anaesthetic nursing one - 6knic601 · journal of perioperative practice 16 (4), 187-190. khan e....

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Anaesthetic Nursing One - 6KNIC601 Level: 6

Credits: 15

Module leader: Sheila Turner

Tel: 020 7848 3217

Email: [email protected]

Academic support: The module teaching team consists of Sheila Turner.

Please do not hesitate to discuss any aspect of your programme with your module leader. I am only too happy to help in any way I can. We are very much aware of the pressures of working, studying and/or family commitments and we have, therefore, provided academic support and guidance throughout the module. The use of learning agreements jointly developed between your practice supervisor and you will encourage self-reliance and self-direction. It will enable you to negotiate the pace and depth of your work and facilitate the integration of theory and practice.

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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 [email protected].

mailto:[email protected]

https://login-keats.kcl.ac.uk/



https://internal.kcl.ac.uk/student/index.aspx

mailto:[email protected]

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Contents Module overview .......................................................................................................... 4

Module aim ............................................................................................................... 4

Learning outcomes ................................................................................................... 4

Teaching arrangements ............................................................................................ 5

Dates for examinations ............................................................................................. 5

Results and resits for examinations ......................................................................... 5

Journals .................................................................................................................... 8

Websites.................................................................................................................... 8

Directed study activities ........................................................................................... 8

Learning resources ....................................................................................................... 9

Day 1 ............................................................................................................................. 9

Session 1 — Learning outcomes & indicative reading .............................................. 9



Session 4 – Learning outcomes & indicative reading .............................................. 10



Day 2............................................................................................................................. 12

Session 1 & 2 — Learning outcomes & indicative reading ........................................ 12

Session 3 & 4 — Learning outcomes & indicative reading ....................................... 13



Day 3............................................................................................................................. 16

Session 1 & 2 ............................................................................................................. 16





Day 4 ............................................................................................................................ 19


Session 2 — Learning outcomes & indicative reading ............................................. 19




Session 6 ................................................................................................................... 22

3

Module evaluation ........................................................................................................ 26

Action from previous evaluations ............................................................................. 26

Timetable – 6KNIC601 ................................................................................................ 27

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Module overview This module forms part of the BSc Clinical Practice. The module contributes to your programme of study by forming the clinical focus of your degree.

The module can also be taken as a freestanding module.

Module aim The aim of this module is:

To critically analyse and evaluate the practice of anaesthetic nursing.

To establish a basis of professional knowledge and competence in the anaesthetic nursing care of adult patients that promotes logical decision making in the planning and delivery of care.

To promote the use of reflective practice in developing expertise in care delivery.

To review the evidence underpinning anaesthetic nursing and evaluate implications for current and future practice.

Learning outcomes By the end of this module you will be able to:

Select and critically evaluate relevant research in order to promote evidence-based practice (KSF-HWB1-10/IK1-3/G2).

Explore personal values, philosophy and the professional role with regard to the delivery of care to effectively meet the social, cultural, and spiritual needs of patients undergoing anaesthesia and surgery (KSF-HWB1-10/IK1-2/G2)

Demonstrate a detailed knowledge-base, for example, can detail the normal physiological parameters and recognizes and responds to changes/abnormalities in the vital signs values measured (KSF-HWB 1, 5 & 6, IK 1-3 and G 1)

Identify individual patient needs and plan/prepare to meet them i.e. selecting appropriate equipment/resources for each individual (KSF-HWB 1, 2, 4-8 & 10, EF 1, IK 1-3 and G 1).

Respond to complex patient and anaesthetist needs during anaesthesia; discuss potentially hazardous situations, which may occur, identifying appropriate actions (KSF-HWB 1, 2, 4-8, IK 1-3 and G 1).

Communicate appropriately and effectively with patients; as well as with members of the multidisciplinary theatre team: respecting and valuing the contributions of all theatre team members. Identify own contribution within the team as an autonomous practitioner (KSF-HWB 1, 2, 4-8, IK 1-3 and G 1).

Participate competently in the nursing care and management of obstetric clients undergoing anaesthesia (KSF-HWB 1, 2, 4-8, IK 1-3, EF 1 and G 1).

Participate competently in the nursing care and management of patients recovering from anaesthesia (KSF-HWB 1, 2, 4-8, IK 1-3 and G 1).

Recommend approaches to care, which have a proven evidence-base, referring colleagues to the sources of the best evidence for nursing care (KSF-HWB 1, 2, 4-8, IK 1-3 and G 1).

Identify your own strengths and weaknesses relevant to anaesthetic nursing care, recognizing limitations of practice/experience seeking advice/guidance where necessary (KSF-HWB 1, 2, 4-8, IK 1-3 and G 1).

Evaluate the most effective use of resources available, taking into account issues of cost-effectiveness, efficiency and quality assurance (KSF-HWB1, 2, 4, 5, 7-10, EF1-3, IK3, G3 & G7)

Critically appraise the professional, ethical and legal issues related to anaesthetic nursing (KSF- HWB1, 5-7, IK 3)

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Teaching arrangements Teaching and learning in this module will be a dynamic process actively involving all nurses. This reflects adult learning, with the aim of building upon your experience as a qualified nurses. We will be utilising a variety of educational approaches to facilitate development of creative and analytical thinking, self-awareness, problem solving and decision making skills.

Lectures and discussion

Independent study

Action learning set journal/reading exercises

Seminars and tutorials

Directed reading

Dates for examinations You will be notified of dates for examination on the Student Records section of the King’s Intranet.

Results and resits for examinations Unratified results from exams will be available on your KEATS module site 4 weeks from the date of the examination. Faculties are required from this academic year 2016/17 to make examination scripts available to any student who makes a request, free of charge. Any requests for examination scripts should still be managed in accordance with the Data Protection Act 1998. Students may request access to their exam paper at any time (after the Assessment Sub Board meeting) during their programme of study. This policy applies to all summative, unseen, written examinations. MCQs and OSCEs are exempt from this process.

Re-sit dates will available on your KEATS module site. If you are unsuccessful, it is recommended that you contact the module leader before submitting your second attempt or re-sitting your examination.

https://mykcl.kcl.ac.uk/?src=HPIcon

https://internal.kcl.ac.uk/index.aspx



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Learning resources & indicative reading

Aitkenhead A.R., Moppett I. & Thompson J. (2013) Smith and Aitkenhead’ s Textbook of Anaesthesia: Expert Consult. 6th ed. Edinburgh, Churchill Livingstone.

Allmann K. & Wilson I. (2011) Oxford Handbook of Anaesthesia. 3rd ed. Oxford University Press, Oxford.

Al-Shaikh B. & Stacy S.G. (2013) Essentials of Anaesthetic Equipment. 4th ed. Churchill Livingstone Edinburgh.

Arrowsmith V.A., Maunder J.A., Sargent R.J. & Taylor R. (2007) Removal of nail polish and finger rings to prevent surgical infection. Cochrane Database of Systematic Reviews 2007(2).

Aston D., Rivers A. & Dharmadasa A. (2013) Equipment in Anaesthesia and Critical Care: A Complete Guide for the FRCA. Scion, London.

Barker M. (1996) Should there be a nursing presence in the operating theatre? British Journal of Nursing 5 (18), 1134-37.

Brady M., Kinn S. & Stuart P. (2007) Preoperative fasting for adults to prevent perioperative complications. Cochrane Database of Systematic Reviews 2007(2).

Cox F. (2008) Perioperative Pain Management. Wiley-Blackwell, Oxford.

Creedon R. (2006) Cultural considerations and surgical consent. Journal of Perioperative Practice 16 (10), 505-509.

Cross M.E. & Plunkett E.V.E (2014) Physics, Pharmacology and Physiology for Anaesthetists: Key Concepts for the FRCA. Cambridge University Press, Cambridge.

Dimond B. (2015) Legal Aspects of Nursing. 7th ed. Pearson, London.

Ellis H. & Lawson A. (2013) Anatomy for Anaesthetists. 9th ed. Wiley-Blackwell, Oxford.

Farrell G.A. (2002) From tall poppies to squashed weeds*: why don’t nurses pull together more? Journal of Advanced Nursing 35 (1), 26-33.

Gan T.J. (2016) Postoperative Nausea and Vomiting: A Practical Guide. Cambridge University Press, Cambridge.

Gilmour D. (2007) HCAIs: a statutory code of practice in England and Wales… Healthcare-associated infections. Journal of Perioperative Practice 19 (6), 266-8, 270-1.

Hatfield A. (2014) Complete Recovery Room Book. 5th ed. Oxford University Press, Oxford.

Hayward J. (1975) Information: A Prescription for Recovery. RCN, London.

Hind M. & Wicker P. (2000) (Eds) Principles of Perioperative Practice Churchill Livingstone, London.

Hurley C. & McAleavy J. (2006) Healthcare challenges: preoperative assessment and intraoperative care planning. Journal of Perioperative Practice 16 (4), 187-190.

Khan E. (2006) Opioids - - factors governing central nervous system availability and implications for perioperative nursing a discussion paper. Journal of Advanced Perioperative Care 2 (3), 113-121.

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Lin T., Smith T., Pinnock C., & Mowatt C. (2016) Fundamentals of Anaesthesia. 4th ed -due for publication in November 2016. Cambridge University Press, Cambridge.

Middleton B., Phillips J., Thomas R. & Stacey S. (2012) Physics in Anaesthesia. Scion, Oxford.

Murgatroyd N. (2005) Patient advocacy in peri-operative practice. Journal of Operating Department Practice 2 (9), 14-16.

NHS Institute for Innovation and Improvement (2009) ‘The Productive Operating Theatre’ available from http://www.institute.nhs.uk/quality_and_value/productivity_series/the_productive_operating_theatre.html (last accessed 4 August 2016).

Nestel D. & Kidd J. (2006) Nurses’ perceptions and experiences of communication in the operating theatre: a focus group interview. BMC Nursing 5 (1), 1-9 from http://www.biomedcentral.com/1472-6955/5/1 (last accessed 4 August 2016)

Peck T.E. & Hill S. (2014) Pharmacology for Anaesthesia and Intensive Care. 4th ed. Cambridge University Press, Cambridge.

Pedersen T., Nicholson A., Hovhanissyan K., Møller A.M., Smith A.F. & Lewis S.R. (2014) Pulse oximetry for perioperative monitoring. Cochrane Database of Systematic Reviews doi: 10.1002/14651858.CD002013.pub3.

Rang H.P., Ritter J.M., Flower R.J. & Henderson G. (2015) Rang and Dale’s Pharmacology. 8th ed. Churchill-Livingstone, Edinburgh.

Roxburgh M., Gall P. & Leek K. (2006) A cover up? Potential risks of wearing theatre clothing outside theatre. Journal of Perioperative Practice 16 (1), 30-33.

Smith S., Scarth E. & Sasada M. (2011) Drugs in Anaesthesia and Intensive Care. Oxford University Press, Oxford.

Stirling L. (2006) Reduction and management of perioperative anxiety. British Journal of Nursing 15 (7), 359-361.

Tooley M. (2011) The Physics, Clinical Measurement and Equipment of Anaesthetic Practice for the FRCA. 2nd ed. Oxford University Press, Oxford.

Windell L. (2005) The peri-operative care of patients with specific anatomical, physiological and psychological needs. Journal of Operating Department Practice 2 (2), 22-27.

Woodhead K. & Fudge L. (2012) Manual of Perioperative Care: An Essential Guide. Wiley-Blackwell, Oxford. World Health Organisation (2009) World Alliance for Patient Safety: The Second Global Patient Safety Challenge: Safe Surgery Saves Lives, Geneva, World Health Organisation available from: http://www.who.int/patientsafety/safesurgery/knowledge_base/SSSL_Brochure_finalJun08.pdf (last accessed 4 August 2016).

Yentis S.M., Hirsch N.P. & Ip J.K. (2013) Anaesthesia and Intensive Care A to Z: An Encyclopaedia of Principles and Practice. 5th ed. Churchill Livingstone, Edinburgh.

You are also advised to explore the Cochrane database www.thecochranelibrary.com, which features research reviews summarizing the findings of peer-reviewed research.

http://www.institute.nhs.uk/quality_and_value/productivity_series/the_productive_operating_theatre.html

http://www.institute.nhs.uk/quality_and_value/productivity_series/the_productive_operating_theatre.html

http://www.biomedcentral.com/1472-6955/5/1

http://www.who.int/patientsafety/safesurgery/knowledge_base/SSSL_Brochure_finalJun08.pdf

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Journals Anaesthesia

Anaesthesia and Intensive Care Medicine (a recommended text, available as an e-journal)

AORN Journal

British Journal of Anaesthesia

British Journal of Perioperative Nursing

Journal of Advanced Perioperative Care

Recent Advances in anaesthesia and analgesia

Seminars in Perioperative Nursing

Websites www.aagbi.org www.barna.co.uk www.afpp.org.uk www.doh.gov.uk www.fleshandbones.com www.kcl.ac.uk/nmvc www.nmc-uk.org www.resus.org.uk www.rcoa.ac.uk http://highered.mcgraw-hill.com/sites/dl/free/0072437316/120060/ravenanimation.html (last accessed 4 August 2016)

Directed study activities It is student participation and collaboration which enrich the taught component of any module. While you should not share work you intend to submit for assessment; you could share references, for example, if one of you finds an article particularly useful, you could post the details for the rest of the group on the KEATS module page. During this module, your taught sessions are delivered 09.00-12.30, 13.30-17.00 you are expected to devote some of your own time to activities designed to further your understanding/improve your knowledge about anaesthetic nursing. You are also expected to invest a similar amount of time (i.e. as a minimum 2-3 hours) weekly (4-6 hours over two weeks) upon your own reading into/research about your specific role as an anaesthetic nurse caring for adult patients. During the majority of your study days, outside the taught sessions the time is your own to use towards your education about patient care before, during and after anaesthesia. However, you are provided with three workbooks to complete and e-learning activities to consider; all of which are voluntary, rather than compulsory. Designed to make you think beyond what is delivered in the classroom, all these activities should help you to make the connection between, in the A&P workbook for example, significant issues related to anatomy and physiology and pharmacology and what happens to the patient undergoing anaesthesia. Anaesthetic ‘Workbook’ activities are designed to add basic knowledge related to anaesthesia.

http://highered.mcgraw-hill.com/sites/dl/free/0072437316/120060/ravenanimation.html

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Learning resources

Day 1

Session 1 — Learning outcomes & indicative reading

Introduction to the module

Introduction to study and the assessment process

By the end of the session students will be able to:

• Adopt a critical stance to reading • Develop an understanding of all the requirements of the module.

Indicative reading

Cottrell S. (2013) The Study Skills Handbook. 4th ed. Palgrave, Basingstoke.


Introduction to anaesthesia

By the end of the session students will be able to define anaesthesia and outline the triad of anaesthesia and its significance in relation to be general and local anaesthetic techniques.

Indicative reading

Duke J. & Keech B.M. (2015) Anaesthesia Secrets. 5th ed. Saunders London.

Greig P. & Crabtree N. (2014) Introducing Anaesthesia. Oxford University Press, Oxford.

The Association of Anaesthetists of Great Britain and Ireland [AAGBI] (2012) Checking anaesthetic equipment 2012, London, AAGBI.

You could also have a look www.virtual-anaesthesia-textbook.com (last accessed 4 August 2016)

Session 3 — Learning outcomes & indicative reading Introduction to the drugs used in local and general anaesthesia exploring how anaesthesia is achieved

By then end of the session students will be able to:

• Name the drugs commonly used in anaesthesia • Identify how the major drug groups work • Outline the significance of this knowledge to anaesthetic nursing practice

Indicative reading

Lambert D.G. (2014) Mechanisms of action of general anaesthetic drugs. Anaesthesia and Intensive Care Medicine 15 (7), 318-320.

Rang H.P., Ritter J.M., Flower R.J. & Henderson G. (2015) Rang and Dale’s Pharmacology. 8th ed. Churchill Livingstone Edinburgh.

http://www.virtual-anaesthesia-textbook.com/

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Session 4 – Learning outcomes & indicative reading

Preparation for anaesthesia — environment, equipment needs.

Preparation for anaesthesia — patient. Simple troubleshooting. Difficult intubation.


Justify the way in which they prepare for every anaesthetic procedure.

Indicative reading

Al Shaikh B. & Stacey S. (2013) Essentials of Anaesthetic Equipment. 4th ed. Churchill Livingstone Edinburgh.

Charters S. & Charters P. (2014) Alternative techniques for tracheal intubation. Anaesthesia and Intensive Care Medicine 15 (5), 209-214.

Davey A.J. & Diba A. (2011) Ward’s Anaesthetic Equipment. 6th ed. WB Saunders, London.

Gardiner E. & Grindrod E. (2005) Applying cricoid pressure. British Journal of Perioperative Nursing 15 (4), 164-168.

Middleton B., Stacey S., Thomas R. & Phillips J. (2012) Physics in Anaesthesia. Scion Oxford.

Murray H. & Clayton T. (2012) Regurgitation and aspiration. Anaesthesia and Intensive Care Medicine 13 (12), 617-620.


Preoperative Patient assessment


Outline the desired features of comprehensive patient assessment prior to surgery.

Use a patient-centred approach to determine the patient’s physical and psychological requirements before any anaesthetic procedure

Identify those aspects of assessment results, which will require patient referral to the anaesthetist

Recognise the requirement for accurate documentation through a critique of the current ‘paperwork’ available to document assessment.

Indicative reading

Radford M., Evans C. & Williamson A. (2011) Pre-operative Assessment and Perioperative Management. M&K Update Ltd London.

The Association of Anaesthetists of Great Britain and Ireland (2010) Pre-operative assessment and patient preparation: the role of the anaesthetist 2 at: https://www.aagbi.org/sites/default/files/preop2010.pdf (last accessed 4 August 2016)

Zastrow S.L. (2009) Perioperative nursing assessments made simple OR Nurse 2010 3 (4), 16- 17

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Introduction to perioperative patient monitoring during anaesthesia


Explain why monitoring is so important

Prepare and commence vital signs monitoring

State the physiologic principals supporting vital signs monitoring

Identify common abnormalities in vital signs monitoring, due to the equipment

Identify common abnormalities in vital signs monitoring, due a change in patient condition

Indicative reading

Griffiths R.V. (2000) Anaesthesia: circulation and invasive monitoring. British Journal of Perioperative Nursing 10 (3), 167-71.

Hampton J.R. (2013) The ECG Made Easy. 8th ed. Churchill Livingstone, Edinburgh.

Higgins C. (1996) Principles and Practice of blood gas measurement. Nursing Times 92 (46), 45-47.

Jubran A. (1999) Pulse oximetry. Critical Care 3: R11-R17.

The Association of Anaesthetists of Great Britain and Ireland (2015) Recommendations for standards of monitoring during anaesthesia and recovery 2015. London, AAGBI.

Wycherly A.S. & Bembridge J.L. (2014) Monitoring techniques: neuromuscular blockade and depth of anaesthesia. Anaesthesia and Intensive Care Medicine 15 (6), 300-303.

http://www.ecgmadesimple.com/ (last accessed 4 August 2016)

http://www.capnography.com/new/index.php?option=com_content&view=article&id=164&Itemid=56v (last accessed 4 August 2016)

Directed study:

Write up notes from today’s sessions; add in material from your reading about the topics. Begin the A+P workbook and Anaesthesia workbook 1. Read all session materials available via KEATS in preparation for next week. Review neuromuscular physiology.

Please also explore the series of articles published in Australia about crisis management during anaesthesia available on the BMJ Quality and Safety website:

http://qualitysafety.bmj.com/collections/qshc_crisis_management_in_anaesthesia (last accessed 4 August 2016)

http://www.ecgmadesimple.com/

http://www.capnography.com/new/index.php?option=com_content&view=article&id=164&Itemid=56v

http://www.capnography.com/new/index.php?option=com_content&view=article&id=164&Itemid=56v

http://qualitysafety.bmj.com/collections/qshc_crisis_management_in_anaesthesia

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Day 2

Session 1 & 2 — Learning outcomes & indicative reading

Anaesthesia-induction and maintenance, will continue in next session


Define the indications for and actions of the commonly used induction agents.

Define MAC.

State the ways in which anaesthesia might be maintained.

Explain the principles of uptake and distribution of volatile agents.

State the factors affecting the choice of volatile agents.

Define emergence from anaesthesia.

Indicative reading

Chapman E. & O’Connor K. (2015) Induction of anaesthesia. Anaesthesia and Intensive Care Medicine 16 (8), 365-370.

Medlock R.M. & Pandit J.J. (2016) Intravenous anaesthetic agents. Anaesthesia and Intensive Care Medicine 17 (3), 155-162.

http://www.frca.co.uk/article.aspx?articleid=100634 (last accessed 4 August 2016) The Anaesthesia UK website article about intravenous anaesthetic agents.

Anaesthesia-induction and maintenance continued (contd)


Define the indications for and actions of the commonly used induction agents.

Define MAC.

State the ways in which anaesthesia might be maintained.

Explain the principles of uptake and distribution of volatile agents.

State the factors affecting the choice of volatile agents.

Define emergence from anaesthesia.

Indicative reading

Everett T. & Tattersall M. (2014) Maintenance of anaesthesia. Anaesthesia and Intensive care Medicine 15 (2), 51-55.

Hofer C., Zollinger A., Büchi S., Klaghofer R., Serafino D., Bühlmann S., Buddeberg C., Pasch T. & Spahn D.R. (2003) Patient wellbeing after general anaesthesia: a prospective, randomized, controlled multi-centre trial comparing intravenous and inhalation anaesthesia. British Journal of Anaesthesia 91 (5), 631-637.

http://www.frca.co.uk/article.aspx?articleid=100634

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Session 3 & 4 — Learning outcomes & indicative reading

Airway management and ventilation


Identify when assistance might be required to support breathing.

Simple adjuncts used to support the airway.

Recognise the ‘gold standard’ for airway management.

Simply outline the features and uses of flow vs. pressure generator ventilators.

Indicative reading

Brown B. & Roberts J. (2016) Principles of artifical ventilation. Anaesthesia and Intensive Care Medicine 17 (3), 120-132.

Calder I. (2014) Identification of the difficult airway. Anaesthesia & Intensive Care Medicine available at: http://ac.els-cdn.com/S1472029914001209/1-s2.0-S1472029914001209-main.pdf?_tid=6cbaf43e-1190-11e4-b0cc-00000aab0f26&acdnat=1406027452_d110770d586f1074dc6a51399ff58389 (last accessed 4 August 2016).

Calder I. & Pearce A. (2010) Core Topics in Airway Management. 2nd ed. Cambridge University Press, Cambridge.

De Beer J.M. & Gould T. (2013) Principles of artificial ventilation. Anaesthesia and Intensive Care Medicine 14 (3), 83-93.

Dolenska S., Dalal P. & Taylor A. (2004) Essentials of Airway Management. Greenwich Medical Media, London.

Dorsch J.A. & Dorsch S.E. (2008) Understanding Anaesthesia Equipment. 5th ed. Lippincott Philadelphia.

Finucane B.T., Sui B.C.H & Santora A.H. (2016) Principles of Airway Management. 4th ed. Springer-Verlag, New York.

Glick D.B. & Cooper R.M. (2016) The Difficult Airway: An Atlas of Tools and Techniques for Clinical Management. Springer London.

Hess D.R. & Kacmarek R.M. (2014) Essentials of Mechanical Ventilation. 3rd ed. McGraw-Hill London.

Orebaugh S.L. & Bigeleisen P.E. (2011) Atlas of Airway Management; Techniques and Tools 2nd ed. Lippincott Philadelphia.

http://ac.els-cdn.com/S1472029914001209/1-s2.0-S1472029914001209-main.pdf?_tid=6cbaf43e-1190-11e4-b0cc-00000aab0f26&acdnat=1406027452_d110770d586f1074dc6a51399ff58389



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Brief overview of neuromuscular physiology followed by Muscle relaxants and

Reversal of anaesthesia


Define activity at the motor end plate

Explain nervous conduction

Define ‘muscle relaxation’

State the drug choices to achieve ‘muscle relaxation’

Effectively care for patients requiring ventilatory support.

Explain the principles of ventilation.

Check and monitor ventilation effectiveness.

Define ‘reversal’ of anaesthesia

Describe inadequate reversal of anaesthesia.

Indicative reading

Farooq K. & Hunter J.M. (2014) Neuromuscular blocking agents and reversal agents. Anaesthesia and Intensive Care Medicine 15 (6), 295-299.

Fletcher A. (2011) Neuromuscular function and transmission. Anaesthesia and Intensive Care Medicine 12 (6), 245-248.

Fletcher A. (2014) Action potential: generation and propagation. Anaesthesia and Intensive Care Medicine 15 (6), 287-291.

Hopkins P.M. (2014) Malignant hyperthermia. Anaesthesia and Intensive Care Medicine 14 (6), 292-294.

Marieb E.N & Hoehn K.N. (2014) Human Anatomy and Physiology. 10th (Global) ed. Pearson London.

Wycherley A.S. & Bembridge J.L. (2014) Monitoring techniques: neuromuscular blockade and depth of anaesthesia. Anaesthesia and Intensive Care Medicine 15 (6), 300-303.

http://www.anaesthesiauk.com/SearchRender.aspx?DocId=76&Index=D%3a%5cdtSearch%5cUserData%5cAUK&HitCount=12&hits=3+4+d+e+1c+43+4e+4f+5e+64+72+85+ Anaesthesia UK resource about neuromuscular blockade and reversal (last accessed 4 August 2016)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789633/ Link for literature review about the use of Sugammadex. (last accessed 4 August 2016).

http://www.anaesthesiauk.com/SearchRender.aspx?DocId=76&Index=D%3a%5cdtSearch%5cUserData%5cAUK&HitCount=12&hits=3+4+d+e+1c+43+4e+4f+5e+64+72+85

http://www.anaesthesiauk.com/SearchRender.aspx?DocId=76&Index=D%3a%5cdtSearch%5cUserData%5cAUK&HitCount=12&hits=3+4+d+e+1c+43+4e+4f+5e+64+72+85

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789633/

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Patient positioning for surgery, the challenge of the bariatric patient


Define the common positions and their consequences

State safe positioning techniques

Conduct a risk assessment prior to every patient positioning situation.

Indicative reading

Brammer A. & Forrest M. (2014) Anaesthesia in the obese patient. Anaesthesia and Intensive Care Medicine 15 (10), 446-448.

O’Connor D. & Radcliffe J. (2015) Patient positioning in anaesthesia. Anaesthesia and Intensive Care Medicine 16 (11), 543-547.

http://www.frca.co.uk/article.aspx?articleid=100620 Anaesthesia UK Obesity and Anaesthesia (last accessed 4 August 2016)

http://ovucla.org/Patient_Positioning_During_Surgery.pdf (last accessed 4 August 2016)

http://www.virtual-anaesthesia-textbook.com/vat/position.htm (last accessed 4 August 2016)

Directed study:

Write up notes from today’s sessions; add in material from your reading about the topics. Complete Anaesthesia workbook 1 and begin Anaesthesia workbook 2. Read all session materials available via KEATS in preparation for next week.

http://www.frca.co.uk/article.aspx?articleid=100620

http://ovucla.org/Patient_Positioning_During_Surgery.pdf

http://www.virtual-anaesthesia-textbook.com/vat/position.htm

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Day 3

Submit your PAD to Sheila before the first session begins.

Session 1 & 2 Examination preparation.


Local anaesthesia


State the actions of common local anaesthetic agents

State the therapeutic effects and side effects of the common local anaesthetic agents.

Indicative reading

Beecroft C. & Davies G. (2016) Systemic toxic effects of local anaesthetics. Anaesthesia and Intensive Care Medicine 17 (4), 146-148.

Carroll C. (2002) Local anaesthetic techniques in ophthalmic surgery. British Journal of Perioperative Nursing, 12 (2), 68-70, 72-74.

Columb M.O. & Hartley R. (2014) Local anaesthetic agents. Anaesthesia and Intensive Care Medicine 15 (2), 83-87.

Hood P.A. (1996) Local Anaesthesia. British Journal of Theatre Nursing 6 (3), 19-22.

Martin-Duce A. (2002) A developmental history of local anaesthesia. Ambulatory Surgery, 9 (4), 187-9.

Odom J. (1996) Tips for RN-administered conscious sedation. Today’s Surgical Nurse 18 (5), 22-25.


Obstetric anaesthesia


Define the care required by an obstetric client

Identify the specific risks associated with the altered maternal anatomy and physiology

Explain Mendelson’s syndrome

Explain Sellick’s manoeuvre

Describe the complications of surgical intervention in the obstetric client

Consider the partner of the obstetric client

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Indicative reading

Ash C. & Flett G.G. (2016) Obstetric emergencies. Anaesthesia and Intensive Care Medicine 17 (8), 384-389.

Clayton R. & Abdulmajeed J. (2016) Failed intubation in obstetrics. Anaesthesia and Intensive Care Medicine 17 (8), 357-364.

Davidson R. & Cockerham R. (2016) General anaesthesia for operative obstetrics. Anaesthesia and Intensive Care Medicine 17 (8), 375-378.

Du Plessis H. & Johnstone C. (2007) Ethics and medico-legal aspects of obstetric anaesthesia. Anaesthesia and Intensive Care Medicine 8 (8), 337-339.

Gaiser R. (1998) Old concepts applied to new problems: the fetus as patient. Current opinion in Anaesthesiology 11 (3), 251-253.

Nour S. & Griffiths S. (2016) Obtaining consent for obstetric procedures. Anaesthesia and Intensive Care Medicine 17 (8), 408-410.


Spinal and Epidural anaesthesia


Define ‘epidural’ anaesthesia.

Define ‘spinal’ (also known as ‘sub arachnoid’ or ‘intrathecal’) anaesthesia.

Identify the equipment required

Identify the preparation and positioning required for the patient

Identify the risks and benefits associated with the two techniques

Identify the common side effects associated with these techniques and their treatment.

Indicative reading

Beecroft C.L. (2012) Spinal Anaesthesia. Anaesthesia and Intensive Care Medicine 13 (11), 545-547.

Chambers D.J. & Howells A.C.L (2016) Neurological complications in obstetric regional anaesthesia. Anaesthesia and Intensive Care Medicine 17 (4), 372-374.

Dale M.C. & Checketts M.R. (2016) Complications of regional anaesthesia. Anaesthesia and Intensive Care Medicine 14 (4), 175-178.

Emmett R.S., Cyna A.M., Andrew M. & Simmons S.W. (2010) Techniques for preventing hypotension during spinal anaesthesia for caesarean section. From: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002251.pub2/full (last accessed 4 August 2016).

Fischer B. & Bosch O.D. (2015) Does regional anaesthesia improve outcome after surgery? Anaesthesia and Intensive Care Medicine 16 (11), 574-577.

Fischer B. & Bosch O.D. (2015) Techniques of epidural block. Anaesthesia and Intensive Care Medicine 16 (11), 557-562.

Kimber Craig S.A. (2015) Regional anaesthesia for caesarean section and what to do if it fails. Anaesthesia and Intensive Care Medicine 17 (8), 365-368.

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002251.pub2/full

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The older client undergoing anaesthesia


Define the specific care required by the older client

Outline the risks associated with anaesthesia administration to the elderly

Define specific care needs of the older client during the perioperative period

Consider the associated problems of ageing-dementia, memory problems

Consider the partner/carer or significant other of the older client

Indicative reading

Horner J. (1993) The ageing client: a perioperative approach. Seminars in Perioperative Nursing 2 (4), 226 -230.

Maguire S.L. & Slater B.M.J (2013) Physiology of ageing. Anaesthesia and Intensive Care Medicine 14 (7), 310-312.

Oresanya L.B., Lyons W.L. & Finlayson E. (2014) Preoperative assessment of the older patient a narrative review. Journal of the American Medical Association 311 (20), 2110-2120.

Reilly M. (1997) Anaesthesia and the Elderly. Seminars in Perioperative Nursing 6 (1), 14-20.

Ruzicha S. (1997) The impact of normal ageing processes and chronic illness on perioperative care of the elderly. Seminars in Perioperative Nursing 6 (1), 3-13.

Directed study:

Write up notes from today’s sessions; add in material from your reading about the topics. Complete A+P workbook.

Assignment activity:

Following the exam preparation session today begin to prepare notes about the scenarios, then do the mock exam.

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Day 4


Emergency anaesthesia

Following last week’s discussion about the elderly client we will explore the example of emergency surgery for a ruptured Aortic aneurysm as an example of an emergency anaesthetic procedure upon a critically ill client.


Define the specific care required by the high risk client requiring urgent anaesthesia

Outline the risks associated with anaesthesia administration to the critically ill

Define specific care needs of the emergency client during the perioperative period

Indicative reading

Cheeseman M. & Maund A .(2016) Anaesthesia for the ruptured aortic aneurysm. Anaesthesia and Intensive Care Medicine 17 (5), 243-248.

Ghosh S.M. & McCullagh I.J. (2013) Anaesthesia for vascular emergencies. Anaesthesia and Intensive Care Medicine 14 (5), 204-207.

Leonard & Thompson (2008) Anaesthesia for ruptured abdominal aortic aneurysm. Continuing Education in Anaesthesia, Critical Care & Pain 8, 11-15

Prout J., Jones T. & Martin D. (2014) Editors; Advanced Training in Anaesthesia: The Essential Curriculum. Oxford University Press Oxford.

Theodosiou C.A., Loeffler R.E., Oglesby A.J., McKeown D.W. & Ray D.C. (2011) Rapid sequence induction of anaesthesia in elderly patients in the emergency department. Resuscitation 82 (7), 881-885.


Exploring the role of the recovery room nurse

Group discussion/seminar.

Indicative reading

Bolton J. & Russell W.J. (2001) Are nasal spectacles adequate for supplementary oxygen in patients after anaesthesia? International Journal of Nursing Practice 7 (4), 329-225.

Bradbury M. & Cruickshank J. (1995) Blood and Blood transfusion reaction. British Journal of Nursing 4 (15), 861-868.

Campbell I. (2009) Physiology of fluid balance. Anaesthesia and Intensive Care Medicine 10 (12), 595-596.

Dice S. & Coles C. (1995) Rewarming Hypothermic Post anaesthetic patients: A comparison between a water coil warming blanket and a forced air-warming blanket. Journal of Post Anaesthetic Nursing 10 (3), 155-158.

Fotheringham D. (1995) Post anaesthetic shaking. British Journal of Nursing 4 (15), 857-860.

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Jørgensen H., Wetterslev J., Møiniche S., Dahl J.B. (2015). Epidural local anaesthetics versus opioid-based analgesic regimens on postoperative gastrointestinal paralysis, PONV and pain after abdominal surgery. Cochrane Database Syst Rev. CD001893

Lockey D.J. & Nolan J.P. (1998) Care of the compromised airway. Care of the Critically Ill 14 (8), 255-9.

Loudon J.D. (2013) Regulation of fluid and electrolyte balance. Anaesthesia and Intensive Care Medicine 16 (6), 276-285.

O'Neill O, (2002) The efficacy of music therapy on patient recovery in the post-anaesthetic care unit. Journal of Advanced Perioperative Care 1 (1), 19-25.

Preston N. & Gregory M. (2015) Patient recovery and the post-anaesthesia care unit (PACU). Anaesthesia and Intensive Care Medicine. http://dx.doi.org/10.1016/j.mpaic.2015.06.015.

Redding N. & Plews D. (2016) Risks of perioperative blood transfusions. Anaesthesia and Intensive Care Medicine 17 (2), 74-78.

Watson-Miller S. (2005) Assessing the postoperative patient: Philosophy, knowledge and theory. International Journal of Nursing Practice 11 (1), 46-51.

Session 3 — Learning outcomes & indicative reading By the end of the session students will be able to:

Assess patients on admission to recovery using ABCDEFG

Plan and prioritise patient care during the immediate post-operative recovery period

Indicative reading Patil J.J. & Maloney D.G. (2014) Measurement of pulse oximetry, capnography and pH Anaesthesia

and Intensive Care Medicine 15 (11), 522-525.

Preston N. & Gregory M. (2015) Patient recovery and post-anaesthesia care unit (PACU). Anaesthesia

and Intensive Care Medicine 16 (9), 443-445.

Watson-Miller S. (2005) Assessing the postoperative patient: Philosophy, knowledge and theory.

International Journal of Nursing Practice 11 (1), 46-51.

Wright J. (2003) Introduction to pulse oximetry. British Journal of Perioperative Nursing 13 (11),

456-460.

Zeitz K. & McCutcheon H. (2006) Observations and vital signs: ritual or vital for the monitoring of

postoperative patients? Applied Nursing Research 19, 204-211

Monitoring and testing the critically ill patient, from the online Merck manual at: http://www.merckmanuals.com/professional/critical_care_medicine/approach_to_the_critically_ill_patient/monitoring_and_testing_the_critical_care_patient.html?qt=Monitoring and testing the critically ill patient&alt=sh (last accessed on 4 August 2016).

http://dx.doi.org/10.1016/j.mpaic.2015.06.015

21


Pain and PONV assessment


Conduct pain assessment.

Plan, administer and evaluate analgesic interventions.

Conduct PONV assessment

Plan, administer and evaluate antiemetic intervention.

Indicative reading

Blackburn J. & Spencer R. (2015) Post-operative nausea and vomiting. Anaesthesia and Intensive Care Medicine: http://dx.doi.org/10.1016/j.mpaic.2015.06.020

Hudspith M. (2016) Anatomy, physiology and pharmacology of pain. Anaesthesia and Intensive Care Medicine. Article ‘in press’ available from: http://ac.els-cdn.com/S1472029916300777/1-s2.0-S1472029916300777-main.pdf?_tid=3cd3d432-5a38-11e6-b594-00000aacb35e&acdnat=1470311006_48ea861c6e1ce7b680c05a39b665b7a9 Last accessed 4 August 2016

Green L. (2013) Assessment of acute and chronic pain. Anaesthesia and Intensive Care Medicine 14 (11), 488-490.

Jack E.S. & Baggott M. (2011) Control of acute pain in postoperative and post-traumatic situations and the role of the acute pain service. Anaesthesia and Intensive Care Medicine 12 (1), 1-4.

Pleuvry B.J. (2015) Physiology and pharmacology of nausea and vomiting. Anaesthesia and Intensive Care Medicine: http://dx.doi.org/10.1016/j.mpaic.2015.06.018.

Rockett M. & Wilson T. (2013) Acute pain management-New challenges. Anaesthesia and Intensive Care Medicine 14 (11), 477-479.

Green L. (2013) Assessment of acute and chronic pain. Anaesthesia and Intensive Care Medicine 14 (11), 488-490.



Identify the common complications associated with anaesthesia

Identify the nurse role in recognizing and managing the complications of anaesthesia

Indicative reading

Dale M.C. & Checketts M.R. (2016) Complications of regional anaesthesia. Anaesthesia and Intensive

Care Medicine 17 (4), 175-178.

Dice S. & Coles C. (1995) Rewarming Hypothermic Post anaesthetic patients: A comparison between

a water coil warming blanket and a forced air-warming blanket. Journal of Post Anaesthetic Nursing

10 (3), 155-158.

http://ac.els-cdn.com/S1472029916300777/1-s2.0-S1472029916300777-main.pdf?_tid=3cd3d432-5a38-11e6-b594-00000aacb35e&acdnat=1470311006_48ea861c6e1ce7b680c05a39b665b7a9



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Fotheringham D. (1995) Post anaesthetic shaking. British Journal of Nursing 4 (15), 857-860.

Lockey D.J. & Nolan J.P. (1998) Care of the compromised airway. Care of the Critically Ill 14 (8),

255-9.

Oxygen desaturation at:

http://www.merckmanuals.com/professional/critical_care_medicine/approach_to_the_critically_ill_patient/oxygen_desaturation.html (last accessed 4 August 2016)

Session 6

Review of learning to date.

Final discussion re: exam and setting up tutorial groups for those who wish to invest more time in preparing for the exam.

End of module evaluation.

Directed study:

Write up notes from today’s sessions; add in material from your reading about the topics. Complete Anaesthesia workbook 2.

http://www.merckmanuals.com/professional/critical_care_medicine/approach_to_the_critically_ill_patient/oxygen_desaturation.html

http://www.merckmanuals.com/professional/critical_care_medicine/approach_to_the_critically_ill_patient/oxygen_desaturation.html

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Submitting coursework/exam information

For this module you are assessed by multiple-choice unseen, scenario-based examination

Assessment criteria The examination will be focused upon the taught content of the module, combined with your learning from clinical practice. You will be provided with reference to one core text relevant to each section of the examination. Three clinical scenarios will be identified, you will be asked to answer questions relate to just two of the three scenarios during the examination.

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

Demonstrate a detailed knowledge-base, for example, can detail the normal physiological parameters and recognizes and responds to changes/abnormalities in the vital signs values measured.

Identify individual patient needs and plan/prepare to meet them i.e. selecting appropriate equipment/resources for each individual.

Respond to complex patient and anaesthetist needs during anaesthesia; discuss potentially hazardous situations, which may occur, identifying appropriate actions.

Communicate appropriately and effectively with patients; as well as with members of the multidisciplinary theatre team: respecting and valuing the contributions of all theatre team members. Identify own contribution within the team as an autonomous practitioner.

You must also complete and submit a Practice Assessment Document (PAD). In your PAD:

The document contains comprehensive user instructions; you and your mentor must read

and become acquainted with what is required to complete your assessment in practice.

For submission the PAD must be complete, with the minimum standard attained in every

aspect.

Formative assessment A mock examination will go live on KEATS on 26 October 2016; it will close at 23.59 on 6 November 2016. You will have a chance to explore the outcome of the mock during small group tutorials following the final study day of the module.

Summative assessment A 90-minute multiple choice, scenario-based examination. Exam instructions and information relating to hard-copy (PAD) submissions are provided on the KEATS module page. You will be provided with additional detail about the location of the examination at least six weeks before the week commencing 9 January 2017 in which the exam will take place. It is essential that you use your candidate number on all examinations/submissions. 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 attend the examination or submit the PAD please refer to the information in your programme handbook about “mitigating circumstances”.

http://keats.kcl.ac.uk/




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Examination date The examination will take place during the week beginning 9 January 2016.

PAD submission date Tuesday 17 January 2016 The external examiner for this module is Karen McCutcheon. 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. If you do not understand your mark please contact Sheila Turner.

To collect your PAD, which will be available from 14 February, 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. PADs and hard copy assignments will be retained for four weeks; if you have not

collected your assignment by then, it will be destroyed.

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.

https://internal.kcl.ac.uk/student/external-examiner-reports/index.aspx

https://internal.kcl.ac.uk/student/external-examiner-reports/index.aspx









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Re-submission date PAD resubmission: Tuesday 25 April 2017

Resubmitted work available for collection Wednesday 24 May 2017

Date for re-sit examination If you are unsuccessful, it is recommended that you contact the module leader before submitting your re-sitting your examination. The re-sit examination will take place during the week commencing 20 March 2017.

Results and re-sits for examinations Unratified results from exams will be available on your KEATS module site 4 weeks from the date of the examination.


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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 Module assessment was changed to an online multiple choice exam at student behest. This is the second year the module has been assessed by examination. All but one student passed at first attempt, needless to say, this form of assessment was largely positively received by the students. In the most recent module evaluation one respondent asked whether students might have their first lectures before beginning placements in anaesthesia; this feedback will be discussed at the module course management meeting in September 2016 when we will also discuss how to improve student participation in module evaluation.


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Timetable – 6KNIC601

Study day 1

Teaching mode

Date Type of Session

Title Time Lecturer Room

University based study

29

September 2016

Introduction Introduction to the module and assignment

09.00-10.00

Sheila Turner

FWB 1.62

Lecture Introduction to anaesthesia 10.00-11.00

Lecture Introduction to drugs for LA and GA 11.30-12.30 FWB 1.70

Lecture Preparation for anaesthesia 13.30-14.30

FWB 4.63 Lecture Preoperative patient assessment 14.30-15.30

Lecture Introduction to perioperative patient monitoring

15.45-16.45

Study day 2


13 October 2016

Lecture Anaesthesia-induction and maintenance

09.00-10.00

Sheila Turner

FWB 3.52 Lecture Anaesthesia-induction and maintenance continued

10.00-11.00

Lecture Airway management and ventilation 11.30-12.30

Lecture Airway management and ventilation contd

13.30-14.30 Nevin LT

St Thomas’ Hospital

Lecture Neuromuscular physiology, muscle relaxants and their ‘reversal’

14.30-15.30

Lecture Patient positioning, challenge of bariatrics

15.45-16.45

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Study day 3

Teaching mode

Date Type of Session

Title Time Lecturer Room


27 October 2016

PAD review

date, please

hand your

PAD in when

you arrive

and it will be

returned at

16.00

Seminar/ Discussion

Examination preparation 09.00-10.00

Sheila Turner

JCMB G14 Seminar/ Discussion

Examination preparation 10.00-11.00

Lecture Local anaesthesia 11.30-12.30

Lecture Obstetric anaesthesia 13.30-14.30

WBW 3/7 Lecture Spinal and epidural anaesthesia 14.30-15.30

Lecture The elderly client 15.45-16.45

Study day 4


10 November

2016

Lecture Emergency anaesthesia 09.00-10.00

Sheila Turner

FWB 2.40

Seminar/ Discussion

Exploring the role of the recovery room nurse

10.00-11.00

Lecture Post-operative assessment 11.30-12.30

Lecture Pain and PONV assessment 13.30-14.30

Lecture Post-operative complications 14.30-16.00

Discussion Learning to date and module evaluation

16.15-16.45

Location key:

FWB – Franklin-Wilkins Building, Waterloo Campus

JCMB – James Clerk Maxwell Building, Waterloo Campus

WBW – Waterloo Bridge Wing, Waterloo Campus

LT – Lecture Theatre

anaesthetic nursing one - 6knic601 · journal of perioperative practice 16 (4), 187-190. khan e....

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