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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].
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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 2 – Learning outcomes & indicative reading .............................................. 9
Session 3 – Learning outcomes & indicative reading .............................................. 9
Session 4 – Learning outcomes & indicative reading .............................................. 10
Session 5 – Learning outcomes & indicative reading............................................... 10
Session 6 – Learning outcomes & indicative reading .............................................. 11
Day 2............................................................................................................................. 12
Session 1 & 2 – Learning outcomes & indicative reading ........................................ 12
Session 3 & 4 – Learning outcomes & indicative reading ........................................ 13
Session 5 – Learning outcomes & indicative reading............................................... 14
Session 6 – Learning outcomes & indicative reading .............................................. 15
Day 3............................................................................................................................. 16
Session 1 - Examination preparation ....................................................................... 16
Session 2 – Learning outcomes & indicative reading .............................................. 16
Session 3 – Learning outcomes & indicative reading .............................................. 17
Session 4 – Learning outcomes & indicative reading .............................................. 18
Session 5 – Learning outcomes & indicative reading............................................... 19
Session 6 – Learning outcomes & indicative reading .............................................. 20
Day 4 ............................................................................................................................ 21
Session 1 – Learning outcomes & indicative reading .............................................. 21
Session 2 & 3 – special event, details to be announced ........................................... 21
Session 4 – Learning outcomes & indicative reading .............................................. 22
Session 5 – Learning outcomes & indicative reading............................................... 23
Session 6 – Learning outcomes & indicative reading .............................................. 24
End of day ................................................................................................................. 24
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Module evaluation ........................................................................................................ 28
Action from previous evaluations ............................................................................. 28
Timetable – 6KNIC601 ................................................................................................ 29
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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 2017/18 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.
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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. Churchill Livingstone, Edinburgh.
Allmann K., Wilson I. & O’Donnell A. (Editors) (2016) 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 (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.
Hurley C. & McAleavy J. (2006) Healthcare challenges: preoperative assessment and intraoperative care planning. Journal of Perioperative Practice 16(4), 187-190.
Kasivisvanathan R. & Chekairi A. (2014) The productive operating theatre and lean thinking systems Journal of Perioperative Practice 24(11), 245-248.
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. Oxford, Scion Publishing.
Murgatroyd N. (2005) Patient advocacy in peri-operative practice. Journal of Operating Department Practice 2(9), 14-16.
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 23 August 2017).
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. Oxford. Wiley-Blackwell.
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 23 August 2017).
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 Error! Hyperlink reference not valid., which features research reviews summarizing the findings of peer-reviewed research.
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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 23 August 2017)
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.
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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.
Session 2 – Learning outcomes & indicative reading
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. (2017) Mechanisms of action of general anaesthetic drugs. Anaesthesia and Intensive Care Medicine 18 (7), 344-346.
Rang H.P., Ritter J.M., Flower R.J. & Henderson G. (2015) Rang and Dale’s Pharmacology. 8th ed. Churchill Livingstone, Edinburgh.
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Session 4 – Learning outcomes & indicative reading
Preparation for anaesthesia – environment, equipment needs.
Preparation for anaesthesia – patient. Simple troubleshooting. Difficult intubation.
By the end of the session students will be able to:
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. Oxford, Scion.
Yarlett L. & Eastaugh-Waring T. (2015) Regurgitation and aspiration. Anaesthesia and Intensive Care Medicine 16(9), 435-438.
Session 5 – Learning outcomes & indicative reading
Preoperative Patient Assessment
By the end of the session students will be able to:
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 23 August 2017)
Zastrow S.L. (2009) Perioperative nursing assessments made simple. OR Nurse 2010 3(4), 16- 17.
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Session 6 – Learning outcomes & indicative reading
Introduction to Perioperative Patient Monitoring during Anaesthesia
By the end of the session students will be able to:
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 23 August 2017)
http://www.capnography.com/new/index.php?option=com_content&view=article&id=164&Itemid=56v (last accessed 23 August 2017)
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/content/qhc/14/3/e1.full.pdf (last accessed 23 August 2017)
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Day 2
Session 1 & 2 – Learning outcomes & indicative reading
Anaesthesia-induction and maintenance, will continue in next session
By the end of the session students will be able to:
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 23 August 2017) The Anaesthesia UK website article about intravenous anaesthetic agents.
Anaesthesia-induction and maintenance continued (cont)
By the end of the session students will be able to:
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
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.
Walton TEF & Palmer J (2017) Maintenance of anaesthesia. Anaesthesia and Intensive Care Medicine 18(3), 113-117.
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Session 3 & 4 – Learning outcomes & indicative reading
Airway management and ventilation
By the end of the session students will be able to:
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 artificial ventilation. Anaesthesia and Intensive Care Medicine 17(3), 120-132.
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.
Gajree S. & O’Hare K.J. (2017) Identification of the difficult airway. Anaesthesia & Intensive Care Medicine 18(9), 447-450.
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.
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Session 5 – Learning outcomes & indicative reading
Brief overview of neuromuscular physiology followed by Muscle relaxants and
Reversal of anaesthesia
By the end of the session students will be able to:
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 23rd August 2017)
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789633/ Link for literature review about the use of Sugammadex. (last accessed 23 August 2017).
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Session 6 – Learning outcomes & indicative reading
Patient positioning for surgery, the challenge of the bariatric patient
By the end of the session students will be able to:
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 23 August 2017)
http://ovucla.org/Patient_Positioning_During_Surgery.pdf (last accessed 23 August 2017)
http://www.virtual-anaesthesia-textbook.com/vat/position.htm (last accessed 23 August 2017)
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.
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Day 3
Submit your PAD to Sheila before the first session begins.
Session 1 - Examination preparation Examination preparation.
Session 2 – Learning outcomes & indicative reading
Local anaesthesia
By the end of the session students will be able to:
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.
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Session 3 – Learning outcomes & indicative reading
Obstetric anaesthesia
By the end of the session students will be able to:
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
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.
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Session 4 – Learning outcomes & indicative reading
Spinal and Epidural anaesthesia
By the end of the session students will be able to:
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. (2015) Spinal Anaesthesia. Anaesthesia and Intensive Care Medicine 16(11), 563-565.
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 23 August 2017
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.
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Session 5 – Learning outcomes & indicative reading
The older client undergoing anaesthesia
By the end of the session students will be able to:
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.
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Session 6 – Learning outcomes & indicative reading
Emergency anaesthesia
Following 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.
By the end of the session students will be able to:
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.
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
Session 1 – Learning outcomes & indicative reading
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.
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. 16(9), 443-445.
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 2 & 3 – special event, details to be announced
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Session 4 – 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 on-line Merck manual at:
http://www.msdmanuals.com/en-gb/professional/critical-care-medicine/approach-to-the-critically-ill-patient/monitoring-and-testing-the-critical-care-patient (last accessed 23 August 2017)
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Session 5 – Learning outcomes & indicative reading
Pain and PONV assessment
By the end of the session students will be able to:
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 17(9), 425-430.
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.
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Session 6 – Learning outcomes & indicative reading
By the end of the session students will be able to:
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.
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 23 August 2017)
End of day
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.
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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 26th October 2017; it will close at 23.59 on 6th November 2017. 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 8 January 2018 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 Y for the academic year 2017/18, 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”.
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Examination date The examination will take place during the week beginning 8 January 2017.
PAD submission date No later than 11.59am on Tuesday 16 January 2018 The PADs will be available for collection from the Student Services Centre, room 3.15 James Clerk Maxwell Building (open 09.00-17.00, Mon-Fri) at 09.00 on Tuesday 13 February 2018. The external examiner for this module is TBC. 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 13 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.
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Re-submission date PAD resubmission: Tuesday 24 April 2018
Resubmitted work available for collection Tuesday 22 May 2018
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 12 March 2018.
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 As part of the university’s Student Voice Strategy, King’s uses an electronic module evaluation system known as EvaSys. This provides an opportunity for you to feedback on different aspects of the module through a series of pre-set questions and qualitative comments. At the end of the module you will receive an automated invitation via your KCL email account to complete your evaluation online.
Please take the time to complete as your feedback is important. It informs ongoing developments to individual modules to ensure that the learning needs and expectations of the Faculty’s student community are met to a high standard.
To strengthen the feedback cycle, a report summarizing the quantitative results for the module as a whole and the module lead’s reflections on your feedback will be sent to you after the online evaluation survey has closed.
Action from previous evaluations Feedback about the module this year has been mixed.
Of 32 respondents (from 40 module participants) four raised issues related to the practice of anaesthesia and being exposed to more practical sessions during taught sessions while in university. Because, as Sheila always explains to module participants, she has no access to a suitable clinical facility to offer the practical demonstrations the participants seek: Sheila is reliant upon mentors offering sufficient support to learners in practice. The issue will be raised at the next course management team meeting.
14 respondents ‘strongly agreed’ that the examination was an appropriate assessment, only one respondent expressed concern about the exam. It must be noted that every participant passed the exam at first attempt, the approach to assessment will be subject to review this academic year.
Six respondents expressed the desire for more face-to-face teaching during the module and one asked for more A&P teaching. While unable to increase contact time with participants, Sheila is exploring ways in which to make the module most relevant to participants. An A&P workbook is provided for students to revise those aspects of A&P which are most relevant to the module.
In order to try and address the concerns about the pace of delivery and the need to acquire multiple skills in practice, instead of study days on alternate weeks, module delivery has been distributed across the term
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Timetable – 6KNIC601
Study day 1
Teaching mode
Date Type of Session
Title Time Lecturer Room
University based study
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September 2017
Introduction Introduction to the module and assignment
09.00-10.00
Sheila Turner
B18 JCMB Lecture
Introduction to anaesthesia 10.00-11.00
Introduction to drugs for LA and GA 11.30-12.30
Preparation for anaesthesia 13.30-14.30
Preoperative patient assessment 14.30-15.30
Introduction to perioperative patient monitoring
15.45-16.45
Study day 2
University based study
19 October 2017
Lecture
Anaesthesia-induction and maintenance
09.00-10.00
Sheila Turner
5.132 FWB Anaesthesia-induction and maintenance continued
10.00-11.00
Airway management and ventilation 11.30-12.30
Airway management and ventilation cont
13.30-14.30
B18 JCMB Neuromuscular physiology, muscle relaxants and their ‘reversal’
14.30-15.30
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
University based study
9 November 2017
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
2.81 FWB
Lecture
Local anaesthesia 10.00-11.00
Obstetric anaesthesia 11.30-12.30
Spinal and epidural anaesthesia 13.30-14.30
B18 JCMB The elderly client 14.30-15.30
Emergency anaesthesia 15.45-16.45
University based study
10 November
2016
Seminar/ Discussion
Exploring the role of the recovery room nurse
09.00-10.00
Sheila Turner
2.40 FWB Experience Special event: details to be confirmed 10.00-12.30
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
