Nursing Care of the Elderly in A Changing Life Situation, 12 credits

Admission to semester 6:
All courses from semester 1-4
Semester 5 Passed assessment from clinical placement 9 credits in (1SJ026).

Students who have failed the clinical training/equivalent due to serious deficiencies in knowledge, skills or attitudes such that patient safety or the patients' trust for healthcare have been jeopardised, is qualified to a new clinical training placement only when the individual action plan has been completed.

The general aim of the course is that the student acquire advanced knowledge in evidence-based and person-centered nursing care of older people with comorbidities and their relatives. The student should also develop and be able to apply a professional attitude in the leadership and in coordination of nursing care, be able to demonstrate application of health care ethics, and demonstrate development in their professional and scientific competence.

Component 1 Person-centered care of older people with comorbidities

Knowledge and understanding
After the course the student should be able to:

• explain relationship between human aging and frailty
• understand and explain commonly occurring signs and symptoms on illness and disease in older people
• explain the physiological reactions to drug treatment in older people
• analyse and explain the nurse's nursing responsibilities in the care of older people

Values and perspectives
After completing the course, the student should be able to:

• discuss issues related to inequality and health among older people
• discuss and apply knowledge about nursing care of frail older patients with comorbidities as well as palliative care based on a person-centered care principles
• be able to independently review and evaluate nursing care of older people based on evidence and clinical expertise.
• analyse ethical dilemmas in the nursing of older people

Part 2 Clinical education

Knowledge and understanding
After the course the student should be able to:

• demonstrate advanced knowledge of nursing care of older people with comorbidities and knowledge and understanding of palliative care
• discuss the leadership role of the nurse based on theories and methods in team interaction around the care of the older patient with comorbidities
• Demonstrate the ability to critically assess nursing responsibilities around multiple medications for older patients and medication-related problems

Skills and abilities
After the course the student should be able to:

• indepdently lead, plan, prioritise, implement, document, and evaluate nursing care of complex health problems in collaboration with the older patient and their relatives based on evidence and a person-centered approach to care
• independently administrate and evaluate medication prescriptions and report and document medication effects and adverse drug reactions, based on laws and regulations
• independently carry out nursing and medical-technical tasks while ensuring patient safety.
• based on an ethical attitude promote participation and support the older and he relatives in a changeable living environment based on care on an equal footing

Values and perspectives
After the course the student should be able to:

• apply a professional attitude and demonstrate assessment, self-awareness, and empathetic ability in collaboration with the elderly and their relatives and in interprofessional cooperation

Contents

The course consists of the following 2 parts:

Part 1: Person-centered care of elderly with comorbidities, 3 credits

Part 2: clinical education, 9 HE credits

Person-centered care of elderly with comorbidities, 3 credits

• Person-centered care of elderly and their relatives
• Socially aging, frailty, corporeality and comfort
• Dignity, integrity and autonomy
• Comorbidity
• Care on an equal footing
• Signs of illness and symptoms of commonly occurring diseases among the elderly
• Evidence-based nursing of commonly occurring illnesses among the elderly
• Palliative care
• Physiological aging and the use of multiple medications
• The responsibility of the nurse in the use of multiple medications
• Critical approach to nursing care, science and clinical expertise

Placement, 9 credits

• Person-centered care and working method
• The nursing process.
• Evidence-based nursing of the elderly with health problems and comorbidity
• Health care ethical attitude
• The leadership and kvalitets- och utvecklingsarbete of the nurse
• The physiological reactions and the use of multiple medications
• Drug effects, adverse drug reactions and interactions
• The responsibility of the nurse in the use of multiple medications
• Coordination of care and social care
• Nursing on an equal footing
• Care and nursing in connection with dying and death
• Medical records and documentation
• Patient safety
• Interprofessional cooperation
• The participation of the elderly and the relatives' in the nursing
• Wound care and pressure care
• S-HLR

The teaching is based on a problem-oriented and collaborative approach to learning in which assignments provide opportunities for students to take active responsibility for their learning. The working methods that are used are lectures, seminars, literature studies, proficiency training and clinical placement. Participation in seminars, proficiency training and placement is compulsory. In case of absence from compulsory parts, compensation is determined in consultation with the examiner.

Study results cannot be reported until the student has participated in compulsory course elements or compensated for any absence in accordance with instructions from the examiner. Absence from a mandatory education element could mean that the student can not do the part until the next time the course is offered.

Distance learning is based on IT and on independent and collaborative learning. The course is based on a variety of teaching methods including individual study assignments, group assignments, virtual discussions, seminars, and lectures. Teacher support is provided via an IT-based learning management system. The number of physical course meetings is limited to at most 2 days/7.5 credits at theoretical components.

The placement of about 6 weeks takes place at either an emergency geriatric ward another clinic/ward where healthcare of elderly is carried out. The placement includes 40 hours/week (full-time studies) of which 32 hours/week are scheduled and located in a nursing setting where structured supervision and reflection take place individually and/or in groups. Clinical training centre assignments may include day, evening, night, weekend and even holiday shifts. Student are not allowed to shorten the length of the clinical placement.

Component 1 is assessed through one written individual written examination and two written individual home examinations.

Component 2 is assessed by an individual clinical examination during the placement. A half-time assessment and a final assessment are carried out. The professional supervisor and/or clinical lecturer provide the basis for student assessment according to established criteria for the clinical placement. During the placement, continuous assessment of the student's achievements takes place. Half-time - and final assessment is carried out. The professional supervisor and/or clinical lecturer provide the basis for student assessment according to established criteria for the clinical placement. If a student risks failing their clincial placement, the responsible university teacher in consultation with professional supervisor and student should establish a written action plan for the continued clinical placement no later than at the half-time assessment.

For a Pass grade in the course, it is required that the expected learning outcomes are satisfied which implies passed results in part 1 and 2 and active participation in compulsory parts. Grades are decided by the examiner.

Student who do not pass the regular examination are entitled to re-sit the examination on five more occasions. A student who has not achieved a passing grade after taking the examination three times can take parts of the course or the whole course again Being able to retake all or parts of the course is subject to availability
If the student has failed six examinations/tests, no additional examination is given.
Submission of blank exam is counted as examination. In case a student is registered for an examination but does not attend, this is not regarded as an examination. An examination that has been opened via the learning management system counts as an examination session even if the examination is not submitted.
Late submissions of examinations are not accepted. Students who have not submitted their examination on time are required to then take another examination.

The examiner may interrupt a student's clinical rotation or equivalent with immediate effect, if the student demonstrates such serious deficiencies in knowledge, skills or attitudes that patient safety or patient confidence in healthcare is at risk. If a clinical placement is interrupted in this way the student is deemed to have failed that element and to have used up one clinical placement opportunity. In such cases, an individual action plan should be set up stating which activities and tests are required before the student is qualified for a new clinical placement on the course.
A failed clinical placement can be repeated only once.

If there are special grounds, or a need for adaptation for a student with a disability, the examiner may decide to deviate from the syllabus's regulations on the examination form, the number of examination opportunities, the possibility of supplementation or exemptions from the compulsory section/s of the course etc. Content and learning outcomes as well as the level of expected knowledge, skills and attitudes may not be changed, removed or reduced.

For a course that has been closed down or undergone major changes, or where the reading list has been changed considerably, three additional tests (excluding regular tests) in the previous literature and contents should be given during a period of a year from the date of the change.

The course evaluation will be conducted according to the guidelines that have been established by the Board of Higher Education.