competencies (Steps2/3), published by the Critical Care National Network Nurse Leads Forum (CC3N). To make up the total recommended 60 credits, you may also wish to study ‘Critical care: policy and practice’ (7KNIM119)”.

The module can also be taken as a freestanding module.

Module aim The aim of this module is to critically evaluate the practice of intensive care nursing with emphasis on the wider context of care. Intensive care nurses will have the opportunity to enhance and evaluate specialist skills, critique their developing role, examine contextual issues, and review the current evidence-base, enabling evaluation and synthesis of knowledge for practice.

Learning outcomes The learning outcomes meet all Knowledge Skills Framework (KSF) core dimensions. Relevant KSF specific dimensions are highlighted against each learning outcome:

• Select and critically evaluate relevant critical care research in order to promote evidence-based practice (KSF-HWB1-10/IK1-3/G2).

• Critically appraise the protocols, organisation and management of care for intensive care patients and their relatives (KSF-HWB1-10/IK1-2/G2).

• Select appropriate therapeutic interventions for intensive care patients to ensure maintenance of homeostasis, and facilitation of recovery (KSF-HWB1-10/IK1-2/G2).

• Critically evaluate such issues as: resource allocation, health care rationing, outcome measurements, and effectiveness of intensive care therapies for patients (KSF-HWB9-10/IK1-3/G2).

• Critically analyse the role, responsibilities, and decisions made by the intensive care nurse in the delivery of new advances in treatments and therapies to patients in ICU (KSF-HWB7/IK1-3/G2).

• Critically evaluate the local and national policies that influence the health care and quality of life for patients in ICU (KSF-HWB1/IK1-3/G2).

• Critically review and revise the professional role of self and others reflecting NMC guidelines (KSF-HWB1-10//G2).

• Critically examine personal values, philosophy and the professional role with regard to the delivery of care and effective meeting of social, cultural, and spiritual needs of critically ill patients (KSF-HWB1-10/IK1-2/G2).

• Evaluate inter-personal communication and critically analyse the effectiveness of the therapeutic relationship between the intensive care nurse, patients, and their relatives (KSF-HWB4,6,7/IK1-3/G2).

• Critically review how the intensive care nurse effectively interacts within the inter-professional team to provide collaborative care within the ICU, hospital, and community setting (KSF-HWB1,8/IK1-3/G2).

• Debate the ethical and legal issues associated with intensive care practice (KSF-HWB1-10/IK1-3).

• Demonstrate a comprehensive understanding of the complex nursing and medical issues associated with treatment withdrawal (KSF-HWB1,7,8/IK1-3/G2).

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Application of knowledge and skills to your clinical area and the development of critical thinking ability will be continuously assessed by use of a clinical competency document. This specifies competencies which will need to be achieved during the module to the identified standard. Identified mentors from practice will be responsible for assisting you to complete the competency assessment document, and providing practice support. The competency document addresses all core KSF dimensions and specific dimensions HWB1-10, EF1&3, IK1-3 and G2 and has been mapped against the National Competency framework for critical care (Step 2/3).

Teaching arrangements For a 30 credit module it is expected that students will spend around 300 hours studying. The educational approach is adult student centred, which builds on your experience as qualified practitioners. You will experience a wide variety of teaching and learning strategies including:

• Lectures • E-Learning • Group work and guided study • Tutorials • Work-based learning • Case study exploration • Independent study.

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Submitting coursework Coursework (competency assessment document) must be submitted in person (or posted) by the deadline.

Assessment criteria 1. Two hour scenario-based examination 2. Competency Assessment document

Formative assessment To help prepare you for the examination, you are required to take part in an online discussion of the evidence base for an identified area of critical care nursing practice. This will require you to:

1. Work in a group to prepare a model answer based on an exam type question 2. Contribute to an online group analysis of the evidence base for an identified area of critical

care nursing

You will be allocated to small study groups. A clinical scenario will be accessed through the KEATS site. You are expected to engage with your study group in an online discussion to produce a group answer to a specific question based on the scenario. Contributions should be collated and a final group answer posted on the discussion board by the deadline.

Contributions might include: reflections from practice, commentary on current evidence, reference to clinical guidelines, academic debate of peer contributions, novel ideas. Extensive reading of relevant literature is expected and all contributions must be free from plagiarism. Full Harvard referencing will not be required, however, the author and date must be cited in the text. You must use an appropriate academic style and adhere to appropriate professional conduct at all times.

The final group answer must not exceed 1000 words. Words in excess of this limit will not be marked. The group answer will be assessed according to the level 6 Faculty assessment criteria contained in the post qualification handbook.

Timetable for completion of formative assessment

Date Activity

4 May 2017 Introduction to online formative assessment.

Allocation of study groups

11 May 2017 Scenario open for viewing and contributions

2 July 2017 Scenario closed

NO FURTHER CONTRIBUTIONS WILL BE MARKED AFTER MIDNIGHT

13 July 2017 On-line feedback

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Summative assessment There are two parts to the summative assessment for this module.

Part 1: Examination

You are required to sit a two hour scenario based examination. Topics will be distributed six weeks prior to the date of the examination. The examination will comprise two scenarios each with three related questions. You will be required to:

• Choose two out of three presented scenarios • Answer all questions assigned to the two chosen scenarios • Interpret clinical data and discuss priorities of nursing care • Demonstrate a contemporary knowledge base, reflecting the physiological, psychological

and social aspects of ICU nursing

There will be opportunity to undertake and discuss practice scenarios within the module timetable.

Part 2: Assessment of clinical competence

You are required to complete a clinical assessment document specifically related to Intensive Care nursing, which has been mapped against the step 2/3 national competencies for critical care (CC3N 2015). Competencies must be assessed in an ICU by an identified practitioner who holds both the intensive care and mentorship qualification. All competencies must be achieved to the minimum standard outlined in the document.

Submission details for the competency assessment document are provided on the KEATS module page. It is essential that you use your candidate number on all assignments/examinations. Your candidate number, which will begin with X for the academic year 2016/17, 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” Submission date for competency assessment document: Tuesday 1 August 2017 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. If your assignment is hard copy please ensure you date stamp it and submit it to the submission room G15 James Clerk Maxwell Building. If your assignment is submitted electronically through TurnItIn, information about how to submit late will be provided on KEATS module sites under assessment information. The external examiner for this module is Annabella Gloster. Students are not to make direct contact with external examiners, in particular regarding their individual performance in assessments

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Results and resubmissions for coursework: 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 envelope to the Student Services Centre ensuring that this is large enough to accommodate your assignments 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 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. 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 Dr Suzanne Bench (suzanne.bench@kcl.ac.uk or Dr Andreas Xyrichis (andreas.xyrichis@kcl.ac.uk). If you are unsuccessful, it is recommended that you contact the module leader before submitting your second attempt. This will enable the module leader to provide you with an appropriate level of support as you prepare to resubmit your work.

Dates for examinations You will be notified of dates for examination on the Student Records section of the King’s Intranet.

Results and resits for examinations Unratified results from exams will be available on your KEATS module site 4 weeks from the date of the examination. Faculties are required from academic year (2016/17) to make examination scripts available to any student who makes a request, free of charge. Any requests for examination scripts should still be managed in accordance with the Data Protection Act 1998. Students may request access to their exam paper at any time (after the Assessment Sub Board meeting) during their programme of study. This policy applies to all summative, unseen, written examinations. MCQs and OSCEs are exempt from this process.

Re-sit dates will available on your KEATS module site. If you are unsuccessful, it is recommended that you contact the module leader before submitting your second attempt or re-sitting your examination. Resubmission date for competency assessment document: Tuesday 17 October 2017

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Learning resources

Lecture 1 – Introduction to Module and Assessments During this session you will learn:

• About the module structure, content and teaching methods/resources • How to access KEATS, the module leader and other group members • The assessment requirements of the module

Reading material Module & programme handbooks.

Lecture 2 – Assessing Oxygenation and Ventilation During this session you will learn:

• The physiological principles underlying oxygen delivery, consumption and acid base disturbance

• ABG interpretation skills including the recognition of compensation, mixed disorders, & relevant interventions

• The evidence for the use of different techniques for assessment of adequacy of oxygen delivery

• How to apply advanced skills to complex clinical examples within the context of holistic patient management.

Reading material Sood P., Paul G. & Puri S. (2010) Interpretation of arterial blood gas. Indian J Crit Care Med. 14(2), 57–64. Ward J. (2006) Oxygen delivery and demand. Surgery (Oxford) 24(10), 354–360.

Lecture 3 – Invasive Mechanical Ventilation During this session you will learn:

• The principles of positive pressure ventilation and the difference between volume and pressure control ventilation

• The advantages and limitations of common ventilatory modes • How to assess the suitability of ventilatory mode to patient status • The nursing care of a patient requiring invasive ventilation.

Reading material Kane C. (2012) Understanding the Alphabet Soup of Mechanical Ventilation. Dimensions of Critical Care Nursing 31(4), 217-222.

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Lecture 4 & Seminar 1 – Acute Respiratory Distress Syndrome (ARDS) During this session you will learn:

• The definition of ARDS and key risk factors • The pathogenesis of ARDS • The evidence base for current treatment and management of ARDS.

Reading material ARDS Definition Task Force; Ranieri, V., Rubenfeld, G., Thompson, B., et al. (2012) Acute respiratory distress syndrome: the Berlin definition. JAMA. 307, 2526-2533. Silversides J. & Ferguson N. (2013) Clinical review: Acute respiratory distress syndrome - clinical ventilator management and adjunct therapy. Critical Care 17, 225. Hamilton J. (2011) The patient with acute lung injury. In Bench and Brown (ed) Critical Care Nursing; learning from practice. Blackwell, London. Chapter 1: 1-29.

Lecture 5 – Positioning the Critically Ill Person During this session you will learn:

• How to position patients in relation to optimise gas exchange • The treatment of hypoxaemia/ hypoxia • Different positions and their relative evidence base

Reading material Johnson K. & Meyenburg T (2009) Physiological rationale and current evidence for therapeutic positioning of critically ill patients. AACN Advanced Critical Care 20(3), 228–240. Methen, N. & Frantz R. (2013) Head-of-bed elevation in critically ill patients: a review. Critical Care Nurse 33(3), 53-67. Park S., Kim H., Yoo K. et al. (2015) The efficacy and safety of prone positioning in adults patients with acute respiratory distress syndrome: a meta-analysis of randomized controlled trials. Journal of Thoracic Disease 7(3), 356–367.

Lecture 6 – The Critically ill Obstetric Patient During this session you will learn:

• The key physiological demands of pregnancy • The treatment strategy for a patient with HELLP syndrome, Pre-eclampsia & Postpartum

haemorrhage. Reading material Scholefield H. et al. on behalf of the Maternal critical; care working group (2011) Providing equity of critical and maternity care for the critically ill pregnant or recently pregnant woman. Royal College of Anaesthetists. Available online at: https://www.rcog.org.uk/globalassets/documents/guidelines/prov_eq_matandcritcare.pdf. Accessed 5 August 2016.

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Lecture 7 – Weaning from Ventilation During this session you will learn:

• The assessment criteria for commencing ventilator weaning • The weaning tools, which aid the nursing management of patients requiring long-term

weaning. Reading material Blackwood, B. (2011) Use of weaning protocols for reducing duration of mechanical ventilation in critically ill adult patients: Cochrane systematic review and meta-analysis. BMJ 342 doi: http://dx.doi.org/10.1136/bmj.c7237. Crocker C. (2011) The patient requiring complex weaning from mechanical ventilation. In Bench & Brown (ed) Critical Care Nursing; learning from practice. Blackwell, London. Chapter 2: 30-48.

Seminar 2 – Non-invasive Ventilation (NIV) During this session you will learn:

• The evidence-base supporting use of NIV in the critically ill • The nursing care of a patient requiring non-invasive respiratory support.

Reading material McNeill G. & Glossop A. (2012) Clinical applications of non-invasive ventilation in critical care. Contin Educ Anaesth Crit Care Pain (2012) 12(1), 33-37. doi: 10.1093/bjaceaccp/mkr047.

Lecture 8 – Pain, Sedation and Delirium During this session you will learn:

• The assessment tools used for levels of sedation, pain and delirium • Different methods of chemical and physical restraint • The indications for and consequences of chemical and physical restraint • The practical, ethical & legal issues concerning the assessment and management of delirium

Reading material Mehigan S. (2011) The patient in acute pain. In Bench and Brown (ed) Critical Care Nursing; learning from practice. Blackwell, London. Chapter 10: 164-175. Moore T. (2011) The patient requiring sedation. In Bench and Brown (ed) Critical Care Nursing; learning from practice. Blackwell, London. Chapter 11: 176-189. NICE (2010) Delirium; Diagnosis, prevention and management of delirium. National Institute for Health and Clinical Excellence. Available online at: http://www.nice.org.uk/nicemedia/live/13060/49909/49909.pdf. Accessed 5 August 2016.

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Lecture 9 – Nutrition in the Critically Ill During this session you will learn:

• How to assess the nutritional requirements of the critically ill person • The advantages, limitations and nursing considerations of enteral & total parenteral

nutrition use in critical care • The management of blood glucose control.

Reading material Dhaliwal R. et al. (2014) The Canadian critical care nutrition guidelines in 2013: an update on current recommendations and implementation strategies. Nutr Clin Pract.29(1), 29-43. doi: 10.1177/0884533613510948. Fullwood D. (2011) The patient with altered glucose. In Bench and Brown (ed) Critical Care Nursing; learning from practice. Blackwell, London. Chapter 7: 117-129.

Lecture 10 & Seminar 3 – Advanced Haemodynamic Assessment and Management During this session you will learn:

• The pros and cons of various advanced haemodynamic assessment tools • The benefits & limitations of the use of crystalloid, colloid, blood & blood products and the

associated nursing responsibilities • The benefits and limitations of inotropes, chronotropes and other vaso-active agents and the

nursing considerations associated with the use of such drugs • To interpret complex haemodynamic data available from the use of advanced monitoring • To integrate knowledge of advanced haemodynamic monitoring as part of holistic patient

management. Reading material Alhashemi, et al. (2011) Cardiac output monitoring: an integrative perspective. Critical Care 15, 214. Gamper G., Havel C., Arrich J. et al. Vasopressors for hypotensive shock. Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No.: CD003709. DOI: 10.1002/14651858.CD003709.pub4. Overgaard C. & Džavík V. (2008) Inotropes and Vasopressors-Review of physiology and clinical use in cardiovascular disease. Circulation 118, 1047-1056. doi: 10.1161/CIRCULATIONAHA.107.728840. Perel P., Roberts I. & Ker K. (2013) Are colloids more effective than crystalloids in reducing death in people who are critically ill or injured? Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD000567. DOI: 10.1002/14651858.CD000567.pub6.

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Simulation Session – Rhythm Recognition, Resuscitation and Pacing During this session you will learn:

• The ALS algorithm (RC (UK) 2016) • To recognise common cardiac arrest and peri-arrest arrhythmias and to understand their

treatment • The principles of temporary & permanent pacing and how to recognise life threatening

events associated with pacing e.g. lack of capture. Reading material McNaughton A. (2013) Indications for post-operative (transthoracic) epicardial pacing. British Journal of Cardiac Nursing 8(12), DOI: http://dx.doi.org/10.12968/bjca.2013.8.12.593. McNaughton A. & Davison J. (2013) Temporary pacing: clinical indications and techniques. British Journal of Cardiac Nursing 8(6), DOI: http://dx.doi.org/10.12968/bjca.2013.8.6.289. Resuscitation Council (UK). (2016). Adult Advanced Life Support. Seventh edition 2016. Available online at: www.resus.org.uk. Accessed 5 August 2016.

Lecture 11 – Advanced Cardiac Support During this session you will learn:

• The principle effects of the IABP • Nursing management of the patient with an IABP • Other advanced mechanical options for supporting a patient with acute cardiac failure.

Reading material Krishna M. & Zacharowski K. (2009) Principles of intra-aortic balloon pump counterpulsation. Contin Educ Anaesth Crit Care Pain 9(1), 24-28. doi: 10.1093/bjaceaccp/mkn051.

Lecture 12 – Acute Brain injury During this session you will learn:

• The aetiology and pathophysiology of primary & secondary brain injury • The evidence based rationale for nursing management strategies to prevent secondary brain

injury • The monitoring devices utilised to measure ICP, CPP, cerebral blood flow & oxygenation.

Reading material Carney N. et al. on behalf of the Brain Trauma Foundation (2016) Guidelines for the Management of severe Traumatic brain injury. 4th ed www.braintrauma.org Haddad S. & Arabi Y. (2012) Critical Care Management of Severe Traumatic Brain Injury in Adults. Emergency Medicine 20(12). Slade D. (2011) The patient with raised intracranial pressure. In Bench and Brown (ed) Critical Care Nursing; learning from practice. Blackwell, London. Chapter 12: 190-203.

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Lecture 13 – Transfer of the Critically Ill During this session you will learn:

• National guidelines relevant to transfer of the critically ill • Nursing responsibilities associated with preparing a patient for & accompanying a patient

during transfer • Possible hazards associated with transfer and how they might be prevented.

Reading material Intensive Care Society (2011) Guidelines for the transport of the critically ill adult. ICS: London.

Seminar 4 – Elderly and Bariatric Patients During this session you will learn:

• The specific needs of specialist population groups, such as the elderly or bariatric patient • The evidence base currently available to support optimum management of these patients.

Reading material Charlebois D. & Wilmoth D. (2004) Critical care of patients with obesity. Critical Care Nurse, 24:19-27. Mick D. & Ackerman M. (2004) Critical care nursing for older adults: pathophysiological and functional considerations. Nursing Clinics of North America 39(3), 473-93. Bajwa S., Sehgal V. & Bajwa S. (2012) Clinical and critical care concerns in severely ill obese patients. Indian Journal of Endocrinol Metab 16(5), 740–748. Lecture 14 & Seminar 5 – Sepsis: Pathophysiology & Management During this session you will learn:

• How to recognise a patient presenting with sepsis • The pathophysiology of the altered inflammatory process • The evidence based management of sepsis • To integrate knowledge to clinical scenarios focusing on nursing care issues

Reading material Rhodes A., Evans L., Alhazzani W. et al. (2017) Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016. Intensive Care Medicine 43(3), 304-377. NCEPOD (2015) Just Say Sepsis! A review of the process of care received by patients with sepsis. National Confidential Enquiry into Patient Outcome and Death (NCEPOD). Available online at: http://www.ncepod.org.uk/2015report2/downloads/JustSaySepsis_FullReport.pdf. Accessed 5 August 2016. NICE (2016) Sepsis: recognition, diagnosis and early management (NG51). National Institute for health and care excellence (NICE). Available online at: https://www.nice.org.uk/guidance/ng51. Accessed 5 August 2016. Singer M. et al. (2016) The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA 315(8), 801-810. doi:10.1001/jama.2016.0287.

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Lecture 15 – End of Life Care During this session you will learn:

• Different perspectives regarding withdrawal of treatment and end of life care • The practical, ethical & legal issues concerning withdrawal of treatment and end of life care.

Reading material Cork R. (2011) The patient requiring end of life care. In Bench and Brown (ed) Critical Care Nursing; learning from practice. Blackwell, London. Chapter 17: 253-262. Department of Health (2008) End of Life Care Strategy. The Stationary Office, London. Leadership Alliance for the Care of Dying People (2014) One chance to get it right; improving people’s experience of care in the last few days and hours of life. Department of Health. Available online at: https://www.gov.uk/government/publications/liverpool-care-pathway-review-response-to-recommendations. Myburgh J., Abillama F., Chiumello D. et al. Council of the World Federation of Societies of Intensive and Critical Care Medicine. (2016) End-of-life care in the intensive care unit: Report from the Task Force of World Federation of Societies of Intensive and Critical Care Medicine. Journal of Critical Care 34, 125-30. doi: 10.1016/j.jcrc.2016.04.017.

Lecture 16 – Severe Acute Pancreatitis During this session you will learn:

• How to define pancreatitis according to severity of illness • To interpret clinical/biochemical findings and link with the pathogenesis of the disease state • To critically analyse current management strategies for severe acute pancreatitis.

Reading material Bench S. (2011) The patient with increased abdominal pressure. In Bench and Brown (ed) Critical Care Nursing; learning from practice. Blackwell, London. Chapter 8: 130-141. Hayden P. & Wyncoll D. (2008) Severe acute pancreatitis. Current Anaesthesia & Critical Care 19(1), 1-7.

Lecture 17 – Renal Replacement Therapies (RRT) During this session you will learn:

• The principles of haemofiltration & haemodiafiltration • The indications for, potential complications and nursing management requirements

associated with RRT. Reading material Richardson A. & Whatmore, J. (2015) Nursing essential principles: continuous renal replacement therapy. Nursing in Critical Care 20(1), 8-15. doi: 10.1111/nicc.12120. Ronco C. et al. (2015) Renal replacement therapy in acute kidney injury: controversy and consensus. Critical Care 19, 146.

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Seminar 6 – Acute Kidney Injury During this session you will learn:

• The causes, complications and key interventions associated with AKI in the critically ill. Reading material Bellomo R., Kellum J., Ronco, C. et al. (2012) Acute Kidney Injury. The Lancet 380(9843), 756-766. Davies A. & Bench S. (2011) The patient with an acute kidney injury. In Bench and Brown (ed) Critical Care Nursing; learning from practice. Blackwell, London. Chapter 9: 142-163. Ronco C., Ftouh S. & Thomas M. (2013) Acute kidney injury: summary of NICE guidance. BMJ 347, f4930.

Lecture 18 – Rehabilitation after Critical Illness During this session you will learn:

• The needs of patients, families and ward staff during and after ICU discharge • The importance and components of structured rehabilitation after critical illness.

Reading material Bench S., Cornish J. & Xyrichis A. (2016) Intensive care discharge summaries for general practice staff: a focus group study. Br J Gen Pract. DOI: https://doi.org/10.3399/bjgp16X688045. Bench S. & Day T. (2010) The user experience of critical care discharge; a meta-synthesis of qualitative research. International Journal of Nursing Studies 47, 487-499. NICE (2009) Rehabilitation after critical illness. NICE. Available online at: http://guidance.nice.org.uk/CG83/Guidance/pdf/English. Accessed 8 April 2016.

Lecture 19 – The Service User Perspective During this session you will learn:

• The needs of patients and their loved ones • Issues associated with quality of care from the perspective of the service user.

Reading material Health talk online. Patient and family experiences. Available online at: http://www.healthtalk.org/peoples-experiences/intensive-care/intensive-care-experiences-family-friends/. Accessed 5 August 2016. ICUsteps (2017). Patients and relatives. Available online at: www.icusteps.org. Accessed 5 March 2017.

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Lecture 20: A – Acute Hepatic Disorders During this session you will learn:

• The current UK epidemiology and causes of liver disease • Pertinent biochemical, haematological and diagnostic tests used in patients with liver disease • The current evidence base medical and nursing management for patients with acute liver

disease. Reading material Bernal W. & Wendon J. (2013) Acute liver failure. New England Journal of Medicine, 369(26), 2525-2534. Siddiqui M. & Stravitz R. (2014) Intensive care unit management of patients with liver failure. Clinical in Liver Disease 18(4), 957-978. DOI: http://dx.doi.org/10.1016/j.cld.2014.07.012.

Lecture 20: B – Cancer Therapies and Haemo-oncology During this session you will learn:

• Key cancer treatments and their action • Types of cancer therapies including chemotherapy side effects and chronic pain which can

lead to critical illness • Developments in acute oncology.

Reading material Azoulay E. et al. (2011) Intensive care of the cancer patient: recent achievements and remaining challenges. Ann Intensive Care. 1(5). doi: 10.1186/2110-5820-1-5. Brown M. & Cutler T. (2012) Haematology Nursing. Wiley-Blackwell, Chichester. Souhami R. & Tobias J. (2015) Cancer and its Management. 7th ed. Wiley-Blackwell, Chichester.

Lecture 21: A – Organ Donation/Brain Stem Death Testing During this session you will learn:

• The difference between solid organ, tissue and non-heart beating donation • The criteria for brain stem death • The nursing role in organ donation

Reading material NICE (2012) Organ donation for transplantation: improving donor identification and consent rates for deceased organ donation. Available online at: http://guidance.nice.org.uk/CG135/NICEGuidance/pdf/English. Accessed 5 August 2016.

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Lecture 21: B – Trauma During this session you will learn:

• Advanced trauma life support (ATLS) guidelines, relating to practical nursing management of the trauma patient from admission to ICU

• The key psychological and physical issues associated with caring for the multiple trauma patient.

Reading material Shere-Wolfe R., Galvagno S. & Grissom T. (2012) Critical care considerations in the management of the trauma patient following initial resuscitation. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 20, 68.

Seminar 7 – Exam Preparation During this session you will learn:

• Examination requirements • How to approach the examination and to improve skills in data interpretation and scenario

based questioning. Reading material Previous papers available from KEATS.

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Module evaluation At the end of the module you are requested to complete the short online evaluation which will be available on your module KEATS site. Student evaluations are very important to us and are required by Health Education England and the regional London Local Education and Training Boards.

Action from previous evaluations The clinical assessment document has been mapped against the updated National competencies for critical care (Critical Care Networks- National Nurse Leads 2015). Available online at: http://www.cc3n.org.uk/competency-framework/4577977310.

The assessment strategy for the module was reviewed by the module management team who agreed to keep it in its current format.

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Timetable Intensive Care Nursing 6KNIC306/7KNIM769 Timetable Term 3 2016/17

Teaching mode Date Type of

session Title Time Room Lecturer

University based Study

4 May 2017

Thursday

Lecture 1 Introduction to module and assessments 09:00-12:00 FWB 5.132

Suzanne/Carolyne Lecture 2 Assessing oxygenation and ventilation 13:00-14:00 Dan Hadfield Lecture 3 Invasive Mechanical ventilation 14:15-16:00 Suzanne Bench

Self-directed study and/or individual tutorials (by appointment) 16:00-17:00

University based Study

11 May 2017

Thursday

Lecture 4 ARDS: pathophysiology & management 09:00-10:45

FWB 5.132 Chris Hill

Seminar 1 Case study: The patient with ARDS 11:00-12:00 Lecture 5 Positioning the critically ill patient 13:00-14:30 Suzanne Bench Lecture 6 The Critically ill Obstetric Patient 15:00-16:00 Sam Bassett

Self-directed study and/or individual tutorials (by appointment) 16:00-17:00

University based Study

18 May 2017

Thursday

Lecture 7 Weaning from ventilation 09:00-10:30

FWB 5.132 Debbie Field

Seminar 2 Case study: The patient requiring non-invasive ventilation 11:00-12:00 Lecture 8 Pain, sedation and delirium 13:00-14:30 Carolyne Stewart Lecture 9 Nutrition in the critically ill 15:00-16:00 Sheela Kurian

Self-directed study and/or individual tutorials (by appointment) 16:00-17:00

Online

25 May 2017

1 June 2017

E-learning

• Chest x-ray interpretation • Chest drain insertion and management • Tracheostomy management • Formative assessment scenario

No classroom sessions

20

Teaching mode Date Type of

session Title Time Room Lecturer

University based Study

8 June 2017

Thursday

Lecture 10 Advanced haemodynamic assessment and management 09:00-10:30 FWB 5.132 Carolyne Stewart Seminar 3 Case study: The patient with shock 11:00-12:00

Simulation Rhythm recognition, resuscitation and pacing 13:00-16:00 SAiL centre, Guys

Campus

Amanda McNaughton/

Nicola Dover/Carolyne

Stewart

Self-directed study and/or individual tutorials (by appointment) 16:00-17:00

University based Study

15 June 2017

Thursday

Lecture 11 Advanced cardiac support 09:00-10:30

FWB 5.132

Carolyne Stewart Seminar 4 Case studies: The elderly and bariatric patient 11:00-12:00

Lecture 12 Acute Brain injury 13:00-14:30 Lizzy Leighton Lecture 13 Transfer of the critically ill 15:00-16:00 Elaine Manderson

Self-directed study and/or individual tutorials (by appointment) 16:00-17:00

University based Study

22 June 2017

Thursday

Lecture 14

Sepsis: pathophysiology & management 09:00-10:30

FWB 5.132 Carolyne Stewart

Seminar 5 Case study: The patient with sepsis 11:00-12:00 Lecture 15 End of Life Care 13:00-14:30 Jo Noble Lecture 16 Severe Acute Pancreatitis 15:00-16:00 Carolyne Stewart

Self-directed study and/or individual tutorials (by appointment)

16:00-17:00

Online 29 June

2017

E-learning

• Disseminated Intravascular Coagulation • Rhabdomyolysis • Critical Care datasets • Formative assessment scenario

No classroom sessions

21

Teaching mode Date Type of

session Title Time Room Lecturer

University based Study

6 July 2017

Thursday

Lecture 17 Renal Replacement Therapies 09:00-10:30 FWB 5.132 Helen Dickie Seminar 6 Case study: The patient with Acute Kidney

11:00-12:00 Lecture 18 Rehabilitation after critical illness 13:00-14:15

FWB G79

Margaret Kirkby Lecture 19 The service user perspective

14:30-16:00 Glenn Blair-

Ford/Carolyne Stewart

Self-directed study and/or individual tutorials (by appointment) 16:00-17:00

University

based Study

13 July 2017

Thursday

Lecture 20 : A Acute Hepatic Disorders 09:00-10:15 FWB 5.132 Adam Riedlinger Lecture 20: B Cancer therapies and haemo-oncology 09:00-10:15 FWB 2.80 Laura Theodossy Lecture 21 : A Organ Donation/Brain Stem Death Testing 10:45-12:00 FWB 5.132 James v-d Walt Lecture 21 : B Trauma 10:45-12:00 FWB 2.80 Sue Whaley

Seminar 7 Exam preparation 13:00-14:15 FWB 5.132 Carolyne Stewart

Module evaluation 15:00-16:00 Self-directed study and/or individual tutorials (by appointment) 16:00-17.00

Classroom key:

FWB – Franklin-Wilkins Building; Waterloo Campus

SAiL Centre – Guy’s Campus; London Bridge

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