Introduction

Nursing 528: Advanced Nursing Practice: Older Adults is part of a program of study leading to an Advanced Graduate Diploma: Advanced Nursing Practice or the Master of Nursing degree.

In NURS 528, students study the primary health care principle of appropriate technology and the community development principle of healthy public policy.

Students learn to provide primary health care, including clinical services, to older adults. Students study wellness counselling of healthy older adults, management of their acute and chronic conditions, and referral of conditions requiring management by other health professionals. Students consider community implications of health concerns of older adults. Students examine trends in the health of older adults, explore issues in the care of older adults, and examine the research agendas of centres investigating health of older adults.

Students complete 140 hours in the clinical practicum focusing on the health of older adults.

Course Goals

After completing this course, students should be able to:

1. critically analyze the primary health care and community development principles of appropriate technology and healthy public policy, and discuss how these influence the health of clients;
2. critically evaluate the appropriateness of technology used with clients;
3. identify strategies for technology assessment within their health region;
4. identify strategies that can be used to influence the creation of healthy public policies;
5. provide evidence-based clinical services to well older adults and to those presenting with acute and chronic health concerns, at a level appropriate to a beginning practitioner, including:
   1. health history and physical examination
   2. clinical decision-making
   3. ordering of laboratory and diagnostic tests
   4. prescription of medications
   5. therapeutic communication
   6. collaborative relationships;
6. refer, to other health professionals, older adults with health concerns that exceed the scope of practice of a beginning practitioner offering extended health services;
7. demonstrate integration of medical and nursing management of health concerns of older adults;
8. synthesize community assessment data to develop inferences about:
   1. influences of public policies on the health of a community’s members
   2. influences of health care technology on the health of a community’s members
   3. community vulnerabilities and strengths in relation to the health of older adults
   4. the status of a community’s health in relation to older adults;
9. discuss issues and trends that affect the health of older adults in a community;
10. review Internet-based sources of information about evidence-based health care with older adults;
11. suggest areas for research in advanced nursing practice with older adults.

Course Materials

NURS 528 comprises online, print-based, and electronic mobile course materials.

Online Materials

• Introduction: Provides essential information about the course materials, the design of the course, and the procedures you should follow to complete the course successfully.
• Schedule: Outlines the timing of course activities
• Units: There are seven units in this course.
• Assessment: Outlines the assignments/evaluation procedures of the course.
• Reference: Listing of required readings, websites, and citations included in the units.
• Clinical Practicum: Explains how to complete the clinical practicum requirements of the course.
• Community Health Component: Explains how to complete the community assessment requirements of the course.

Print Materials

The following textbook is used in this course.

Ham, R., Sloane, P., Warshaw, G., Bernard, M., & Flaherty, E. (2007). Primary care geriatrics: A case-based approach (5th ed.). Philadelphia: Mosby.

Mobile Electronic Materials

Kennedy-Malone, L., Fletcher, K., & Plank, L. (2004). NPGeriatric for PDAs, Management guidelines for nurse practitioners working with older adults (2nd ed.). Philadelphia: F. A. Davis.

Other Materials

Textbooks, mobile resources, and readings from other Advanced Nursing Practice courses will be used as appropriate.

Course Structure

In this course, you will access health-related websites worldwide. You will also participate in email and computer conferencing with other students. Students are expected to connect to an Internet Service Provider at their own expense.

Technical Requirements

Computer System

In order to successfully complete this course, you must own or have ready access to certain computer hardware and software programs. For complete and up-to-date information on the minimum computer requirements required to complete the graduate nursing courses, visit the Centre for Nursing and Health Studies technical site.

Course Outline

NURS 528 consists of the following 7 units:

Unit 1: Clinical Practicum and Community Assessment: Processes and Requirements
Unit 1 provides an overview of the processes and requirements of the clinical practicum and community assessment of Nursing 528: Advanced Nursing Practice: Older Adults. As well, the unit poses questions for you to consider during your clinical practicum and community assessment, about the health status of women and the influence of technology and public policy on health status.

Unit 2: Primary Health Care and Nurse Practitioners: Appropriate Technology
Unit 2 opens with a discussion of the definition of technology and of what is considered to be “appropriate” technology. The unit then examines technology from two perspectives: the use of health and information technologies in client care, and the influences of technology on the development and delivery of nursing and health care services.

Unit 3: Community Development and Nurse Practitioners: Healthy Public Policy
Unit 3 explores the community development principle of healthy public policies. Unit 3 discusses the history of healthy public policy and development of healthy public policies by various levels of government and non-governmental organizations. The relevance of healthy public policies for vulnerable groups is studied. The unit closes with study of strategies through which nurses can influence the creation of healthy public policies.

Unit 4: Well Older Adults
In Unit 4 students focus on advanced nursing assessment skills in the delivery of clinical services to well older adults. Students learn about counselling, education, and prevention of diseases that are common in health care of older adults.

Unit 5: Older Adults with Acute Presentations
In Unit 5 students study acute conditions that may present in older adults and consider a framework for assessing older adults with acute illness. Treatment and management strategies are also discussed.

Unit 6: Older Adults with Chronic Presentations
Unit 6 examines several chronic illnesses that occur during older adulthood. The major categories of illness discussed in this unit include cognitive impairment, diabetes, cardiac problems of congestive heart failure and hypertension, altered mobility, and sensory impairment. The effects of these conditions on the functional health patterns are considered.

Unit 7: Issues, Trends and Research in Older Adult Health
In this unit, students study ethical decision-making in regard to the health of older adults, including issues related to death and dying and elder abuse. As well, students explore issues and trends that influence the health of older adults in their own communities and explore resources for research regarding the health of older adults.

Assessment Structure

The assessment structure for NURS 528 is based on the following course activities, with the percentage weighting of each activity as indicated. The final grade for the course is a composite mark based on your performance on these course activities.

In order to pass NURS 528, you must achieve a minimum mark of 60% on each element of the assessment structure (conference participation, written assignments, and average mark on the midterm exam and the final exam). That is, you must achieve a minimum mark of 60% (12/20) on conference participation, a minimum average mark of 60% (24/40) on the written assignments, and a minimum average mark of 60% (24/40) on the mid-term exam and final exam.

In addition to these activities, you must receive a satisfactory evaluation of the clinical practicum.

If the minimum mark is not achieved on any element of the assessment structure (conference participation, written assignments, exams or clinical practicum), then a failing grade will be assigned for NURS 528. If the student re-registers in NURS 528, then all elements of the course must be repeated (conference participation, written assignments, exams and clinical practicum).

Conference Participation (20%)

Feedback regarding conference participation will be ongoing. Quality of input (not quantity) is the goal. Feedback will focus on the student's ability to provide organized and original contributions that reflect analysis and synthesis of the material presented.    

Participation Criteria

Participation will be measured against the following criteria:

1. Complete online contributions during the unit conference timeframe.
2. Respond to online discussions at least twice each week.
3. Contribute original thoughts or ideas to online discussions.
4. Cite relevant resources to validate points made.
5. Demonstrate openness to divergent points of view.
6. Be respectful of the perceptions of others.
7. Integrate material from previous units to formulate ideas and generate dialogue.
8. Present responses that follow the rules of grammar and spelling in the online contributions.

Assignment 1: Functional Health Patterns and the Well Older Adult (10%)

Assignment 1 is a scholarly paper centered on Marjorie Gordon's Functional Health Patterns and the well older adult.  The assignment allows students to choose one functional health pattern and discuss its relevance to the well older adult.

Assignment 2: Community Health Development Record (10%)

Assignment 2 consists of completing the NURS 528 Community Health Development Record.

Assignment 3: Older Adult Health: A Case Study (20%)

Assignment 3 consists of a written case study involving an older adult. The case study begins with examination of the client and continues through management of the client's health concerns.  The case study has been designed to test the student's critical thinking, clinical problem-solving, and integration of nursing and medical knowledge in the provision of comprehensive family-centered, community-based care.

Midterm Examination (15%)

The course includes a midterm exam consisting of 20 multiple choice questions

Final Examination (25%)

The course includes a midterm exam consisting of 40 multiple choice questions.