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护理计划与实施 II

发布时间:2012-6-18      来源:admin      阅读次数:3718

护理计划与实施Ⅱ

课程代码:1000127                      开课学院:HOPE护理学院

开课学期:秋季                         授课对象:三年级学生

    分:4                           课程负责人:邹智杰(中国)

课程简介:

教学目的

课程结束时,学生能够:

  1. 讨论依据护理对象生理改变所作的护理。
  2. 提出对身体系统方面具体的生理改变不同的护理方案。
  3. 分析有心理改变的护理对象的适应性反应。
  4. 分析护理措施对解决护理对象的问题是否有效。
  5. 对护理对象进行宣教:讲解内容需适合每个人对健康、疾病、饮食、药物、治疗等方面的理解水平。
  6. 评估在以一个护理理论为根据的假设情况下所进行的护理实施。

主要教学内容

第一单元:对有遗传/慢性改变护对象的护理

第二单元:对有心理状态改变的护理对象的护理

第三单元:对有生理改变的护理对象的护理

第四单元:对有外科手术改变的护理对象的护理

具体内容和课程安排如下:

第一单元对有遗传性或有慢性改变的护理对象进行护理

单元概述:本单元分析遗传/慢性病患者自我管理的重要性,讨论遗传/慢性病对个人、家庭和社会的影响,帮助学生了解个人和家庭的社区资源。讨论慢性病/遗传病预防的重要性。

单元教学目标:

本单元结束时,学生能:

1. 讨论遗传/慢性病患者自我管理的重要性。

2. 讨论慢性/遗传病对个人、家庭和社会的影响。

3. 叙述个人和家庭的社区资源。

4. 讨论预防对遗传/慢性改变患者及家庭的重要性。

目标1. 讨论遗传/慢性病患者自我管理的重要性。(2学时,讲授、课堂讨论)

内容:

  1. 介绍本单元的教学目标,教学安排,学习要求,考核方法, 参考书目;

2. 讨论慢性病自我管理方法。

3. 讨论临床慢性病自我管理的循证研究。思考如何将结果应用到临床中?

4. 明确护士在慢性病管理中的作用。

预习:

1. 学生复习上学期所学相关知识。

2. 学生自己查询慢性病自我管理的相关研究报道至少2篇,其中英文文献至少1篇。阅读后带到课堂进行讨论。

作业:将课堂讨论结果应用到临床实践中,并书面报告应用效果、心得体会(第四周周日8pm前提交到BB平台)。

 

目标2. 讨论慢性/遗传病对个人、家庭和社会的影响。(3学时,案例陈述报告、课堂讨论)

内容:

  1. 慢性病对个人、家庭和社会的影响。
  2. 护士在评估与慢性病/遗传病有关的抑郁和/或自杀倾向中的角色。
  3. 从临床实习中选择3个病例讨论遗传/慢性病对个人、家庭和社会的影响。

预习:

1. 学生复习上学期所学精神心理相关知识,尤其是抑郁、自杀倾向的评估。

2. 学生查询慢性病最新流行病学数据,包括发病率、病死率、住院率、住院费用、医疗费用等。阅读并整理后带到课堂进行报告。

3. 学生分成3组,每组从既往实习中选取1个病例,组内成员讨论遗传/慢性病对个人、家庭和社会的影响后做成PPT进行汇报,然后所有学生参与讨论。

作业:评估自己所护理的病人有无抑郁、焦虑、自杀倾向,并向老师汇报评估结果。

目标3:讨论遗传/慢性病患者和家庭的社区资源。(3学时,讲授、课堂讨论)

内容:

  1. 了解遗传/慢性病患者和家庭的支持系统。

2. 识别慢性病/遗传病患者及其家庭成员的社区资源、社会支持网络。

3. 考虑慢性病/遗传病患者及其家庭成员获得社区资源的途径。

  1. 从临床实习中选择3个病例讨论。

预习:

1. 学生查询国际及国内遗传/慢性病相关的政策、法律,社区在慢性病方面的最新举措。阅读并整理后带到课堂参与讨论。

2. 学生分成3组,每组从既往实习中选取1个病例,组内成员讨论该患者和家庭能获取的社区资源及途径并到课堂汇报。

作业:为自己所护理的病人及其家庭寻找可及的社区资源。告知病人及其家属,书面汇报寻找方法、结果,寻找到的社区资源对病人是否有用(第三周周日8pm前提交到BB平台)。

目标4:讨论预防对遗传/慢性改变患者及家庭的重要性。(10学时,讲授、课堂讨论、模拟教学)

内容:

  1. 讨论三级预防在慢性病中的重要性。(2学时,讲授、课堂讨论)

1) 介绍三级预防的概念。

2) 如何针对遗传/慢性病进行三级预防。

3)小组讨论:分别讨论高血压、糖尿病、肿瘤患者三级预防的特点,在医院内、家庭、社区范畴如何贯彻;

预习:

1. 学生复习/预习三级预防概念。

2. 学生课前查阅高血压、糖尿病、肿瘤三级预防相关护理研究,阅读并分析。

3. 遗传筛选和遗传咨询的重要性。(1学时,课堂讨论)

  1. 让学生列举常见遗传性疾病。
  2. 明确遗传筛选的目的、方法。
  3. 讨论遗传筛选的高危人群。
  4. 护士在遗传筛选中的作用。

预习:

1. 学生复习所学常见遗传性疾病及其相关医学知识。

2. 学生预习遗传咨询、遗传筛选的概念及相关政策。

3. 明确运动管理对遗传/慢性病的重要性。(1学时,讲授)

  1. 明确运动管理的定义。
  2. 介绍运动管理制定的原则。
  3. 讨论运动管理的内容。

预习:

1. 学生回顾临床实习中做过的运动指导。

2. 完成老师布置的阅读任务。

作业:选择自己护理的病人,为其进行运动指导。书面报告详细的运动指导计划及应用心得体会(第二周周日8pm前提交到BB平台)。

4. 康复护理对提高慢性病患者生活质量的影响。(6学时,讲授、课堂讨论)

  1. 明确康复护理的概念。(0.5学时)
  2. 如何对慢性病患者进行康复评估:残疾、肌力、关节、日常生活能力。(1学时)
  3. 介绍常用康复护理技术。(1学时)
  4. 讨论康复护理对提高慢性病患者生活质量的影响。学生查阅康复护理最新文献,了解康复护理的循证研究。(0.5学时)

5)  模拟教学:护理一例2型糖尿病并发糖尿病足的患者。(3学时)

预习:

1. 学生按老师要求提前一周预习和复习模拟教学前需具备的知识和技能。.

2. 学生模拟教学活动前需完成一份完整的护理计划。

3. 学生提前分配好模拟教学中的角色。

第二单元对有心理状态改变的服务对象的护理

单元描述

本单元的目的是解决与心理状态改变(包括精神疾病及心理健康)相关的护理概念。重点是关注服务对象的急性和慢性精神疾病及心理健康。探讨和实践适合于个体、家庭和团体的评估及干预护理策略以促进心理健康。

单元目标:

课程结束时,学生能够完成下列目标:

1.整合护理及相关学科的理论知识,发展与临床护理实践相关的内环境、人际关系及外环境的发展框架,促进心理健康与疾病预防;

2.阐明在精神心理护理中自我意识的重要性;

3.发展临床护理的判断及技巧为经历急性和慢性心理健康改变的服务对象提供直接的护理;

4.讨论应用于精神心理改变的护理对象的治疗方式;

5.为服务对象提供基于家庭及社区背景的与心理健康,心理疾病及寻求健康行为相关的健康教育及咨询;

6.与跨学科的健康照顾团队成员在计划与实施过程中建立合作关系,为服务对象提供最佳服务;

7.基于相应的理论(Peplau 人际关系理论)实施策略以建立治疗性护患关系;

8.识别可用于精神心理护理中的治疗性沟通技巧;分析治疗性沟通的过程,在为患有心理疾病的儿童、青少年、成人及其家庭提供照顾的过程中,治疗性运用自我。(Travelbee, 1971)

9.在同经历急性及慢性心理健康改变的服务对象互动的过程中以专业的护理标准及服务对象的权益为指导;

10.护理经历各种心理障碍的服务对象过程中,总结与诊断、护理照顾或治疗处理相关的研究发现;

11.识别所有年龄的护理对象无效应对行为模式;

12.叙述有心理改变的护理对象的无效应对模式;

 

具体安排:

完成目标Ⅰ:目标1、3、4、8;(整体发展框架;临床护理的判断及技巧;治疗方式;专业标准)

 

第一周危机干预及自杀行为的护理(5学时)

预习:

  1. 回顾上学期第七讲危机干预的内容;
  2. 预习危机的性质,危机的发展阶段及类型。
  3. 结合精神心理病房的实习经验,识别并分析精神课护士在危机干预中的角色。

 

内容及教学方法:

第一讲3学时

  1. 介绍本单元的教学目标,教学安排,学习要求,考核方法, 参考书目
  2. 基于过往经历,共同探讨危机的发展阶段
  3. 案例分析:给出3个案例
    • 分析3个案例中的危机类型
    • 鉴别意外性危机和发展性危机
    • 就其中的一个案例分析如何进行危机干预
    • 总结危机处置的步骤与方法(环境安排,一般性支持,广泛性支持,个别性支持)
  4. 讨论自杀可能的诱因及相关理论。
  5. 护士对自身的态度;自杀应有的正确态度与观念;对自杀处理的误解
  6. 案例分析:如何实施自杀行为的护理

 

模拟教学特定预习内容:

1. 学生按老师要求提前一周预习和复习模拟教学前需具备的知识和技能。

1)定义并区分愤怒及冲动;

2)识别愤怒的表达何时成为问题;

3)识别愤怒非适应性表达的诱发因素;

4)运用护理程序进行愤怒及冲动管理;

5)预习“未加标明的心境障碍及边缘型人格障碍”的相关知识;

6) 复习治疗性沟通的技巧;

7)复习相应的症状学知识。

 

2. 学生模拟教学活动利用概念图完成一份冲动、愤怒控制的护理计划(基于一定的理论基础及治疗技术,如认知、行为治疗,放松训练,辅助治疗等)。

3. 学生提前分配好模拟教学中的角色。

 

第二讲2学时  模拟教学:冲动及愤怒控制

模拟教学:

Introductory learning: key points of anger/aggression management;

Objective:

  1. Effective teamwork;
  2. Provide care according to clients’ responses;
  3. Evidenced based interventions are encouraged to implement.
  4. Scenario:  a 22-year-old woman with unclassified Mood Disorder/Borderline personality disorder, irritation and being high risk for aggression.
  5. Arrangement: students divided into 2 groups, simulate in the scenario in sequence and debriefing separately.

 

作业:

1. 对模拟情境中的主要问题进行分析。

2. 至少阅读一篇危机干预相关的英文文献,对相应措施进行总结,第三周周日8pm前提交到BB平台。

 

完成目标Ⅱ:目标1、4、10、11、12;(整体发展框架;治疗方式;总结各项研究发现;应对)

 

第二周心理干预:治疗性小组、家庭治疗、环境治疗、放松训练及辅助疗法(5学时)

 

预习内容:

1. 治疗性小组

1)“小组”的含义及功能;小组的类型;治疗性小组及小组治疗的区别;

2)小组治疗的影响因素(机械性因素及治疗性因素);小组治疗的功能;

3)小组治疗的三个阶段;

4)领导类型;成员角色;

5)小组治疗中的护士角色。

2. 环境治疗

1)环境治疗的定义,重要性,发展及理论框架;

2)环境治疗的目的、功能、原则;

3) 多学科治疗团队中护士的角色;

3. 家庭治疗

1)家庭治疗的定义及家庭的发展阶段;

2)适应性家庭功能型态的特征;

3)家庭系统、结构及治疗策略;

4)将护理程序应用于家庭干预过程中。

4. 放松训练

1) 确定何种情况使用放松训练是最为恰当的;

2) 描述放松的生理及行为表现;

3) 讨论获取放松的多种方法;

4) 描述放松训练中护士的角色;

5. 辅助疗法:讨论辅助治疗使用的技巧(草药、针灸、饮食及营养,推拿、治疗性抚触、按摩、瑜伽及宠物治疗)

 

内容及教学方法Contents and teaching strategies

第三讲3学时

  1. 共同回顾及探讨心理医院小组治疗的类型及护士在小组治疗中的角色;
  2. 共同讨论治疗性小组和小组治疗的区别;
  3. 由学生表演情景剧(角色扮演):分成两组,表演后相互点评;
  4. 结合精神卫生中心及心理医院的特点,探讨环境治疗的意义及护士在多学科团队中的角色;

 

第四讲2学时  Lecture 2hr

1. Based on the students’ own families, identify the stages of family development together

2. Case study: family systems and structural and strategic therapies, nursing process in therapeutic intervention with families.

3. Discuss together based on some scenarions: Identify conditions for which relaxation is appropriate therapy

4. Enjoy relaxation: listen music, experience progressive relaxation; do exercises;

5. Discuss the techniques used in various complementary therapies (herbal medicine, acupressure and acupuncture, diet and nutrition, chiropractic medicine, therapeutic touch and massage, yoga, and pet therapy) by students.

作业:至少检索三篇与以上干预措施相关的英文文献,阅读并写出总结报告,需写出该文献的循证证据分级。

 

完成目标Ⅲ:目标5、6、11、12;(基于家庭及社区背景;跨团队合作;无效应对)

第三周心理社会适应性发生改变的服务对象的护理及精神心理的连续性护理(5学时)

预习内容:

1.物质的分类;物质成瘾的定义及特点;物质成瘾的临床特征;

2.酒精成瘾及药物滥用的过程;物质成瘾的病因;

3.如何将护理程序运用于照顾物质成瘾患者过程中;

4. 酒精成瘾匿名团体的特征;

5. 如何在临床实践中监测自我意识,促进同理心

6. 精神心理三级预防的概念、内涵及护士的角色;

7. 临床路径及个案管理的概念及内涵;

8. 通过检索,查找关于无家可归者及农村地区的精神卫生现状。

 

第五讲物质成瘾及护理3学时

  1. 回顾周围环境存在的“物质”及“物质成瘾”现象
  2. 讨论我国物质成瘾相关的法律:“管制药品”及“毒品”
  3. 提问及回答:耐受性,躯体依赖,心理依赖及物质依赖的定义及表现;
  4. 共同回顾物质成瘾相关的护理诊断;
  5. 影片赏析:疯狂的心
    • 分析酗酒的原因;
    • 酒精及药物成瘾的四个阶段;
    • 归纳护理问题;
    • “AA”团体的功能及特点;
    • 分小组讨论相应的护理措施: 应对方式,社会支持等等。

第六讲精神心理的连续性护理2学时

  1. Discuss components of clinical pathway
  2. Case study (eating disorder) : how to utilize clinical pathway; how to relearn socially appropriate behaviors.
  3. Introduce case management and case manager
  4. Case study: Discuss nursing intervention in primary prevention of mental illness within the community

作业:检索与酒精成瘾匿名团体相关的信息或国外及港台地区精神卫生社区护理相关研究。

 

第四周特殊人群的精神心理护理:老年人主要心理障碍及认知干预(痴呆) 3学时

预习内容:

  1. Define dementia, memory impairment;
  2. Identify nursing diagnoses common to clients with dementia  and memory impairment;
  3. Identify topics for client and family teaching relevant to cognitive disorders.
  4. Discuss various treatment modalities relevant to care of patients with dementia.

 

内容及教学方法Contents and teaching strategies

  1. Review together about physiopathology of cognitive disorder
  2. Differentiate Dementia of the Alzheimer's Type and Vascular Dementia
  3. Case study: 1) Identify the pertinent assessment data from which nursing care will be devised; 2) what is the primary nursing diagnosis for Joe? 3) How would outcomes be identified.
  4. Enjoy movie: Away from her; discuss as groups:
  5. how to identify the manifestations of the early stage of dementia
  6. How to help family members to cope with alterations
  7. How to slow down cognitive impairment
  8. How to monitor self-awareness.

 

作业:检索与酒精成瘾匿名团体相关的信息或国外及港台地区精神卫生社区护理相关研究。

Assignments:Search information about “AA” or search papers related to current psychiatric and mental health community nursing of western countries, Hongkong or Taiwan.

第三单元为有生理改变的护理对象制定教与学的计划

单元描述

本单元重点关注服务对象对生理改变及其引发的各种问题的适应,提供对有生理改变的服务对象的护理。

 

单元目标

1.对由于妊娠引起的生理改变的服务对象的护理。

2.对由于分娩引起的生理改变的服务对象的护理。

3.新生儿的护理。

4.对由于衰老引起的生理改变的服务对象的护理。

5.对由于疾病引起生理改变的服务对象的护理。

6.对由于饮食引起生理改变的服务对象的护理。

具体安排:

目标5 第一讲对由疾病引起的生理改变的护理对象所进行的护理(3学时)

  1. 熟悉护理诊断的分类
  2. 呼吸系统疾病引起的生理改变及其护理,包括护理常规、如何提出护理诊断(重点:如血气分析结果,症状,体征等)、常用的护理诊断及相应的护理措施
  3. 鉴别容易混淆的相关护理诊断,如气体交换受损、低效性呼吸型态、清理呼吸道无效;

4.  案例:COPD病人的整体护理(课前预习相关知识,包括病因、发病机制、病理、临床表现、实验室及其他检查、治疗要点、可能的护理诊断和措施、用药)

 

目标5 第二讲对由疾病引起的生理改变的护理对象所进行的护理—循环系统生理改变的护理(2学时)

  1. 循环系统疾病引起的生理改变及其护理,包括护理常规、如何提出护理诊断、常用的护理诊断及相应的护理措施;
  2. 模拟案例:心肌梗死病人的整体护理(课前预习心肌梗死相关知识,包括病因、发病机制、病理、临床表现、实验室及其他检查、治疗要点、可能的护理诊断和措施、用药)

 

目标5 第三讲对由疾病引起的生理改变的护理对象所进行的护理(3学时)

  1. 消化系统疾病引起的生理改变及其护理,包括护理常规、常用的护理诊断及相应的护理措施;常用药物有哪些,及作用
  2. 泌尿系统疾病引起的生理改变的护理,包括护理常规、常用的护理诊断及相应的护理措施;常用药物有哪些,及作用
  3. 个案护理:一例慢性肾脏疾病人的护理(课前预习相关知识,包括病因、发病机制、病理、临床表现、实验室及其他检查、治疗要点、可能的护理诊断和措施、用药)

 

目标5 第四讲对由疾病引起的生理改变的护理对象所进行的护理(2学时)

  1. 血液系统疾病引起的生理改变的护理,包括护理常规、常用的护理诊断及相应的护理措施;常用药物有哪些,及作用
  2. 内分泌系统引起的生理改变的护理,包括护理常规、常用的护理诊断及相应的护理措施;常用药物有哪些,及作用
  3. 个案护理:一例糖尿病患者的护理(课前预习相关知识,包括病因、发病机制、病理、临床表现、实验室及其他检查、治疗要点、可能的护理诊断和措施、用药)

 

目标5 第五讲对由疾病引起的生理改变的护理对象所进行的护理(3学时)

  1. 免疫系统疾病(结缔组织病、风湿病)引起的生理改变的护理,包括护理常规、常用的护理诊断及相应的护理措施;常用药物有哪些,及作用
  2. 神经系统疾病引起的生理改变的护理,包括护理常规、常用的护理诊断及相应的护理措施;常用药物有哪些,及作用(躯体障碍、角色适应)
  3. 个案护理:一例脑血管疾病的护理(预习)

 

目标5第六讲模拟教学:一例1型糖尿病患儿的整体护理(2学时)

 

目标6 第七讲对与饮食失调有关的生理改变的服务对象的护理(3学时)

  1. 饮食与健康的关系:哪些饮食容易引起血脂增高?肥胖?血压升高?便秘?伤胃?什么是健康的饮食?如何做到?
  2. 学生汇报:同学之前被任意指定一个与饮食状况相关的案例,根据个案研究及饮食状况,制定一个教学计划(健康宣教计划),PPT形式,在课堂上陈述,每人10-15分钟。
  3. 针对汇报内容评价

 

第四单元外科手术改变单元

单元描述:本单元的目的是介绍与手术经历各部分的护理概念,关注有手术经历的服务对象及其家属在生理,心理和社会层面所受到的影响,并针对这些影响提出有效的护理措施,促进学生将理论知识和临床实践结合起来,更好得提供有质量的护理。

单元目标

1. 学生能够正确评估手术患者及其家属的需求并提供及时合理的护理措施

2.学生能够掌握病人安全的护理

3. 学生能够通过正确的评估,预见手术对患者生活及发展阶段的影响。

4.学生能够运用相关概念在制定个性化的整体护理计划。

课程安排

目标1:学生能够正确评估手术患者及其家属的需求并提供及时合理的护理措施

第一周:识别手术改变对服务对象及其家属的影响(5学时)

课堂目标:

1. 学生能够识别手术改变对服务对象生理改变的影响

2. 学生能够识别手术改变对服务对象及其家属的心理方面的影响,并提出有效的护理措施

3. 学生能够识别手术改变对患者、家人以及两者在社会交往中所产生的影响

4. 以宫颈癌和乳腺癌为例分析手术改变对服务对象及其家属的影响

课堂安排:

手术改变对服务对象及其家属的影响3学时)

1.介绍手术改变的相关概念(应激,焦虑,疼痛,自我形象紊乱)

2.以宫颈癌和乳腺癌为例介绍手术改变对服务对象及其家属的生理,心理,社会适应等方面的影响

3.讨论针对上述影响的相关护理措施。

模拟教学2学时)

学生针对所给的宫颈癌和乳腺癌的病例分组进行情景模拟来照顾病人。

课后作业:预习脑外科术前术后护理的基本知识,复习护理学基础中《预防和控制医院感染》、《生命体征观察和护理》、《病人的情洁卫生》、《静脉输液和输血》等章节的内容。

目标2:讨论病人安全的护理

第二周:病人安全的护理(学时5)

课堂目标:

1、学生能够识别影响病人安全的因素。

2、学生能够明确引起术后感染的危险因素。

3、学生能够制定合理有效的措施避免患者术后感染。

4、学生能够通过对案例的学习掌握脑外科术前术后护理常规;

5、学生能够正确评估脑外科手术患者的需求,发现护理问题,制订合理的护理计划

课堂安排

病人安全(3学时)

1.介绍病人安全的相关概念(安全,风险,事故,差错,预防,感染,压疮)

2.通过回顾上学期实习科室中潜在的危害病人安全的因素,引导学生提出恰当的保障病人安全的措施

3.讨论术后感染控制和压疮预防以及护士在其中承担的角色。

4.通过泌尿外科及脑外科病例分析保障患者的安全的护理措施

课后作业:1 预习颅脑手术患者的护理

          2 复习如何迎接手术患者返回病房

模拟教学颅脑手术术后患者返回病房后的护理(2学时)

         核心内容:病情观察,患者安全及避免感染的措施

课后作业:结合临床经验,通过查阅资料阅读文献的方式完成一篇循证小论文。主题为:保障病人安全或者控制外科感染。

目标三:预见手术对患者生活及发展阶段的影响

第三周  手术患者的康复5学时

课堂目标:

1 掌握骨科患者术前术后的护理

2 掌握骨科术后功能锻炼

3 识别骨科术后常见的并发症并提出护理措施

4 讨论引起患者术后并发症的因素

5 通过正确的评估,预见手术对患者生活及发展阶段的影响。

6 学生能够提供及时、合理的护理干预,使手术患者最大限度地恢复正常的生活

课程安排

病人康复(3学时)

  • 小组讨论:通过对一例膝关节置换术后患者功能锻炼的讨论,掌握患者术后康复护理的核心要点。
  • 小组讨论基于骨科病例手术对患者发展及社会功能的影响

课后作业:为各组的病例制定术后康复计划。(内容涵盖院内康复计划及出院周康复计划)

术后并发症(2学时)

  • 课堂游戏:根据上学期临床经验辨别术后并发症
  • 小组讨论:如何避免骨科术后并发症
  • 骨科术后并发症的护理

目标四:学生能够运用相关概念在制定个性化的整体护理计划。

第四周  整体护理计划(学时3)

  角色扮演:根据临床上自选的实际病例,分小组演绎围手术期的患者的护理过程

教学策略:

本课程采取小班授课,单元形式进行教学。教学方法包括讨论、学生讲述、个案研究、模拟教学、讲课、利用电影、录像片、录音带之类的音像资料。

考核方式:

评估的依据是圆满完成各单元的学习、积极参加课堂讨论和活动、历次课程考试成绩和期末测试。

1.    考勤          10%

2.    课堂表现      25%

3.    平时测验      40%

4.    多站考核      25%

    材:

1.Smeltzer S.C. & Bare B. (2004). Chronic Illness. Textbook of Medical-Surgical Nursing (10th edition). Lippincott Williams & Wilkins.

2.尤黎明,吴瑛.内科护理学.第三版.北京:人民卫生出版社,2005.

3.Townsend, M.C. (2006). Psychiatric-mental health nursing: Concepts of care in evidence based practice (5th ed.). Philadelphia: F.A. Davis.

4.萧淑贞,王纯娟,刘玉云等.精神科护理概论:基本概念及临床应用. 台北: 华杏出版股份有限公司, 2010. (Xiao Shuzhen, Wang Chunjuan, Liu Yuyun, et. al.. Psychiatric Nursing: Concept and Practice. Taipei: Farseeing Publishing Group,2010.)

5.高玉玲等. 精神科临床护理导引:精神科个案护理. 台北:华杏出版股份有限公司,2000.

6.Deitra L Lowdermilk & Shannon E. Perry, Maternity & women’s health care, 8 edition, an affiliate of Elsevier, 2004

7.Michele R. Davidson, Marcia L. London, Patria A. Wieland Ladewig. Olds’ maternal-newborn nursing & women’s health across the lifespan, 8th edition, Prenrice hall, 2008

8.郑修霞,夏海鸥. 妇产科护理学, 第四版, 人民卫生出版社, 2006

9.陈月枝编著,实用儿科护理,华杏出版股份有限公司,2004年出版

10.曹伟新,李乐之。外科护理学。第4版,北京,人民卫生出版社,2006。

11.湖南医科大学附属湘雅医院。病人标准护理计划(外科分册)。第1版,长沙,湖南科学技术出版社,2002。

12.吴在德,吴肇汉。外科学。第六版,北京,人民卫生出版社,2004

13.李和惠,林丽秋,黄玉琪,吴碧云,林贵满。内外科护理学,第三版,台湾,华杏出版社,2010。

 

参考书目:

第一单元

  1. Smeltzer S.C. & Bare B. (2004). Chronic Illness. Textbook of Medical-Surgical Nursing (10th edition). Lippincott Williams & Wilkins.
  2. http://www.rwjf.org
  3. 尤黎明,吴瑛.内科护理学.第三版.北京:人民卫生出版社,2005.
  4. 陆再英等.内科学.第七版.北京:人民卫生出版社,2008.
  5. http://www.who.int/chp/chronic_disease_report/part1/zh/index.html
  6. http://www.nihe.org.cn/
  7. http://www.tnbzy.com/default.html
  8. http://chinacdc.net/
  9. Brunner L.S. & Suddarth O.S. (1992). Textbook of Medical-Surgical Nursing (7th edition). Philadelphia: Lippincott, 1992
  10. 慢性非传染性疾病预防医学诊疗规范(试行).卫生部疾病控制司,2002.
  11. 中国慢性病报告.中华人民共和国卫生部疾病预防控制局,2006.
  12. Reinvention of Depression Instruments by Primary Care Clinicians. Baik SY.; Gonzales JJ.; Bowers B.J.; Anthony J.S.; Tidjani B.; Susman J.L. Reinvention of Depression Instruments. 2010, 8(3):224-230
  13. http://www.biomedcentral.com/1472-6963/10/95
  14. http://www.implementationscience.com/content/5/1/43
  15. some more references will be added.

第二单元

  1. Mary C T. Essentials of psychiatric mental health nursing, 3rd ed. Philadelphia: F.A. Davis Company, 2004.
  2. Katherine M F. Psychiatric nursing care plans, 4th ed. St. Louis: Mosby, 2003.
  3. Katherine M F, Patricia A. Psychiatric mental health nursing, 3rd ed. St. Louis: Mosby, 2003.
  4. Sheila L V. Psychiatric mental health nursing, 3rd ed. Philadelphia: Lippincott, 2004.
  5. Patricia D. Barry. Psychosocial Nursing, 3rd ed. Philadelphia: Lippincott, 1996.
  6. Rawlins Williams Beck. Metal Health Psychiatric Nursing-A Holistic-Cycle Approach, 3rd ed. St. Louis: Mosby, 1993.
  7. 沈渔邨. 精神病学. 第5版. 北京:人民卫生出版社, 2009.
  8. 姚树桥,孙树礼. 医学心理学. 第5版. 北京:人民卫生出版社, 2008.
  9. 李小妹.精神科护理学—护理双语教材.北京:人民卫生出版社, 2006.
  10. 李峥,王志英.临床护理学:认知/感知. 北京: 中国协和医科大学出版社, 2002.

推荐影片:

  1. 飞越疯人院
  2. 柳暗花明away from her (Dementia)
  3. 雨人Rain man (Autism)
  4. 美丽心灵Beautiful minds (struggle with Sch)
  5. 疯狂的心Crazy heart (substance abuse)
  6. 心理医师The Shrink (Self-awareness)
  7. 碧海蓝天The Big Blue (interpersonal relationship)
  8. 海上钢琴师The Legend Of 1900 (isolation from society)
  9. 双面伊娃double faced
  10. 七年之痒seven-year itch

11. 阳光小美女

12. AVIATOR

13. Wit

14.偷心

15. Cancer

第三单元

  1. 李和惠,林丽秋,黄玉琪,吴碧云,林贵满. 内外科护理学,第三版,台湾,华杏出版社,2010
  2. 尤黎明,吴瑛.内科护理学.第4版. 北京:人民卫生出版社,2006
  3. 曹伟新,李乐之. 外科护理学, 第4版, 北京: 人民卫生出版社, 2006
  4. 湖南医科大学附属湘雅医院, 病人标准护理计划(内科分册), 第1版, 长沙: 湖南科学技术出版社, 2002
  5. 焦广宇. 临床营养学,人民卫生出版社,2007
  6. 陈月枝,实用儿科护理,第3版,华杏出版社,2004
  7. Smeltzer, S.C., Bare, B. G., Hinkle, J. L. Cheever, K. H. Brunner and Suddarth's Textbook of Medical-Surgical Nursing. 11th edition, Lippincott Williams & Wilkins , 2008.

第四单元

1.    曹伟新,李乐之。外科护理学。第4版,北京,人民卫生出版社,2006。

2.    湖南医科大学附属湘雅医院。病人标准护理计划(外科分册)。第1版,长沙,湖南科学技术出版社,2002。

3.吴在德,吴肇汉。外科学。第六版,北京,人民卫生出版社,2004

4.李和惠,林丽秋,黄玉琪,吴碧云,林贵满。内外科护理学,第三版,台湾,华杏出版社,2010。

5.Smeltzer, S.C., Bare, B. G., Hinkle, J. L. Cheever, K. H. Brunner and Suddarth's Textbook of Medical-Surgical Nursing. 11th edition, Lippincott Williams & Wilkins 2008.

6. http://www.orlive.com

Nursing Planning and Implementation

Course Code: 1000127                  College: HOPE School of Nursing

Semester:Fall                         Intended Students: The third year students

Credits: 4                            Instructor: Zou ZhijieChina

Course Content:

Course Objectives: At the end of the course, the student will be able to:

1.   Discuss the care to be given to clients based on physiological alterations.

2.   present alternatives of care for specific physiological based on body systems:

3.   Analyze adaptive responses of clients with psychological alterations.

4.   Evaluate care given to clients for its effect upon resolution of clients problem(s).

5.   Teach clients content appropriate to individual level of comprehension about personal health, disease, diet, medications, treatment, etc.

6.   Evaluate the implementation of care in given situations based upon nursing theory.major Teaching content:

Topic outline:

Module 1: Nursing care of the clients with Altered psychological status

Module2: Nursing care of the clients with Genetic /Chronic Alterations

Module3: Nursing care of the clients with physiological alterations from Disease, Diet and Deterioration

Module 4: Nursing care of the clients experiencing surgical Alterations

Module 1 nursing care of clients with genetic/chronic alterations

Module description: module 1 analyzes the importance of self-management for client/family with genetic/chronic alteration. Discuss the effect of genetic/chronic diagnosis on individual and family. Present the community resources for the individual and family. And the students should understand the importance of prevention.

Module Objectives

At the end of the module the student will be able to:

1. Discuss the importance of self-management to client/family with genetic/chronic alteration.

2.  Discuss the effect of genetic / chronic alteration on client/family.

3. Consider community resources for the individual and family with a chronic debilitating condition.

4. Discuss the importance of prevention for client/family with genetic/chronic alteration.

Objectives 1Discuss the importance of self-management to client/family with genetic/chronic alteration.

(2 class hours;Lecture and discussion)

Contents

  1. Introduce the objectives, schedule, requirement, evaluation, and references of this module.

2.  Discuss the self-management of client with genetic/chronic alteration.

3. Discuss the evidence based researches on self-management. How the students apply the results in the clinical?

4. Describe the nurse’s role in management of chronic illness.

Pre-class preparation

1.  The students should review the concepts they learned last semester.

2. The students need to search at least 2 articles on self-management of patients/families with genetic/chronic illness, which includes at least 1 English article. They need to read all of them before the class.

Assignment:the students need to apply the results of the discussion in the class into the clinical. They also need to turn in written report to the teacher about the effectiveness and experience. (the written report should be turned in before 8pm of the fourth week of each shift.)

 

Objectives 2: Discuss the effect of genetic / chronic alteration on client/family.

(3 class hours; Presentation and Discussion)

Contents

  1. Analyze the effect of genetic/chronic alteration on individual, family, and society.
  2. The nurse’s role in the assessment of depression and/or suicide tendency related to the genetic/chronic illness.
  3. Select three of the cases in clinical practice. Discuss the effect of genetic/chronic        

alteration on client, family, and society.

Pre-class preparation

1. The students should review the psychological knowledge they learned last semester, especially the assessment of depression and suicide potential.

2. The students need to search the newest demographic data of genetic/chronic illness, which includes morbidity, mortality, admission rate, hospital expenses, and medical expenses, etc. They need to read all of them before the class and report it.

3.Divide the students into 3 groups. Each group can choose one case they took care before to discuss the effect of the genetic/chronic illness on the patient, family, and society. Then the students need to present it with PPTs. After the presentation, all the students attend the discussion.

Assignment:assess if the patient has depression, anxiety, and suicide tendency, and report the assessment results to the clinical teachers.

 

Objectives 3: Consider community resources for the individual and family with a chronic debilitating condition.

(1 class hours; Lecture and Discussion)

Contents

  1. Identify individual and family support systems.

2. Identify community resources, social support network for the individual and family with a chronic debilitating condition.

3.  Consider the access to gain the community resources.

  1. Choose 3 cases from clinical practice to discuss.

Pre-class preparation

1. The students need to search the international and domestic policies and laws related to genetic/chronic illness, the newest information and action that community do to genetic/chronic illness. They need to read all of them before the class.

2. Divide the students into 3 groups. Each group can choose one case they took care before to discuss the access that the patient and family to gain the community resources and what community resources they can have currently. Then the students need to present it by oral or PPTs. After the presentation, all the students attend the discussion.

Assignment:to search the useful community resource for the patients/families the students are taking care. Tell the patients/families the information, and then turn in the written report of the whole process and evaluation of the usefulness of the community resource before 8pm of the third Sunday each shift.

Objectives 4: Discuss the importance of prevention for client/family with genetic/chronic alteration.

(10 class hours; Lecture, Discussion, and Simulation activity)

Contents

  1. Discuss the importance of three levels of prevention. (2 class hours; Lecture and Discussion)

1) Introduce the definition of prevention and three levels of prevention.

2) How to do intervention to prevent the chronic diseases?

3)Group discussion: discuss the characteristics of prevention for hypertension, diabetes, and tumor. How to do it in different area, such as hospital, home, and community?

 

Pre-class preparation

1. The students need to review the concept of prevention.

2.The students need to search the research on the prevention of hypertension, diabetes, and tumor. They need to read the articles and analyze.

3. The importance of genetic screening and genetic counseling for families. (1 class hours; Discussion)

  1. Let the students list common genetic diseases
  2. Identify the purposes and methods for genetic screening
  3. Discuss the high risk population of genetic screening.
  4. The role of the nurse in genetic counseling.

Pre-class preparation

1. The students need to review the genetic diseases they learned and the medical knowledge.

2. The students need to understand the concepts of genetic screening and counseling before the class, as well related policies.

3. Identify the importance of exercise in patients with genetic/chronic illness. (1 class hours; Lecture)

  1. Identify the definition of exercise.
  2. Introduce the principles of exercise in patients with genetic/chronic illness.
  3. Discuss the contents of exercise which should be considered when making the exercise plan.

 

Pre-class preparation

1. The students need to review the exercise instruction to the patients during the practice.

2. The students need to finish the reading assignment.

Assignment:make a detailed exercise instruction plan for the patient. Turn in the written report with the plan and the experience before 8 pm of the second Sunday each shift).

 

4. The influence of rehabilitation to the patients with chronic illness. (6 class hours; Lecture and Discussion)

  1. Identify the definition of rehabilitation. (0.5 class hour)
  2. How to assess the need of rehabilitation of the patients with chronic illness, such as disability, muscle force, joint activity, and daily life ability, etc. (1 class hour)
  3. Introduce the common rehabilitation methods. (1 class hour)
  4. Discuss the influence of rehabilitation to the patients with chronic illness. Let the students search the newest evidence based research on rehabilitation and share the information. (0.5 class hour)

5) Simulation activity: let the students take care a patient with type 2 diabetes who just got the complication, diabetes foot. (3 class hours)

Pre-class preparation

1. The students should review the required knowledge and skills before the simulation activity.

2. The students should to finish a detailed medication management plan before the simulation activity.

3. The students need to make sure their roles before the simulation activity.

 

 

 

 

 

Module 2 Nursing care of the patient with psychological alternation

Module description:

This Module is designed to address nursing concepts related to altered psychological status (psychiatric and mental health). The focus is on clients with acute and chronic psychiatric disorders and their mental health. Nursing strategies that are appropriate for assessment and intervention with individuals, families, and groups to facilitate optimal holistic health especially mental health will be discussed and practiced.

 

Module Objectives

By the completion of this course, the student will achieve the following objectives related to the care of persons with psychosocial disorders:

1. Integrate theoretical knowledge from nursing and related disciplines, in the development of a framework for clinical nursing practice that addresses intrapersonal, interpersonal, and extrapersonal influences on mental health promotion and illness prevention.

2. Articulate the importance of self-awareness in mental health nursing.

3. Formulate clinical nursing judgments and skills in providing direct care to clients experiencing acute and chronic alterations in mental health.

4. Discuss treatment modalities utilized with clients who are experiencing alternations in mental health.

5. Educate and counsel clients within the context of the family and group about mental health, mental illness, and health-seeking behaviors.

6. Develop collaborative relationships with members of the interdisciplinary health care team in planning and implementing optimal client care.

7. Implementing strategies based on corresponding theories (Peplau, therapeutic interpersonal process) to develop the therapeutic nurse-patient relationship.

8. Identify the types of therapeutic communication applicable to mental health nursing. Analyze the processes of therapeutic communication and therapeutic use of self with children, adolescents, adults and families experiencing mental health concerns(Travelbee, 1971).

9. Utilize professional nursing standards and clients rights as guidelines for interacting with clients experiencing acute and chronic alterations in mental health.

10. Summarize relevant research findings related to the diagnosis, nursing care, or modalities of treatment of clients experiencing a variety of psychosocial disorders.

11. Identify ineffective coping behavioral patterns in clients of all ages.

12. Relate patterns of ineffective coping in clients with psychological alternations.

Corresponding objectives : objective 1,3,4,9;(Holistic framework; promote self-awareness;formulate clinical nursing judgments and skills in providing direct care,treatment modalities,Utilize professional nursing standards and clients rights as guidelines)

 

Week 1.  Crisis intervention and Nursing care of suicide (Class 5 hr)

 

Pre-class preparation

1. Review Lecture 7 of last semester (Crisis intervention- Nursing care of unexpected and violence events.

2. Prepare knowledge of characteristics of a crisis; phases and types of crisis.

3. Identify and analyze roles of nurses during crisis intervention based on psychiatric and mental health hospital clinic practice and then report in the following class.

 

Contents and teaching strategies:

Lecture 3hr

1. Introduce the objectives, schedule, requirement, evaluation, and references of this module.

2. Discuss phases in the development of a crisis together based on experience together.

3. Case study: 3 cases

1) Identify the types of crisis (as 3 groups)

2) Identify and compare situational crisis and developmental crisis

3) Conclude steps and measures of crisis intervention (environmental manipulation, general support, generic approach, and individual approach)

4. Review Theoretical Perspectives on Suicide

5. Nurses’ attitude to suicide;Facts and fables about Suicide

6. Case study: Nursing care of suicide

 

Specific Pre-class preparation for Simulation

1. The students should review the required knowledge and skills before the simulation activity.

1)Define and differentiate between anger and aggression;

2)Identify when the expression of anger becomes a problem;

3)Discuss predisposing factors to the maladaptive expression of anger;

4)apply the nursing process to clients expressing anger or agrees ion;

5)Prepare knowledge of unclassified Mood Disorder/Borderline personality disorder;

6) Review knowledge and skills of therapeutic communication.

7) Prepare knowledge of related psychopathology.

2. Utilize concept map finish a nursing care plan of Aggression/anger management before the simulation activity (based on specific theories and therapeutic interventions, such as cognitive, behavior therapy, relaxation therapy and complementary therapies.)

3. The students need to make sure their roles before the simulation activity.

 

Lecture 2hr  Simulation : Anger/Aggression management

Simulation:

Introductory learning: key points of anger/aggression management;

Objective:

  1. Effective teamwork;
  2. Provide care according to clients’ responses;
  3. Evidenced based interventions are encouraged to implement.
  4. Scenario:  a 22-year-old woman with unclassified Mood Disorder/Borderline personality disorder, irritation and being high risk for aggression.
  5. Arrangement: students divided into 2 groups, simulate in the scenario in sequence and debriefing separately.

 

Assignment: 1)Identify and analyze the major problems during simulation;2)at least reading one English paper and summarizing interventions.  submit into BB before 8pm of the third Sunday of each shift.

 

Corresponding objectives : objective 1,4,10,11,12;(Holistic framework; therapeutic interventions;Summarize relevant research findings; Coping)

 

Week2. Therapeutic interventions: Therapeutic groups, intervention with families, milieu therapy, relaxation therapy and complementary therapies (Class 5 hr)

 

Pre-class preparation

1. Therapeutic Groups

1) Define a group; identify various types of groups; differentiate therapeutic group and group therapy.

2) Describe physical conditions that influence groups; Discuss “curative factors” that occur in groups;

3) Describe physical conditions that influence groups;

4) identify various roles that members assume within a group;

5) describe the role of the nurse in group therapy;

2. Milieu Therapy-the therapy community

1) Define milieu therapy, articulate the importance of milieu therapy, theoretical concepts and development; 

2) Explain the goal of therapeutic community; identify seven basic assumptions of a therapeutic community;Function and principles of milieu therapy;

3) Describe the role of the nurse on the inter-disciplinary treatment team.

3. Interventions with family

1) Define the term family; identify the stages of family development;

2) Describe characteristics of adaptive family functioning;

3) Discuss the essential components of family systems, structural, and strategic therapies;

4) Apply the steps of the nursing process in therapeutic intervention with families.

4. Relaxation therapy

1) Identify conditions for which relaxation is appropriate therapy;

2) Describe physiological and behavioral manifestations of relaxation;

3) Discuss various methods of achieving relaxation;

4) Describe the role of the nurse in relaxation therapy;

5. Complementary therapies:Discuss the techniques used in various complementary therapies (herbal medicine, acupressure and acupuncture, diet and nutrition, chiropractic medicine, therapeutic touch and massage, yoga, and pet therapy.

 

Lecture 3hr

  1. Discuss and explore about the types of groups and the role of the nurses in group therapy together, based on the clinic practice in Psychiatric hospital and mental health center.
  2. Discuss about the difference between therapeutic groups and group therapy together.
  3. Demonstrate psychodrama by students;Students divided into 2 groups and play in sequence, and then analyze together.
  4. based on current situation in psychiatric hospital and mental health center, articulate the importance of milieu therapy and  the role of the nurse on the inter-disciplinary treatment team

 

Lecture 2hr

1. Based on the students’ own families, identify the stages of family development together

2. Case study: family systems and structural and strategic therapies, nursing process in therapeutic intervention with families.

3. Discuss together based on some scenarions: Identify conditions for which relaxation is appropriate therapy

4. Enjoy relaxation: listen music, experience progressive relaxation; do exercises;

5. Discuss the techniques used in various complementary therapies (herbal medicine, acupressure and acupuncture, diet and nutrition, chiropractic medicine, therapeutic touch and massage, yoga, and pet therapy) by students.

Assignments:Reading 3 English papers related to therapeutic interventions and summarize based on evidence and then s submit before 8pm of third Sunday each shift.

Corresponding objectives : objective 1,9,11,12;(Educate and counsel clients within the context of the family and group;  Develop collaborative relationships with members of the interdisciplinary health care team ;Identify ineffective coping behavioral patterns in clients of all ages,Relate patterns of ineffective coping in clients with psychological alternation)

 

Week 3 Nursing care of clients with alterations in psychosocial adaptation and Continuous nursing.

Pre-class preparation

  1. Define abuse, dependence, intoxication and withdrawal; types of substance; identify symptomatology and use of the information in assessment of clients with various substance-use disorders and substance-induced disorders;
  2. Discuss predisposing factors implicated in the etiology of substance-related disorders.
  3. Identify nursing diagnoses, select appropriate interventions.
  4. Characteristics and functions of “AA”.
  5. monitor self-awareness, promote empathy based on clinic practice;
  6. Concepts、components and nurses’ roles of primary, secondary and tertiary prevention;
  7. concepts and components of clinical pathway and case management;
  8. Collect information about the mental health status among homeless people and those who live in rural places.

 

Lecture Substances-related disorder  3hr

  1. Review “Substance” and “Substance abuse” around you.
  2. Discuss “substance abuse” related law, especially law referring to medical staff;
  3. Questions and answers:Tolerance, Physical dependence, Psychological dependence, substance dependence.
  4. Review nursing diagnoses related to substance abuse.
  5. Enjoy movie: Crazy heart:
  6. Identify the predisposing factors of Bad Bladder
  7. Four stages of alcohol addiction (and drug abuse)
  8. Identify and conclude the nursing problems
  9. Function and components of AA
  10. Discuss corresponding interventions: coping, social support.
  11.  

Lecture Continuous Nursing of Psychiatric and mental health nursing 2hr

  1. Discuss components of clinical pathway
  2. Case study (eating disorder) : how to utilize clinical pathway; how to relearn socially appropriate behaviors.
  3. Introduce case management and case manager
  4. Case study: Discuss nursing intervention in primary prevention of mental illness within the community

Assignments:Search information about “AA” or search papers related to current psychiatric and mental health community nursing of western countries, Hongkong or Taiwan.

 

Week 4: Nursing care of clients with alterations in psychosocial adaptationDementia and Memory Impairment, 3hr

Pre-class preparation

  1. Define dementia, memory impairment;
  2. Identify nursing diagnoses common to clients with dementia  and memory impairment;
  3. Identify topics for client and family teaching relevant to cognitive disorders.
  4. Discuss various treatment modalities relevant to care of patients with dementia.

 

Contents and teaching strategies

  1. Review together about physiopathology of cognitive disorder
  2. Differentiate Dementia of the Alzheimer's Type and Vascular Dementia
  3. Case study: 1) Identify the pertinent assessment data from which nursing care will be devised; 2) what is the primary nursing diagnosis for Joe? 3) How would outcomes be identified.
  4. Enjoy movie: Away from her; discuss as groups:
  5. how to identify the manifestations of the early stage of dementia
  6. How to help family members to cope with alterations
  7. How to slow down cognitive impairment
  8. How to monitor self-awareness.

Assignments:Search information about “AA” or search papers related to current psychiatric and mental health community nursing of western countries, Hongkong or Taiwan.

Module 3 Nursing Care of Clients with Physiological Alterations from

Disease, Diet, and Deterioration

Module description:

This module is designed to address nursing concepts related to physiological alterations. The focus is method and caring that help clients adapt their physiological alterations.

 

MODULE OBJECTIVES:

At the end of the module, the student will be able to:

  1. Discuss appropriate nursing care based on nursing diagnosis for clients with physiological alterations of pregnancy.
  2. Discuss appropriate nursing care based on nursing diagnosis for clients with physiological alterations of childbearing.
  3. Nursing care for newborn.
  4. Nursing care for clients with physiological alteration related to general aging.
  5. Nursing care based on nursing diagnosis for clients with physiological alterations from selected diseases.

Objective 5: Lecture 1 Nursing care based on nursing diagnosis for clients with physiological alterations from selected diseases.

  1. Familiar with the classification of nursing diagnosis

Respiratory physiological changes and care for these changes, including how to make nursing diagnosis (such as: blood gas analysis, the symptoms, signs, etc.), common nursing diagnosis and implementations

2. Identify relevant nursing diagnosis which is easy making confusing,

3. Case study : holistic care for a patient with COPD  (prepare the knowledge before the class : the etiology, pathogenesis, pathology, clinical manifestations, laboratory and other tests, treatment points, the possible diagnosis and implementation, medication)

 

Objective 5:

Lecture 2 Nursing care based on nursing diagnosis for clients with physiological alterations from selected diseases.

  1. physical changes and care for Circulatory system diseases, including how to make nursing diagnosis, common nursing diagnosis and implementations
  2. case study: holistic care for a patient with myocardial infarction (prepare the knowledge before the class : the etiology, pathogenesis, pathology, clinical manifestations, laboratory and other tests, treatment points, the possible diagnosis and implementation, medication)

 

Objective 5:

Lecture 3  Nursing care based on nursing diagnosis for clients with physiological alterations from selected diseases.

  1. physical changes and care for Digestive diseases, including how to make nursing diagnosis, common nursing diagnosis and implementations
  2. physical changes and care for Urinary system diseases, including how to make nursing diagnosis, common nursing diagnosis and implementations
  3. case study: holistic care for a patient with chronic kidney disease (prepare the knowledge before the class : the etiology, pathogenesis, pathology, clinical manifestations, laboratory and other tests, treatment points, the possible diagnosis and implementation, medication)

 

Objective 5:

Lecture 4 Nursing care based on nursing diagnosis for clients with physiological alterations from selected diseases.

  1. physical changes and care for Hematological disease, including how to make nursing diagnosis, common nursing diagnosis and implementations
  2. physical changes and care for Endocrine system disease,including how to make nursing diagnosis, common nursing diagnosis and implementations
  3. case study: holistic care for a patient with DM (prepare the knowledge before the class : the etiology, pathogenesis, pathology, clinical manifestations, laboratory and other tests, treatment points, the possible diagnosis and implementation, medication)

 

Objective 5:

Lecture 5  Nursing care based on nursing diagnosis for clients with physiological alterations from selected diseases.

  1. physical changes and care for Immune system diseases, including how to make nursing diagnosis, common nursing diagnosis and implementations
  2. physical changes and care for Nervous system diseases, including how to make nursing diagnosis, common nursing diagnosis and implementations
  3. case study: holistic care for a patient with Cerebrovascular disease (prepare the knowledge before the class : the etiology, pathogenesis, pathology, clinical manifestations, laboratory and other tests, treatment points, the possible diagnosis and implementation, medication)

 

Objective 5:

Lecture6  simulation teaching:Nursing care for a child with DM1

 

Objective 6 :

Lecture 7: Nursing care for clients with physiological alterations related to dietary imbalances.

  1. relationship between diet and health
  2. report by students based on different cases
  3. evaluation

Module 4 Nursing Care of the Patient Experiencing Surgical Alterations

Module Description:

This module is to introduce the main concepts in patients with surgical experience. Identify the main influence on the patients and their families physiologically and psychologically. And make nursing care plans for the patients with surgery and make some interventions.

OBJECTIVES: Nursing care of the clients experiencing surgical Alterations

At the end of the course ,the student will be able to:

1. Assess the needs of clients and family and to give up interventions

2. Discuss safety care in surgical module

3. Foresee effects of surgery on patients’ life and developmental stage

4. Utilize related concepts in formulating holistic nursing plan.

Course arrangement

Objective 1Assess the needs of clients and family and to give up interventions.

Week 1: recognize the effects of surgical alterations on client and family (5hours)

Class objectives

1. Students can recognize the the effects of surgical alterations on client’s physiology

2. Students can identify the effects of surgical alterations on psychology of client and family and develop effective intervention.

3. Students can recognize the effects of surgical alterations on social interaction of client and family.

4. Students can discuss the effects of surgical alterations of client and family illustrating cervical and breast cancer.

Class arrangement

The effects of surgical alterations on client and family (3hours)

1. Introduce related factors with surgical alterations (stress, anxiety, pain, self-image disorder)

2. Introduce the effects of surgical alterations on physical, psychological and social interaction of client and family illustrating cervical and breast cancer.

3.Discuss and develop effective nursing intervention.

Simulation (2hours)

Students need to do scenario simulation to take care of the patient in given cases of cervical cancer and breast cancer

Assignment: Preview the pre-operative and post-operative nursing of cerebral surgery.

Review chapters in fundamental nursing, such as Hospital Infection Prevention and Control, Vital Signs, Hygiene, Intravenous Infusion and Blood Transfusion.

Objective 2: Discuss safety care in surgical module

Week 2: safety care (5hours)

 Class objectives

1、Students can recognize the effected factors of patient’s safety

2、Students can identify the risk factors of post-operative infection

3、Students can develop effective interventions to prevent post-operative infection

4、Students can master pre-operative and post-operative route nursing through cases

5、Students can assess the needs of patients with cerebral surgery, make diagnosis and develop effective nursing plan.

Class Arrangement

Patient’s safety (3hours)

1. Introduce related concepts (safety, risk, accident, error, prevention, infection, pressure sore)

2. Review and discuss the potential risky factors in clinic, and guide the students to develop interventions to protect patient’s safety.

3. Discuss the nurse’s role in infection control and prevention of pressure sores.

4. Analyze the interventions to ensure safety illustrating cerebral surgery and urologic surgery cases.

Assignment: 1 preview nursing care of patient with cerebral surgery

          2. review the route nursing in anesthesia recovery period

Simulation: Nursing care of patients with cerebral surgery return to ward (Condition monitoring, avoid safety and infection)

Assignment: Integrate clinic experience with literature review to complete written evidence-based paper.

Topic: Ensure patients’ safety and control surgical infection

           Review nursing care of orthopedic surgery

Objective 3Foresee effects of surgery on patients’ life and developmental stage

Week 3  rehabilitation in post-operative patients (5hours)

Class Objectives

1 Master the nursing care of pre-operative and post-operative care of orthopedic surgery

2 Master rehabilitation exercises for patients with orthopedic surgery.

3 Recognize common complications after orthopedic surgery and develop its nursing interventions

4 Discuss the the factors that cause postoperative complications 

5 Through assessment, students bring up effects of surgery on patients’ life and developmental stage

6 Develop timely and effective interventions to resume normal life as possible for patients with surgery 

Class Arrangement

Rehabilitation (3hours)

  • Group discussion: master the post-operative rehabilitation for patients with knee joint replacement surgery
  • Group discussion: the effects on patients development and social function based on cases of orthopedic surgery

Assignment: develop rehabilitation plan for cases (including inpatient rehabilitation and outpatient rehabilitation plan)

Post-operative Complications (2hours)

  • Discuss: identify complications according clinic experience last semester.
  • Group discuss: how to avoid complications in orthopedic surgery
  • Summarize the nursing care for patients with complications of orthopedic surgery

Utilize related concepts in formulating holistic nursing plan.

Week 4  Holistic nursing plan (3hours)

 

Role play: select clinic cases, two groups of students make performance of taking care of patients in perioperative period.

 

Teaching Strategies:

The course will utilize a modular approach in small-size class to instruction. Teaching methods will include discussion, student presentations, case studies, scenario simulation, lecture and audio-visual materials such as films, video, and audio tapes.

Evaluation Methods:Evaluation will be based upon satisfactory completion of modules, active participation in classroom discussions, and course examinations including a comprehensive final test and quiz.

1. Attendance        10%

2. Class Performance  25%

3. Quiz             40%

4. Final test         25%

Textbook:

1.Smeltzer S.C. & Bare B. (2004). Chronic Illness. Textbook of Medical-Surgical Nursing (10th edition). Lippincott Williams & Wilkins.

2.尤黎明,吴瑛.内科护理学.第三版.北京:人民卫生出版社,2005.

3.Townsend, M.C. (2006). Psychiatric-mental health nursing: Concepts of care in evidence based practice (5th ed.). Philadelphia: F.A. Davis.

4.萧淑贞,王纯娟,刘玉云等.精神科护理概论:基本概念及临床应用. 台北: 华杏出版股份有限公司, 2010. (Xiao Shuzhen, Wang Chunjuan, Liu Yuyun, et. al.. Psychiatric Nursing: Concept and Practice. Taipei: Farseeing Publishing Group,2010.)

5.高玉玲等. 精神科临床护理导引:精神科个案护理. 台北:华杏出版股份有限公司,2000.

6.Deitra L Lowdermilk & Shannon E. Perry, Maternity & women’s health care, 8 edition, an affiliate of Elsevier, 2004

7.Michele R. Davidson, Marcia L. London, Patria A. Wieland Ladewig. Olds’ maternal-newborn nursing & women’s health across the lifespan, 8th edition, Prenrice hall, 2008

8.郑修霞,夏海鸥. 妇产科护理学, 第四版, 人民卫生出版社, 2006

9.陈月枝编著,实用儿科护理,华杏出版股份有限公司,2004年出版

10.曹伟新,李乐之。外科护理学。第4版,北京,人民卫生出版社,2006。

11.湖南医科大学附属湘雅医院。病人标准护理计划(外科分册)。第1版,长沙,湖南科学技术出版社,2002。

12.吴在德,吴肇汉。外科学。第六版,北京,人民卫生出版社,2004

13.李和惠,林丽秋,黄玉琪,吴碧云,林贵满。内外科护理学,第三版,台湾,华杏出版社,2010。

List of Recommended References:

Module 1

  1. Smeltzer S.C. & Bare B. (2004). Chronic Illness. Textbook of Medical-Surgical Nursing (10th edition). Lippincott Williams & Wilkins.
  2. http://www.rwjf.org
  3. 尤黎明,吴瑛.内科护理学.第三版.北京:人民卫生出版社,2005.
  4. 陆再英等.内科学.第七版.北京:人民卫生出版社,2008.
  5. http://www.who.int/chp/chronic_disease_report/part1/zh/index.html
  6. http://www.nihe.org.cn/
  7. http://www.tnbzy.com/default.html
  8. http://chinacdc.net/
  9. Brunner L.S. & Suddarth O.S. (1992). Textbook of Medical-Surgical Nursing (7th edition). Philadelphia: Lippincott, 1992
  10. 慢性非传染性疾病预防医学诊疗规范(试行).卫生部疾病控制司,2002.
  11. 中国慢性病报告.中华人民共和国卫生部疾病预防控制局,2006.
  12. Reinvention of Depression Instruments by Primary Care Clinicians. Baik SY.; Gonzales JJ.; Bowers B.J.; Anthony J.S.; Tidjani B.; Susman J.L. Reinvention of Depression Instruments. 2010, 8(3):224-230
  13. http://www.biomedcentral.com/1472-6963/10/95
  14. http://www.implementationscience.com/content/5/1/43

Module 2

  1. Mary C T. Essentials of psychiatric mental health nursing, 3rd ed. Philadelphia: F.A. Davis Company, 2004.
  2. Katherine M F. Psychiatric nursing care plans, 4th ed. St. Louis: Mosby, 2003.
  3. Katherine M F, Patricia A. Psychiatric mental health nursing, 3rd ed. St. Louis: Mosby, 2003.
  4. Sheila L V. Psychiatric mental health nursing, 3rd ed. Philadelphia: Lippincott, 2004.
  5. Patricia D. Barry. Psychosocial Nursing, 3rd ed. Philadelphia: Lippincott, 1996.
  6. Rawlins Williams Beck. Metal Health Psychiatric Nursing-A Holistic-Cycle Approach, 3rd ed. St. Louis: Mosby, 1993.
  7. 沈渔邨. 精神病学. 第5版. 北京:人民卫生出版社, 2009.
  8. 姚树桥,孙树礼. 医学心理学. 第5版. 北京:人民卫生出版社, 2008.
  9. 李小妹.精神科护理学—护理双语教材.北京:人民卫生出版社, 2006.
  10. 李峥,王志英.临床护理学:认知/感知. 北京: 中国协和医科大学出版社, 2002.

Movie

  1. 飞越疯人院
    1. away from her (Dementia)
    2. Rain man (Autism)
    3. Beautiful minds (struggle with Sch)
    4. Crazy heart (substance abuse)
    5. The Shrink (Self-awareness)
    6. The Big Blue (interpersonal relationship)
    7. The Legend Of 1900 (isolation from society)
    8. double faced
    9. seven-year itch

11. 阳光小美女

12. AVIATOR

13. Wit

14.偷心

15. Cancer

Module 3

  1. 李和惠,林丽秋,黄玉琪,吴碧云,林贵满. 内外科护理学,第三版,台湾,华杏出版社,2010
  2. 尤黎明,吴瑛.内科护理学.第4版. 北京:人民卫生出版社,2006
  3. 曹伟新,李乐之. 外科护理学, 第4版, 北京: 人民卫生出版社, 2006
  4. 湖南医科大学附属湘雅医院, 病人标准护理计划(内科分册), 第1版, 长沙: 湖南科学技术出版社, 2002
  5. 焦广宇. 临床营养学,人民卫生出版社,2007
  6. 陈月枝,实用儿科护理,第3版,华杏出版社,2004
  7. Smeltzer, S.C., Bare, B. G., Hinkle, J. L. Cheever, K. H. Brunner and Suddarth's Textbook of Medical-Surgical Nursing. 11th edition, Lippincott Williams & Wilkins , 2008.

Module 4

1.    曹伟新,李乐之。外科护理学。第4版,北京,人民卫生出版社,2006。

2.    湖南医科大学附属湘雅医院。病人标准护理计划(外科分册)。第1版,长沙,湖南科学技术出版社,2002。

3. 吴在德,吴肇汉。外科学。第六版,北京,人民卫生出版社,2004

4. 李和惠,林丽秋,黄玉琪,吴碧云,林贵满。内外科护理学,第三版,台湾,华杏出版社,2010。

5. Smeltzer, S.C., Bare, B. G., Hinkle, J. L. Cheever, K. H. Brunner and Suddarth's Textbook of Medical-Surgical Nursing. 11th edition, Lippincott Williams & Wilkins 2008.

6. http//:www.orlive.com

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