Essay NRSG266 – Principles of Nursing: Contexts of Ageing

Essay NRSG266 – Principles of Nursing: Contexts of Ageing

Essay NRSG266 – Principles of Nursing: Contexts of Ageing

Year

2021

Credit points

10

Prerequisites

Nil

Unit description and aim

While the Registered Nurse plays a central role in the provision of health care for people who experience health alterations, they are also involved in caring for those aspects of care required through healthy ageing Health alterations occur across a range of settings and it is a requirement that the nurse is able to provide care for people experiencing these alterations. This unit is required by students to assist their ongoing development of theoretical knowledge underpinning the many facets of nursing care required by the older person, including aspects of care which are required as a result of normal ageing.

This unit will focus on the importance of promoting quality of life, independence, maintaining choice and dignity for older people as they live with age-related changes, risk factors, sociocultural issues and functional consequences that may occur with ageing. Key principles that underpin best practice will be demonstrated by the use of evidence-based case studies. The roles of the registered nurse across a variety of settings, and within the context of multi-disciplinary care, will be explored. The theoretical knowledge gained in this unit will inform nursing students’ future clinical practice across a variety of settings.

This aim of this unit is to support students to develop knowledge and skills for the provision of person-centred, evidence-based nursing care of the older person.

Learning outcomes

On successful completion of this unit, students should be able to:

LO1 – Critically analyse the concept of healthy ageing and its promotion at an individual and community level; (GA4)

LO2 – Understand experiences of ageing and how these are impacted by biopsychosocial, spiritual and cultural factors; (GA1, GA4)

LO3 – Demonstrate advanced knowledge of pathophysiology related to the ageing process; (GA5)

LO4 – Critically apply the Roper-Logan-Tierney Model of Nursing to the context of ageing; (GA1, GA4, GA5, GA9)

LO5 – Implement the Levett-Jones’ Clinical Reasoning Cycle across a range of settings, to plan safe, evidence-based, culturally sensitive, person-centred nursing care for the older adult; (GA3, GA4, GA5, GA8, GA9)

LO6 – Critically apply legal and ethical principles related to care of the older adult. (GA3)

Graduate attributes

GA1 – demonstrate respect for the dignity of each individual and for human diversity 

GA3 – apply ethical perspectives in informed decision making

GA4 – think critically and reflectively 

GA5 – demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA8 – locate, organise, analyse, synthesise and evaluate information 

GA9 – demonstrate effective communication in oral and written English language and visual media 

NMBA Standards for Practice

The Nursing and Midwifery Board of Australia’s Registered Nurse Standards for Practice developed in this unit are:

Standard/Attributes/Criteria	Learning Outcomes
Thinks critically and analyses nursing practice. 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7	LO1, LO2, LO4, LO5
Engages in therapeutic and professional relationships.2.1, 2.2, 2.3, 2.4, 2.5, 2.6, 2.7, 2.8	LO4, LO5
Maintains the capability for practice.3.1, 3.2, 3.3, 3.4, 3.7	LO1, LO2, LO3, LO4, LO5, LO6
Comprehensively conducts assessments.4.1, 4.2, 4.3, 4.4	LO2, LO3, LO4, LO5
Develops a plan for nursing practice.5.1, 5.2, 5.3, 5.4	LO1, LO2, LO3, LO4, LO5
Provides safe, appropriate and responsive quality nursing practice.	LO1, LO2, LO3, LO4, LO5, LO6
Evaluates outcomes to inform nursing practice.7.1, 7.2	LO1, LO4, LO5

Content

Topics will include:

Older people, families, communities and healthy ageing

• Demographic profile of the Australian older population
• Impact of multiculturalism on health care needs of older Australians, including A&TSI and CALD older people.
• Impact of demographics on older adults, their family, community and health care
• General health status of older people;
• Common health issues for older Australian people, including A&TSI and CALD older people;
• Australian National Health Priorities and their implications for nursing care for older people
• Healthy ageing
• Definition
• Strategies 
• Theoretical approaches to ageing
• Biological and physiological ageing
• Biological theories (e.g., genetic, wear-and-tear, immunity, cross-linkage, free radicals)
• Normal age-related physiological changes and their consequences
• Ageing changes in specific organ systems and their consequences (e.g. cardiovascular, respiratory, ENT, endocrine, gastrointestinal, genital/sexual, renal, musculoskeletal, dermatological, and neurological)
• Dementia
• Psychological aspects of ageing
• Psychological theories (e.g. theory of personhood, life course and personality development, gerotranscendence)
• Risk factors that impact on psychosocial well-being
• Social and spiritual aspects of ageing
• Sociological theories and the experience of ageing (e.g., health inequalities, disengagement, activity, person-environment fit)
• Ageism, stereotypes and myths of ageing
• Social determinants, such as gender and social class
• Spiritual theories (e.g., innovation, spiritual needs, multi-paradigm model)
• Spiritual growth and identity
• Spiritual well-being and activities

Person-centred nursing care for older people

• Holistic nursing assessment of the older adult (informed by Roper-Logan-Tierney Model of Nursing and Levett-Jones’ Clinical Reasoning Cycle)
• Use of assessment tools/instruments
• Prioritising care
• Choice and dignity for older person
• Overview of continuum of care services for older adults
• Community care services including a range of government funded services
• Models of care coordination (i.e. chronic care models, and case management services)
• Respite services
• Acute and subacute care services
• Residential aged care facilities
• Working within a multidisciplinary team
• Nurses’ roles
• Evidence-based care
• Palliative approach in aged care
• Health practitioners’ attitudes toward care of the older person 
• Factors which can influence activities of living for older people and families
• Mobility/balance issues
• Cognitive impairment
• Continence issues
• Independent self-care issues
• Nutrition/hydration issues
• Sensory deficits
• Sexuality in older age
• Social isolation

Quality use of medicines

• Pharmacological issues
• National Medicines Policy – Quality Use of Medicines
• Polypharmacy
• Evidence-based nursing strategies to promote medication safety

Nursing strategies to promote health and quality of life for older adults and their families, within a legal and ethical framework

• Quality of life
• Loss and grief
• Care-giver burden
• Promoting carer wellness
• Needs of family and carers
• Legal and ethical issues across a continuum of care settings
• Autonomy and rights
• Advance care planning
• Advance care directives
• Facilitating decisions about care
• Transition to residential care
• Elder abuse and neglect

Learning and teaching strategy and rationale

Modes of delivery in this unit include lectures, tutorials, online activities and self-directed study. Consistent with adult learning principles, the teaching and learning strategies used within these modes of delivery will provide students with foundational knowledge and skills relevant to professional nursing practice. These strategies will also support students in meeting the aim, learning outcomes and graduate attributes of the unit and the broader course learning outcomes. Learning and teaching strategies will reflect respect for the individual as an independent learner. Students will be expected to take responsibility for their learning and to participate actively with peers.

Students at university need to operate effectively as self-sufficient learners who drive their own learning and access the learning supports they require. To guide students in their learning, feedback is required to identify what is being done well, what requires additional work and to identify progress toward required learning outcomes. Located in the second year of the programme, this theory unit includes moderate face-to-face teaching hours and an increasing online component of learning to build life-long learning skills. Lectures are utilised to convey content and its central principles while tutorials deliver interactive and student driven learning sessions which require an increasing reliance on students to extend their community of learners and increase self-reliance. Online materials provide students with the opportunity to undertake directed, self-motivated study and continue to transition to independent study and life-long learning.

An optional formative online quiz for this unit will also be made available to students in week 4 of semester. This quiz will provide feedback on their progress and guide their unit learning. The formative quiz does not contribute to the student’s grade and follows the same format as the online quizzes used in first year. First year quizzes were summative and did contribute to the unit grade; second year quizzes are predominantly formative and will not contribute to the final unit grade – they are designed to assist students in reinforcing good study patterns which will assist them in their transition toward independent study and life-long learning.

This unit may also be offered on or off campus in intensive mode for sponsored / special cohorts, with the learning and teaching strategies being equitable with on campus mode offerings as endorsed by the Discipline Curriculum Implementation Committee. 

Assessment strategy and rationale

Modes of delivery in this unit include lectures, tutorials, online activities and self-directed study. Consistent with adult learning principles, the teaching and learning strategies used within these modes of delivery will provide students with foundational knowledge and skills relevant to professional nursing practice. These strategies will also support students in meeting the aim, learning outcomes and graduate attributes of the unit and the broader course learning outcomes. Learning and teaching strategies will reflect respect for the individual as an independent learner. Students will be expected to take responsibility for their learning and to participate actively with peers.

Students at university need to operate effectively as self-sufficient learners who drive their own learning and access the learning supports they require. To guide students in their learning, feedback is required to identify what is being done well, what requires additional work and to identify progress toward required learning outcomes. Located in the second year of the programme, this theory unit includes moderate face-to-face teaching hours and an increasing online component of learning to build life-long learning skills. Lectures are utilised to convey content and its central principles while tutorials deliver interactive and student driven learning sessions which require an increasing reliance on students to extend their community of learners and increase self-reliance. Online materials provide students with the opportunity to undertake directed, self-motivated study and continue to transition to independent study and life-long learning.

An optional formative online quiz for this unit will also be made available to students in week 4 of semester. This quiz will provide feedback on their progress and guide their unit learning. The formative quiz does not contribute to the student’s grade and follows the same format as the online quizzes used in first year. First year quizzes were summative and did contribute to the unit grade; second year quizzes are predominantly formative and will not contribute to the final unit grade – they are designed to assist students in reinforcing good study patterns which will assist them in their transition toward independent study and life-long learning.

This unit may also be offered on or off campus in intensive mode for sponsored / special cohorts, with the learning and teaching strategies being equitable with on campus mode offerings as endorsed by the Discipline Curriculum Implementation Committee.

Overview of assessments

Brief Description of Kind and Purpose of Assessment Tasks	Weighting	Learning Outcomes	Graduate Attributes
Written Assignment Enables the student to articulate understanding healthy ageing.	40%	LO1, LO2,	GA1, GA4, GA5, GA9
Oral Presentation This assessment enables students to demonstrate an understanding and application of theory to aged care nursing practice.	20%	LO1, LO3, LO5	GA1, GA4, GA5, GA9
Case Study Based Assessment Enables students to demonstrate a sound knowledge of aged care nursing and application of theory in practice.	40%	LO2, LO3, LO4, LO6	GA1, GA3, GA4, GA5, GA8, GA9

Representative texts and references

Brown, D., Edwards, H., Seaton, L., & Buckley, T. (2015). Lewis’s medical-surgical nursing: Assessment and management of clinical problems (4th ed.). Chatswood, N.S.W.: Elsevier Australia.

Bullock, S., & Hales, M. (2013). Principles of pathophysiology. Frenchs Forest, N.S.W.: Pearson.

Bullock, S., & Manias, E. (2014). Fundamentals of pharmacology (7th ed.). Frenchs Forest, N.S.W.: Pearson.

Holland, K., Jenkins, J., Solomon, J., & Whittam, S. (2008). Applying the Roper-Logan-Tierney Model in practice, London: Churchill Livingston.  

Hunter, S., & Miller. C. A. (2015). Miller’s nursing for wellness in older adults (2nd ed.). Sydney, N.S.W.: Wolters Kluwer/Lippincott, Williams & Wilkins.

Johnson, A., & Chang, A. (2014). Caring for older people in Australia: Principles for nursing practice. Brisbane, Qld.: Wiley.

Levett-Jones, T. (2013) Clinical reasoning: Learning to think like a nurse, Frenchs Forest, NSW: Pearson.

Miller, C. A. (2015). Nursing for wellness in older adults: Theory and practice (7th ed.). Philadelphia, PA. : Wolters Kluwer Health/Lippincott Williams & Wilkins.

Tiziani, A. P. (2013). Havard’s nursing guide to drugs (9th ed.). Chatswood, N.S.W.: Elsevier Australia.