CARDIAC CARE: HEART FAILURE ASSESSMENT AND MANAGEMENT - 7KNIM749 Level: 7 Credits: 15 credits Module leader: Amanda McNaughton Tel: 020 7848 3679 Email: Amanda.mcnaughton@kcl.ac.uk Module deputy: Dr Ehsan Khan Tel: 020 7848 3509 Email: eu.khan@kcl.ac.uk Academic support is offered by the module leader and teaching team. Amanda McNaughton. 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. 1
Contents Module overview... 3 Module aim... 3 Learning outcomes... 3 Teaching arrangements... 3 Submitting coursework... 4 Assessment criteria... 4 Formative assessment... 4 Summative assessment... 4 Results and resubmissions for coursework... 5 Learning resources... 6 Week 1 Learning Outcomes... 6 Defining Heart Failure... 6 Incidence & Co-morbidities... 6 Week 2 Learning Outcomes... 7 Principles of Assessment... 7 Respiratory assessment... 7 Respiratory Assessment/Classroom... 7 Cardiovascular Assessment... 7 Week 3 Learning Outcomes... 8 Renal Dysfunction... 8 Pharmacology... 8 Week 4 Learning Outcomes... 9 Palliative Care... 9 Electrical devices... 9 Indicative Reading... 10 Module evaluation... 12 Action from previous evaluations... 12 Timetable... 13 2
Module overview This module forms part of the MSc Advanced Practice. The module contributes to your programme of study. The module can also be taken as a freestanding module. Module aim This module will enable students to perform an expert assessment of patients with heart failure. This assessment will inform their understanding of the advanced management of heart failure. Learning outcomes This course will equip practitioners to carry out advanced cardiac assessments and develop an expert knowledge of the management of patients in the hospital and community setting. Practitioners will: 1. Demonstrate an advanced understanding of the theoretical and clinical basis of physical examination and history taking for heart failure patients 2. Demonstrate an expert ability to analyse and interpret complex assessment data and to discriminate between normal and abnormal findings in heart failure. 3. Critically apply diagnostic reasoning to differential diagnosis and clinical decision making 4. Demonstrate an advanced understanding of pharmacology and therapeutics as they relate to patients with heart failure 5. To have an expert understanding of the principles of clinical management as they apply to patients at different stages of heart failure Teaching arrangements A variety of teaching strategies will be used throughout the module. This module uses a blended learning approach. E-learning will incorporate pathophysiology, systematic, structured history taking and will also include areas to build on for the taught classroom sessions. Included are: Lectures Directed reading Student presentations Guided study E-learning The taught sessions will include a systematic and structured approach to physical examination e.g. inspection, palpation, percussion and auscultation. You will be expected to examine each other during the supervised practice sessions. Throughout the module lecturers will provide supervision and advice. In your own clinical setting you will be required to undertake and document histories and clinical examinations of clients/ patients for each system. An appropriate clinical supervisor will be required. (Details around this can be found on the module website assessors guide, or ask the module leader) 3
Submitting coursework Portfolio of learning. All parts of the assessment must be completed and submitted. Failure to submit assignments will result in a fail grade being awarded. For this module you are assessed by Amanda McNaughton/Dr Ehsan Khan. Assessment criteria Portfolio of learning. Formative assessment Part A-The assessment will comprise of a portfolio demonstrating 1 assessment of a patient with heart failure. Summative assessment Part B-Based on your assessment critically analyse how you used the information to inform your nursing assessment and management using evidence. (2000 words). In your portfolio you should also submit your formative exercise. Coursework submission 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. 4
Submission date for coursework: 18 July 2017; 11.59am 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 JCMB. 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 TBC. Students are not to make direct contact with external examiners, in particular regarding their individual performance in assessments. The College and its Examination Boards in the ten Faculties (Institutes/Schools, King's Learning Institute and the Association of King's College (AKC), work with over 500 external examiners to ensure the quality and standard of our taught awards. Find the latest report on the External Examiners Report page, navigate to the Faculty of Nursing and Midwifery section. 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 Amanda McNaughton. 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 re-submit your work. Resubmission date: 17 October 2017 5
Learning resources Week 1 Learning Outcomes 9 May Defining Heart Failure By the end of the session students will: Have a critical understanding of definitions of heart failure Have an understanding of the presentations of heart failure and be able to apply expert reasoning Be able to demonstrate an expert knowledge of the aetiology of heart failure Be able to demonstrate an advanced awareness of the challenges to providing care for this complex patient group. Incidence & Co-morbidities By the end of the session students will be able to: Critically discuss the incidence of heart failure and demonstrate an advanced understanding Expertly apply the incidence and co morbidities to their local area of practice. Demonstrate an advanced understanding of co morbidities that can accentuate heart failure based treatments Apply evidence based practice to the evaluation of heart failure management 6
Week 2 Learning Outcomes 30 May Principles of Assessment By the end of the session students will be able to: Critically analyse the interpersonal skills required to conduct a patient assessment Understand and have practiced the skills required to undertake An expert systematic structured history Demonstrate an advanced knowledge when analysing data enabling differential diagnosis in patients with heart failure Be aware of the knowledge and skills required for developing an expert management plan Respiratory assessment E-learning Understand the principles of history taking focussing on respiratory assessment in heart failure Understand the principles of documenting a respiratory assessment Undertake a written history of a patient presenting with a respiratory problem related to heart failure Apply relevant pathophysiology to the patients data collected Respiratory Assessment/Classroom By the end of this section the student will be able to: Apply the principles of advanced clinical examination to an assessment of the respiratory system Demonstrate an expert knowledge of normal /abnormal breath sounds Critically apply and advanced understanding of common respiratory signs and symptoms, applying this to taking a history and physical assessment of a patient with heart failure Critically apply differential diagnosis for a patient presenting with heart failure Accurately document an advanced respiratory assessment Cardiovascular Assessment By the end of this section the student will be able to: E-learning Understand the principles of history taking focused on the cardiovascular system Understand the principles of documenting a cardiovascular assessment Undertake a written history of a patient presenting with heart failure Apply relevant pathophysiology to the patients data collected Classroom Apply the principles of clinical examination to an advanced assessment of the cardiovascular system Demonstrate an expert knowledge of normal and abnormal heart sounds commonly found in heart failure Critically apply an advanced understanding of common cardiovascular signs and symptoms, applying this to taking a history and physical assessment of the patient with heart failure Critically apply differential diagnosis for a patient presenting with heart failure Accurately document an advanced cardiovascular assessment Have an expert understanding of normal variants for patients with heart failure 7
Week 3 Learning Outcomes 20 June Renal Dysfunction By the end of this session the student will be able to: Demonstrate an advanced knowledge of Chronic Kidney Dysfuntion (CKD)in patient with heart failure Have an advanced understanding of the aetiology of CKD related to heart failure To understand the both the pathological and clinical relationship between heart failure and kidney disease To examine all 5 stages of the cardiorenal syndrome To identify and discuss the management of cardiorenal syndrome with the assistance of case studies. Pharmacology By the end of this session the student will be able to: Demonstrate an advanced knowledge of national and international policies and guidelines related to medications in patient with heart failure Have an advanced understanding of the principle drug actions related to heart failure Have an expert understanding of why some medications may not be appropriate for patients with heart failure Demonstrate an expert knowledge of the practical considerations that influence concordance with heart failure medications and challenges faced 8
Week 4 Learning Outcomes 4 July Palliative Care By the end of this session the student will be able to: Demonstrate an advanced understanding of the intricacies that challenge the provision of palliative care in heart failure Demonstrate an expert knowledge of palliative care in heart failure Critically evaluate currently used care modalities Have an expert understanding of relevant available services and resources Electrical devices By the end of this session the student will be able to: Have an expert understanding of the use of electrical devices in patients with heart failure Have an advanced understanding of the implications of electrical devices to the user Have an expert understanding of policies and guidelines that may impact upon electrical devices Demonstrate an expert knowledge of contributing factors to post implantation complications 9
Indicative Reading Blann A. (2006) Routine blood results explained: A guide for nurses and allied health professionals. M&K, Cumbria. Bickley L.S. & Szilagyi P.G. (2007) Bates Guide to Physical Examination and History Taking.10 th ed. Lippincott, Williams & Wilkins, Philadelphia. Brown et al (2008) Heart Sounds Made Easy. 2 nd ed. Churchill Livingstone, London. Corne et al (2009) Chest X-ray Made Easy. 3 rd ed. Churchill Livingstone, London. Cox C. (2004) Physical Assessment for Nurses. Blackwell Publishing, Oxford. Cross S. (2002) Nurse Practitioner Manual of Clinical Skills. Bailliere Tindall, London in association with RCN. Dimond B. (2005) Legal Aspects of Nursing. 5 th ed. Pearson Longman, Harlow. Douglas G., Nicol F. & Robertson C. (2009) Macleod s Clinical Examination. 12 th ed. Churchill Livingstone Elsevier, London. Ellenbogen K. & Wood M. (2008) Cardiac Pacing & ICDs. 5 th ed. Blackwell Publishing, Oxford. Epstein O., Perkin D.G., de Bono D.P. & Cookson J. (2008) Clinical Examination. 4 th ed. Churchill Livingstone Elsevier, London. Gill D. & O Brien N. (2002) Paediatric Clinical Examination Made Easy. 4 th ed. Churchill Livingstone, Edinburgh. Gray D. & Toghill P. (2001) An Introduction to Symptoms and Signs in Clinical Medicine. Arnold, London. Hopcroft K. (2003) Symptom Sorter. 2 nd ed. Radcliffe Medical, Oxon. Jarvis C. (2008) Physical Examination and Health Assessment. 4 th ed. Saunders, Philadelphia. Jevon P. (2009) Clinical Examination Skills. Wiley Blackwell, Oxford. Johnson G. (2000) The Minor Illness Manual. 2 nd ed. Radcliffe Press, Oxon. Lloyd M. & Bor R. (2004) Communication Skills for Medicine. 2 nd ed. Harcourt, London. Levick, J.R. (2009) An Introduction to Cardiovascular Physiology. 5 th ed. Hodder Arnold, London. Marieb E.N. & Hoehn K. (2007) Human Anatomy and Physiology. 7 th ed. Pearson Benjamin Cummings, San Francisco. McCance K.L. & Huether S.E. (2006) Pathophysiology: the biological basis for disease in adults and children. 5 th ed. Elsevier Mosby, St Louis. Murray S.E. & White B.S. (1999) Critical Care Assessment Handbook. Saunders, Philadelphia. NICE Guidelines (2010) Chronic heart failure management in primary and secondary care. Clinical guideline 108. www.nice.org.uk accessed (15 Aug 2011). Rafferty A.T. & Lim E. (2005) Churchill s Pocket Book of Differential Diagnosis. 2 nd ed. Elsevier Churchill Livingstone, Edinburgh. 10
Rawles Z., Griffiths B., Alexander T. (2010) Physical Examination Procedures for Advanced Nurse and Independent Prescribers: Evidence and rationale. Hodder Arnold, London. Rushforth H. (2009) Assessment Made Incredibly Easy. UK ed. Lippincott Williams and Wilkins, London. Skinner S. (2005) Understanding Clinical Investigations: A Quick Reference Manual. 2 nd ed. Bailliere Tindall, London. Tortora G.J. & Derrickson B. (2006) Principles of Anatomy and Physiology. 11 th ed. John Wiley, New York. Weber J. (2005) Nurses Handbook of Health Assessment. 5 th ed. Lippincott Williams & Wilkins, Philadelphia. Woods S.L., Sivarajan Froelicher E.S. & Underhill Motzer S. (2009) Cardiac Nursing. 5 th ed. Lippincott, Philadelphia. 11
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 1. Less assessment ACTION: This has been implemented from 2016. 12
Timetable Teaching Mode Date University based study 9 May 2017 Term 3 Timetable: Cardiac Heart: Failure Assessment and Management (7KNIM749) Type of session Lecture 1 Introduction to the module and heart failure. 09:30-11:00 Title Time Room Lecturer FWB G80 Amanda McNaughton Winnie Nwosu Lecture 2 Heart failure 11:30-13:00 Dr Ehsan Khan Lecture 3 Comorbidities 14:00-16:00 FWB 5.132 Frances Szuminska Self-directed study 16:00-17:00 University based study 30 May 2017 Lecture 1 Principles of Assessment 09:30-10:00 Lecture 2 Respiratory Assessment & cardiac assessment 10:15-12:00 Lecture 3 Practical assessment 13:00-16:00 Self- directed study 16:00-17:00 CSC 1.6 Amanda McNaughton University based study 20 June 2017 Lecture 1 Heart Failure and Renal disease 10:00-13:00 FWB G80 Annette Davis Lecture 2 Pharmacology 14:00-16:00 FWB 5.132 Dr Ehsan Khan Self- directed study 16:00-17:00 University based study 4 July 2017 Lecture 1 Palliative care 10:00-12:00 Lecture 2 Electrical devices 12:00-13:00 Lecture 3 Student formative presentations 14:00-15:00 Assignment guidelines & Evaluation 15:30:1600 Self- directed study 16:00-17:00 FWB G80 FWB 5.132 Joanna De Souza Amanda McNaughton Key: FWB Franklin-Wilkins Building; Waterloo Campus WBW Waterloo Bridge Wing; Waterloo Campus CSC Chantler SaIL Centre, Guy s Campus 13