INFERMIERISTICA CLINICA IN AREA CRITICA

Degree course: 
Corso di First cycle degree in Nursing
Academic year when starting the degree: 
2020/2021
Year: 
3
Academic year in which the course will be held: 
2022/2023
Course type: 
Basic compulsory subjects
Seat of the course: 
Varese - Università degli Studi dell'Insubria
Credits: 
2
Period: 
First Semester
Ore minime di frequenza: 
22.5
Standard lectures hours: 
20
Detail of lecture’s hours: 
Seminar (20 hours)
Assessment: 
Voto Finale

- The critically ill patient and the branches of Critical Care: Out of Hospital Medical Emergency System, Emergency Department. The role played by nursing triage.

- In hospital evaluation and treatment of the critically ill: the ABCDE approach, MEWS scale, emergency trolley, the outreach team, transportation of the patient to the intensive care area.

- Airways: learn and apply the maneuvers necessary to maintain patency of the anatomical airways, provide assistance in maneuvers like tracheal intubation and percutaneous tracheostomy, manage artificial airways.

- Breathing: recognize main alterations of breathing, monitor respiratory function, know and manage devices for oxygen therapy, assist the person undergoing non-invasive and invasive ventilation, assist the person with severe acute respiratory insufficiency (pronation, notions on extracorporeal ventilatory support techniques), share and apply a respiratory weaning plan (ABCDEF bundle) within the team.

- Circulation: monitor cardiocirculatory function, assist a shocked patient, learn how to administer vasoactive and antiarrhythmic drugs, learn about invasive cardiocirculatory support techniques. Bases of nursing in Cardiac Surgery ICU.

- Disability: early recognition of sensory alterations, apply neurological examination and evaluation scales, continuous monitoring of neurological functions, learn how to administer sedative-hypnotic, analgesic and muscle relaxants, bases of nursing in Neurosurgical Intensive Care.

- Exposure: learn and apply the principles of "basic nursing care" in ICU: Interventional Patient Hygiene Model, body care, positioning of the critical patient. Learn the role of the trauma team and provide assistance to the polytraumatized patient, perform "head to feet" examination, learn mobilization techniques, manage immobilization devices during in-hospital transportation of trauma patients. Care for burned patients.

- Family and spiritual involvement (F): involving the critically ill patient's family: visiting policies and open intensive care units, PTSD and the role of intensive care diaries. Dealing with the end of life in intensive care: therapeutic withdrawal and palliation. Nursing role in organ donation.

- Measuring the quality of nursing care in intensive care: nursing sensitive outcomes:
- prevent aspiration pneumonia, manage enteral nutrition, gastric stagnation and alvus;
- manage intravascular accesses and prevent related infections;
- prevent infections associated with urinary catheter;
- prevent hospital-acquired injuries (DRPUs, restraints and the risk of falls);
- reduce the risk of venous thromboembolism.

The course is divided into lectures. The topics are presented to students through presentations in ppt format accompanied by images, diagrams and videos. The lessons will be provided to students in pdf format to facilitate participation in the course. During the lectures, films will also be shown to illustrate nursing care procedures in the emergency department and intensive care units. Students will occasionally attend demonstrations with medical aids. Students will also be provided with bibliographic references or excerpts from updated scientific publications to supplement the topics covered.

SUGGESTED REFERENCES

Bambi S., Peris A. (2017) Ossigenoterapia con cannule nasali ad alto flusso nei pazienti critici adulti. Quaderni dell’Assistenza in Area Critica. Pistoia: Nuova Fag Litografica.

Chiaranda M. (2016) Urgenze ed Emergenze: istituzioni. Quarta edizione. Padova: Piccin.

Comisso I., Lucchini A., Bambi S., Giusti G. D., Manici M. (2021) Infermieristica in terapia intensiva. Principi di assistenza di base e avanzata. Firenze: Giunti Psychometrics.

Giusti G. D., Benetton M. (2013) La cura del corpo in Terapia Intensiva. Quaderni dell’Assistenza in Area Critica. Santarcangelo di Romagna: Maggioli Editore.

Giusti G. D., Benetton M. (2015) Guida al monitoraggio in Area Critica. Quaderni dell’Assistenza in Area Critica. Santarcangelo di Romagna: Maggioli Editore.

Hinkle J. I., Cheever K. H. (2017) Brunner Suddarth, Infermieristica Medico-chirurgica. Quinta edizione. Milano: Casa Editrice Ambrosiana.

Italian Resuscitation Council (2015) Advanced Life Support. Edizione italiana delle linee guida ERC 2015. Manuale del corso. Niel: European Resuscitation Council

Professors

D'ANDREA LUCA