Ateneo - UPO

The Clinical Nursing Methodology module provides the scientific nursing methodology principles, through the different phases that make up the healthcare process. Assessment models are analyzed, especially the health functional models proposed by Gordon. Nursing care problems are identified, according to Carpenito's Bifocal Model, up to nursing diagnoses identification according to the NANDA taxonomy. For each investigated functional model, nursing diagnoses related to the dysfunctional model are identified and the related assistance interventions and the final evaluation criteria are proposed.

Reference bibliography- Carpenito L.J.,.(2024) “Manuale delle diagnosi infermieristiche” 8^ edizione Milano: CEA. - Craven R.F., Hirnle C.J., Henshaw C.M. (2024) Principi fondamentali dell'assistenza infermieristica. 7^ edizione Milano: CEA. - Gordon M., Diagnosi infermieristiche. Processo e applicazioni (2009), CEA, Capitoli 5-6-7, appendici H,I.- Wilkinson J.M. (2013). Processo infermieristico e pensiero critico. 3^ edizione. Milano: CEA.Palese A. et al, (2020) Fundamentals of care: revisione narrativa della letteratura. L’infermiere, 57(6), 109-e116 (https://www.infermiereonline.org/2021/01/02/fundamentals-of-care/)In-depth bibliography:- Artioli G., Copelli P., Foà C., La Sala R. (2016) Valutazione infermieristica della persona assistita -un approccio integrato Poletto Editore.

At the end of the module students are able to: - define the whole nursing care process - define the concepts of nursing diagnosis and collaborative problem, according to Carpenito's bifocal model - use the theoretical reference models for nursing assessment, especially models proposed by Gordon - provide nursing problems characteristics and main assistance interventions. Apply the whole nursing process to a predefined healthcare case.

No prerequisites

Lectures on the covered topics, through PowerPoint presentations.
Participatory lessons with Problem Solving methodology application, through analysis and discussion of simple clinical cases.

To support teaching, supplementary teaching activities are provided, aimed at acquiring clinical reasoning skills and technical and practical skills.
The teaching starts the communication skills development, which are examined in depth during the care relationship module.

Students with physical disabilities, Learning Disabilities or Special Education Needs can request specific services and tools via the Staff Sviluppo e Coordinamento Carriere e Servizi alle Studentesse e agli Studenti, consulting the University webpage: https://www.uniupo.it/en/services/services-students-physical-or-learning-disabilities

Students with disabilities, learning disabilities or special education needs, once they have contacted the University Staff, can refer to the tutor in charge of the course to define the examination modalities, concerning academic aspects.

The exam consists of a single session for the whole integrated course of NURSING SCIENCES (disciplines: Clinical Nursing Methodology, General Nursing, Professional Ethics, Moral Philosophy). The test consists of a quiz test (multiple choice, with only one correct answer) for Moral Philosophy and an oral test for the disciplines of Clinical Nursing Methodology, General Nursing, Professional Ethics.
To even up the number of students that each Commission have to evaluate in the oral phase, students may take the exam at a Center different from their home and be assessed by Commissioners (teachers) from other training centers.
Admission to the oral exam is subject to passing 60% of the Moral Philosophy quiz. (15 questions, 60% = 8 questions). The written test lasts 20 minutes.
To pass the oral exam, students must demonstrate integrated and sufficient knowledge and competence of all module topics and the marks are given in thirtieths.
The average between the grades of the oral exam, if sufficient, and the teaching certification of the Moral Philosophy test will determine the certification assessment.
To achieve 30/30 cum laude, students must demonstrate excellent knowledge of all course topics. The oral exam mark determines the mark of the integrated course.

- Problem solving: problem perception and observation, phenomenon or problem description, goal formulation. Nursing Problem Solving Strategies.

- Introduction to fundamentals of care (FOC)

- The nursing process and its phases: assessment, data interpretation, nursing diagnoses formulation, planning, implementation and evaluation.
- Nursing assessment: methods, types, tools, data validation method, suitable assessment tool usage. The interview.

- Data organization systems: Gordon functional models, head-foot model, body systems model.
- From data to care problem planning for grownups: the diagnostic reasoning process, through data interpretation and care problems definition
- The different diagnosis types and collaborative problems according to Carpenito's Bifocal Model.

- Result and intervention planning: how to define objectives and establish interventions to be implemented.
- Implementation of planned interventions
- Final evaluation: planned objective achievement evaluation, through ongoing and final evaluation
- Definition and characteristics of health management problems:
• ineffective health maintenance;
• risk of falls;
• risk of injury (physical trauma, aspiration, injury due to impaired cognitive function and mobility).

Conley Scale for assessing the risk of falls.

- Nursing interventions related to problems of ineffective health maintenance and risk of falls.
- Definition and defining characteristics of problems related to mobility and physical exercise, personal care and hygiene, immobility:
• deficit in self-care;
• intolerance to activity;
• risk of immobilisation syndrome;
• impaired walking;
• impaired mobility.
Assessment scales in nursing practice: ADL, IADL, Barthel Index.
- Nursing interventions related to mobility and physical exercise problems, body care and hygiene, immobility, compromised skin integrity.
- Definition and defining characteristics of nutritional problems:
• nutrition below requirements;
• impaired swallowing (water swallowing test);
• Risk of pressure injury in adults/Pressure injury in adults

Assessment scales. Braden, Norton, NPUAP
Malnutrition risk assessment scales: MUST and MNA
- Nursing interventions related to nutritional problems.
- Definition and defining characteristics of urinary and bowel elimination problems:
• changes in urinary elimination;
• urinary retention;
• urinary incontinence;
• constipation;
• diarrhoea;
• faecal incontinence.
Nursing interventions related to urinary and bowel elimination problems

Assessment scale: Bristol Stool Scale
- Definition and defining characteristics of rest and sleep problems:
• insomnia;
• circadian rhythm disorders,
• sleep apnoea.
Related nursing interventions.
- Definition and defining characteristics of sensory and cognitive perception alteration problems:
• Impaired well-being
• Pain
Related nursing interventions.
Assessment scales: VAS, NRS, Wong-Baker Faces, Faces Pain Scale
- Definition and defining characteristics of self-perception/self-concept:
• anxiety;
• fear;
• body image disturbance.
Related nursing interventions.
- Definition and defining characteristics of role and relationship problems:
• bereavement.
Related nursing interventions.
- Definition and defining characteristics of sexuality problems:
• ineffective sexuality model.
Related nursing interventions.
- Definition and defining characteristics of coping and stress tolerance problems:
• ineffective coping;
• tension in the role of caregiver.
Related nursing interventions.
- Definition and defining characteristics of spiritual health problems:
• spiritual suffering.
Related nursing interventions.

* Knowledge and understanding. At the end of the module students know: - The main theoretical assumptions of Scientific Problem Solving and of the whole Nursing Process - The theoretical reference models used for nursing assessment. - The characteristics and main care interventions of nursing problems in the contexts of: health safety and management, mobility, nutrition, elimination, rest and sleep, cognition and perception, self-concept, role and relationships, stress coping and adaptation, sexuality and spirituality. - The criteria for evaluating nursing care activities for people's response. * Application of knowledge. Students have skills in: - Analysis and interpretation of data collected to recognize the nursing care needs expressed by the assisted people - Program specific assistance interventions to the assistance problems that emerged while evaluating obtained results * Autonomy of judgment. Students are able to: - Analyze problems and propose solutions, based on scientific evidence - Define care priorities - Establish customized interventions, based on the person uniqueness - Critically evaluate the outcomes of taken decisions * Learning ability. Students demonstrate self-learning skills by self-seeking information, based on best practices, required for care problems solving.