Course Details

Hospital-territory continuity

MS2213

Course
Hospital-territory continuity
Code
MS2213
Academic Year
2026/2027
Curriculum Year
2025/2026
Degree Programme
NURSING AND MIDWIFERY SCIENCES
Curriculum
000 - CORSO GENERICO
Course coordinator
Credits
6
Lecture Hours
72
Scientific Disciplinary Sector (SSD)
BIO/14 - Pharmacology, MED/45 - General, Clinical and Pediatric Nursing, MED/15 - Blood Diseases, MED/40 - Gynaecology and Obstetrics
Course Type
Integrated learning activity
Course Delivery
OPZ - Opzionale
Year
2
Teaching period
Primo Semestre
Campus
NOVARA
Teaching language
Italian
Course Contents
Pharmacology

Gynecology and Obstetrics

Hematology

Medication Management

Hospital-to-Community Continuity of Care
Reference Texts
Specific texts are available in the syllabi of the individual disciplines.
Learning Outcomes
At the end of the integrated course, the student will be able to:

Understand the mechanisms of action, drug interactions, and toxicity profiles of the main drugs used in complex and chronic diseases.

Describe the pathophysiology and clinical features of the main hematological conditions and gynecological-obstetric disorders relevant to primary and community care.

Contextualize the dynamics related to polypharmacy, medication reconciliation, and treatment adherence in elderly and frail patients.

Recognize the organizational models of continuity of care (Family and Community Nurse - FCN/IFoC, Community Health Centers / Case di Comunità, Community Hospitals / Ospedali di Comunità, Home Healthcare Services / ADI) and the network of local health and social services.
Prerequisites
NONE
Teaching Methods
LECTURES, CLINICAL CASE DISCUSSIONS, SCIENTIFIC LITERATURE READING
Additional Information
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/servicesstudents-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.
Assessment Methods
Written Exam: Multiple-choice questions and short-answer questions focused on basic theoretical concepts. The test consists of 48 multiple-choice questions with 4 options, of which only one is correct. A passing grade is achieved if students answer at least 60% of the proposed questions correctly.
Detailed Syllabus
Pharmacology

Mechanisms of action, toxicity profiles, and drug interactions in chronic diseases.

Assessment of polypharmacy, medication reconciliation, and deprescribing (Beers / STOPP-START criteria).

Clinical risk management, adverse drug reactions (ADRs), and strategies for treatment adherence and therapeutic education at home.

Hematological Disorders and Community Gynecology-Obstetrics

Pathophysiology and clinical features of anemias, myelodysplastic syndromes, hematological malignancies, and thrombocytopenias.

Onco-hematological home therapies, complication surveillance, and long-term vascular access management (PICC, Port).

Prevention, screening, and gynecological disorders in Community Women's Health Centers (Consultori); monitoring of physiological pregnancy and the postpartum period.

Organizational Models and Continuity of Care

Primary and community care facilities: Community Health Centers (Case di Comunità), Community Hospitals (Ospedali di Comunità), Special Continuity Care Units (UCA), and Integrated Home Care (ADI).

Role of the Family and Community Nurse (FCN / IFoC) and frailty assessment.

Management of protected discharge, hospital-to-community transition, and structured communication (SBAR).

Social and healthcare network integration (Multidimensional Assessment Unit - UVM, Individualized Care Plan - PAI, and social services).

Nursing Care of the Complex Patient in Primary Care

Multidimensional clinical assessment, early recognition of instability, and prioritization of interventions.

Community nursing documentation and collaboration within the multiprofessional team (GPs, specialists, social workers).

Autonomous use of Evidence-Based Practice (EBP methodology, databases, guidelines, and diagnostic-therapeutic care pathways / PDTA) and professional self-assessment.
Expected Learning Outcomes
Understand the mechanisms of action, drug interactions, and toxicity profiles of the main drugs used in complex and chronic diseases.

Describe the pathophysiology and clinical features of the main hematological conditions and gynecological-obstetric disorders relevant to primary and community care.

Contextualize the dynamics related to polypharmacy, medication reconciliation, and treatment adherence in elderly and frail patients.

Recognize the organizational models of continuity of care (Family and Community Nurse - FCN/IFoC, Community Health Centers / Case di Comunità, Community Hospitals / Ospedali di Comunità, Home Healthcare Services / ADI) and the network of local health and social services.

Moduli

Course year 2
Code MS2214
Course Pharmacology
Lecturers Simona POLETTI
SSD BIO/14
Campus NOVARA
Curriculum CORSO GENERICO
Credits 2
Course year 2
Code MS2215
Course Management of polypharmacology
Lecturers Antonino CALABRO'
SSD MED/45
Campus NOVARA
Curriculum CORSO GENERICO
Credits 1
Course year 2
Code MS2216
Course Nursing management of hospital-territory continuity
Lecturers Sonia PRATILLO
SSD MED/45
Campus NOVARA
Curriculum CORSO GENERICO
Credits 1
Course year 2
Code MS2218
Course Management of complex haematological patients in the community
Lecturers Gianluca GAIDANO
SSD MED/15
Campus NOVARA
Curriculum CORSO GENERICO
Credits 1
Course year 2
Code MS2217
Course Gynaecology and Obstetrics
Lecturers Daniela SURICO
SSD MED/40
Campus NOVARA
Curriculum CORSO GENERICO
Credits 1
Last update:13-11-2026 00:13:14