Teaching code

4S000109

Teacher

Sebastiano Fogolin

Credits

2

Language

Italian

Scientific Disciplinary Sector (SSD)

MED/45 - NURSING

Period

INF VI - 2° anno 2° sem dal Apr 27, 2020 al Jun 26, 2020.

Lessons timetable Moodle Seminars

To show the organization of the course that includes this module, follow this link:  Course organization

Learning outcomes

The course of Clinical Nursing in Chronic conditions aims to provide student Knowledge in order to analyze and understand the problems of care and the areas of vigilance connected to the main chronic degenerative diseases, in different stages of trajectory of the disease, with particular reference to chronic phase. Describe and analyze interventions aimed at the management of these problems and the development of self-care skills with a view to continuity in the different care settings and in the different phases of the disease.

Program

Introduction. Noncommunicable diseases and the management of chronic patients

- The noncommunicable disease’s impact on health systems and economy, through the analysis of epidemiologic data, national recommendations and local experiences
- The definitions of: noncommunicable disease, disability and fragility according with the World Heath Organization, the Italian Department of Health and some recognized scientific societies
- Principles of the Chronic Care Model for taking care of the chronic patients and the fundamentals of care centered on people and their families.

First part. Three issues of caring in the chronicity

1) The cognitive function alteration and his impact on caring:
- aphasia: definition, physiopathology, assessment and rehabilitative strategies on nursing
- neglect: definition, physiopathology, assessment and rehabilitative strategies on nursing
- delirium: definition, assessment tools, analysis of the prognostic factors, caring strategies

1.2) The management of the oral therapy on patient with cognitive problems
- the refusal by the patients: epidemiological framework and implication through the comment of some results of studies conducted in some Italian rest homes.

2) Dysphagia and his functional impact on patients:
- dysphagia: definition, physiopathology and assessment
- dysphagia and malnutrition: definition of malnutrition, diagnostic criteria, risk factors and management

2.2) Focus on feeding the person with dysphagia and alteration of the cognitive function
- feeding people with dysphagia: rehabilitative and educative strategies
- feeding people with cognitive impairments living in Italian rest homes: organizational framework
- caring strategies to manage the feeding of elderly people with dementia

2.3) The oral therapy of people with dysphagia
- The enteral nutrition: devices managements, administration strategies of the meal, prevention of the complications and the therapy administration.

3) The mobility alterations and their functional impact on patients:
- the mobility alteration: definitions, physiopathology, assessment and rehabilitative strategies
- the hospitalization related disability: framework, practical implications, the rehabilitation planning in nursing
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3.1) Focus on prevention and management of falls
- risk factors and prognostic factors of falls on elderly patients
- preventive interventions and management of a fallen person

Second part. Nursing in the chronicity

4) Caring the person with stroke and his family:
- the PDTA (Percorso Diagnostico Terapeutico Assistenziale) in Friuli Venezia Giulia, a clinical pathway example for patients with stroke
- the Stroke Care in the acute phase through the analysis of the recommendations contained in the most recent international Guide Lines
- the Stroke Care in the chronic phase: principals three-months and one-year outcomes and future challenges on rehabilitation of patients with stroke

4.1) Focus on education of the patient with stroke in the discharging phase:
- an example of a educative project: witch patient are eligible for a educative intervention, witch information are better to give, how verify the given information

5) Caring the person with Parkinson’s disease and his family:

- the therapy management during the hospitalization and the daily life at home
- the clinical pathway of a patient undergoing the intervention of deep brain stimulation

6) Caring the person with dementia and his family:

- clinical framework and behavioral manifestations in the different kinds of dementia
- the impact of dementia in hospitals and rest homes and restraint related issues
- Gentle Care and future challenges through the Golgi Istitute experience and the documents of the Italian Network Non Autosufficienza

7) Caring the person with Diabetes Mellitus and his family

- the management of diabetes patients: self-therapy-management, physical activity and prevention of the complications

Examination Methods

Written exam with closed questions with multiple choice answers, or open short answers and oral exam.
The written test will consist of 15 questions that will cover all the contents of the program, the questions will be constructed mainly with mini-cases / situations in order to assess the level of acquisition of the theoretical content and the student's ability to apply such content to situations of clinical practice, e.g. decision-making, problem-solving, ...
The written exam is considered outdated if the student correctly answers 10 out of 15 questions.
Access to the oral exam is limited to passing the written test.
The oral exam will assess the student's argumentative ability to present in a clear and logical way one of the topics of the program and the capacity for clinical reasoning applied to situations of clinical practice referred to the topics of the program.