NANYANG POLYTECHNIC SCHOOL OF HEALTH SCIENCES

ADVANCED DIPLOMA IN NURSING (EAR, NOSE & THROAT) ACADEMIC & CLINICAL MANUAL

October 2011

LECTURER COPY

Copyright 2011 by NYP

Dear Student Welcome to the School of Health Sciences, and congratulations on your successful admission to the Advanced Diploma in Nursing - Ear, Nose and Throat (ENT) course. You have demonstrated a desire to keep abreast with the changing trends in nursing and your realization of assuming the specialist roles in ENT nursing can only be achieved through a commitment to continuing education. The course is structured to promote unity of theory and practice with clinical rotations built into the course to broaden your experiential base and provide opportunities for you to develop the essential diagnostic and decision-making skills. This will enable you to practise with innovations analytically in a variety of health care settings on graduation. It is assumed that as adult learner capable of self-directed learning, you will optimize all available opportunities available to you throughout the course. This manual presents you with useful and specific information regarding the course including the objectives and assessment requirements. It serves as an excellent reference and guide to your study throughout the year. If you have any problems or concerns relating to your study, please see the course coordinator, Ms Aishah Latiff, or me as early as possible. I wish you every success and trust that you will find the course challenging, enriching and rewarding. Ms Wong Luan Wah, Director/School of Health Sciences (Nursing), and all staff in the Department of Nursing wish you an enjoyable year ahead.

Tan Ah Suan Manager / Nursing (CET) October 2011

ADVANCED DIPLOMA IN NURSING (EAR, NOSE & THROAT) CONTENTS 1. Course Outlines PAGE

Core Modules 2. 3. HS8014 Leadership and Health Care Management HS8015 Professional Issues in Advanced Nursing Practice

Specialist Modules 4. HS8027: Advanced Pathophysiology and Pharmacology in Ear, Nose and Throat Nursing 5. HS8028: Psychosocial Perspectives of Ear, Nose and Throat Nursing 6. 7. 8. 9. 10. HS8025: Research and Evidence-Based Practice HS8026: Heath Assessment and Clinical Decision-Making HS8029: Advanced Ear, Nose and Throat Nursing l HS8030: Advanced Ear, Nose and Throat Nursing ll HS8031: Advanced Ear, Nose and Throat Nursing Clinical Practice

COURSE OUTLINE ACADEMIC MODULES ACADEMIC COMMON MODULES HS8014 HS8015 Leadership And Health Care Management Professional Issues In Advanced Nursing Practice HOURS 60 30 30 360 60 45 60 30 90 75 HOURS Advanced Ear, Nose & Throat Nursing Clinical Practice 420 378 42

SPECIALIST MODULES HS8025 HS8026 HS8027 HS8028 HS8029 HS8030 CLINICAL HS8031 Research and Evidence-Based Practice Health Assessment and Clinical Decision Making Advanced Pathophysiology and Pharmacotherapy In Ear, Nose & Throat Nursing Psychosocial Perspectives of Ear, Nose & Throat Nursing Advanced Ear, Nose & Throat Nursing I Advanced Ear, Nose & Throat Nursing II

Clinical Attachment Field visits

COMPONENT COMMON MODULES SPECIALIST MODULES CLINICAL PRACTICE MODULE TOTAL

HOURS 60 360 420 840

MODULE CODE: MODULE DESCRIPTION:

HS8014 LEADERSHIP AND HEALTHCARE MANAGEMENT

HOURS:

30

1.

GENERAL AIM This module provides an understanding of the impact that economic, political and social issues have on the Singapore healthcare system. Learners will be introduced to concepts of care transition, intermediate and long-term care and advance care planning. In addition, learners will also develop management and leadership skills to prepare them for future roles as managers and leaders. 2. LEARNER OBJECTIVES At the completion of the module, the learner will be able to: 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 3. analyse the changing demographical and disease patterns in Singapore and their impact on health care delivery; examine the economic aspects of policy making explore the concept of care transition in relation to patient management; identify the role of intermediate and long-term care services in meeting the healthcare needs of Singaporeans; explore the concept of advance care planning in the delivery of healthcare; discuss strategic planning and risk management in healthcare; examine the management approaches used by health care institutions and its impact on nursing practices; discuss the role of nurse leaders in influencing health care policies and human resources management; discuss the impact of leadership on organisational effectiveness; discuss the impact of quality improvement programmes in health care institutions; develop and implement staff development programmes and maximise employee performance; apply conflict resolutions, decision -making and problemsolving skills in staff management; discuss the role of nurse managers in motivating, counseling, coaching and mentoring; discuss the role of nurse managers in clinical operation planning

CONTENT 3.1 3.2 Singapore demographical and epidemiology status Healthcare economics and policies

3.3

3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12

3.13 3.14

3.15 3.16 3.17 4.

Care Transition Intermediate and Long-term Care Advance Care Planning Chronic disease management and case management Principles of management Strategic planning and risk management Human resources management Leadership and delegation Organisational communication, behavior and culture Care transition and advance care planning Health informatics in nursing Quality improvement Programmes Staff development Change and Risk management Performance appraisal Counseling Coaching Mentoring Motivating Clinical operational planning Budgeting Conflict management

LEARNING AND TEACHING PROCESSES Lectures, tutorials, e-learning, self-directed learning and presentation.

5.

ASSESSMENT 5.1 5.2 In-Course Assessment Exam 40% 60%

6.

REFERENCES Baker, J. J., & Baker, R. W. (2006). Health care finance: Basic tools for nonfinancial managers. Sudbury: Jones and Bartlett Publishers. Barsky, A. E. (2007). Conflict resolution for the helping professions (2nd ed.). Sydney: Thomson-Brooks/Cole. Sullivan, E. J. (2008). Effective leadership and management in nursing (7th ed.). Upper Saddle River: Prentice-Hall.

MODULE CODE: MODULE DESCRIPTION: HOURS:

HS8015 PROFESSIONAL ISSUES IN ADVANCED NURSING PRACTICE 30

1.

GENERAL AIM This module focuses on issues that significantly influence professional nursing practice and outcomes. Learners will analyze the various approaches and undertake exercises and activities that will further assist them in their interpersonal and professional relationships for the advancement of nursing as a profession. In addition, learners will discuss the legal and ethical issues that impact nursing practice.

2.

LEARNER OBJECTIVES At the completion of the module, the learner will be able to: 2.1 2.2 2.3 2.4 2.5 2.6 2.7 3. examine the challenges nursing must meet to achieve professionalization; explain the evolvement and dimension of change in nursing knowledge; explain the importance of educational preparation to enhance knowledge and skills for advanced nursing practice; discuss issues and trends in advanced nursing practice; describe the role development of the advanced practice nurse; discuss the ethical legal considerations in nursing practice and analyze ethical and legal problems in clinical nursing practice.

CONTENT 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 Introduction to advanced nursing practice Challenges to professionalization in nursing Role development in advanced practice nursing Nursing education: issues and challenges Nursing care outcomes Current and future trends in nursing development Legal and ethical issues in nursing Common Torts Negligence

 3.9 4.

False imprisonment

Nursing legislation

LEARNING AND TEACHING PROCESSES Lectures, tutorials, e-learning, self-directed learning and learner presentation.

5.

ASSESSMENT 5.1 In-Course Assessment 100%

6.

REFERENCES

Davis, A. J., Fowler, M., & Aroskar, M. (2009). Ethical dilemma and nursing practice (5th ed.). Upper Saddle River: Prentice-Hall. Hamric, A. B., Spross, J. A., & Hanson, C. M. (2008). Advanced practicenursing: An integrative approach (4th ed.). New York: ChurchillLivingstone. Lachman, V. D. (2006). Applied ethics in nursing. New York: Springer Publishing Co. Zerwekh, J., & Claborn, J. C. (2008). Nursing today: Transition and trends (6th ed.). New York: Churchill-Livingstone.

MODULE CODE: MODULE DESCRIPTION:

HS8025 RESEARCH AND EVIDENCE-BASED PRACTICE 60 Hrs

HOURS:

1.

GENERAL AIM

The module aims to develop a critical and evaluative approach to research utilising a range of different approaches and methods. It seeks to foster and develop in learners the ability to critically appraise studies as well as to plan a specific piece of research. The module places equal emphasis on qualitative and quantitative research traditions.
2. LEARNER OBJECTIVES

At the completion of this module, the learner will be able to: 2.1 2.2 2.3 discuss the relevance of healthcare research in clinical practice; discuss the emergence of evidence-based practice; utilise the various databases to gather information to support evidence-based practice; 2.4 discuss the importance of systemic reviews and evidence-based practice; 2.5 critically appraise the strengths and limitations of evidence-based practice; 2.6 identify the sequential steps and components involved in the research process; 2.7 select the appropriate research methodology; 2.8 critically evaluate published research reports in relation to mental health nursing; 2.9 write a research proposal for Institutional Review Board approval; 2.10 discuss the application of various research utilization models in clinical practice.

3.

CONTENT
3.1 Healthcare research and practice 3.2 Databases and their utilisation 3.3 The research process 3.4 Evidence-based practice, systemic reviews and meta-analysis 3.5 Research critique 3.6 Research proposal 3.7 Integrating research into nursing practice 3.8 Strategies for improving research utilisation LEARNING AND TEACHING PROCESSES Lectures, e-learning, tutorial, self-directed learning.

4.

5.

ASSESSMENT

5.1

In-Course Assessment

100%

Mode of Assessment
ICA 1: Research Critique1,500 words (Individual) 20%

Date due: Wk 13, Monday by 5pm.

ICA 2: Research Proposal Presentation (Group) 20%

Date Due: Week 22-23

ICA 3: Research Proposal for IRB Submission 60%

3,000 words (Individual) Date Due: Week 24, Monday, by 5pm

6.

REFERENCES Boswell,C. & Cannon.,S.(2007). Introduction to nursing research: Incorporating evidence-based practice. Boston: Jones and Bartlett Publishers. Burns, N. & Grove, S.K. (2007). Understanding nursing research: Building an evidence-based practice. (4th ed.). St. Louis: Mosby Saunders/Elsevier. Burns, N. & Grove, S.K. (2009). The practice of nursing research: Appraisal, synthesis and generation of evidence. (6th ed). St. Louis: Mosby Saunders/Elsevier. Craig,J.V. & Smyth,R.L. (2007). The evidence-based practice manual for nurses. (2nd ed.) Philadelphia : Churchill Livingstone/Elsevier. Greenhalgh,T. (2006). How to read a paper: The basics of evidencebased medicine (3rd ed.). Malden: BMJ Books/Blackwell Pub.

Grove,S.K.; Burns,N. & Ihlenfeld.,J.T.(2007). Study guide for understanding nursing research : building an evidence -based practice: study guide. (4th ed.). St. Louis: Saunders Elsevier. Houser,J.(2008). Nursing research: reading using and creating evidence. Boston: Jones and Bartlett Publishers. LoBiondo-Wood, G., & Haber, J. (2009). Nursing research: Methods and critical appraisal for evidence-based practice. (7th ed.). St Louis: Mosby Macnee,C.L. & McCabe.,S.(2008). Understanding nursing research: Using research in evidence-based practice (2nd ed.). Philadelphia: Wolters Kluwer Health Munro, B. H. (2005). Statistical methods for health care research (5th ed.). Philadelphia: Lippincott. Newhouse,R.P (2007). Johns Hopkins nursing evidence-based practice model and guidelines .Indianapolis: Sigma Theta Tau International Honor Society of Nursing. Pearson,A.; Field,J. & Jordan.Z. (2007). Evidence-based clinical practice in nursing and health care assimilating research, experience and expertise. Malden: Blackwell Pub. Polit, D.F. & Beck, C.T. (2005). Essentials of nursing research: Methods, appraisal and utilisation. Philadelphia: Lippincott Williams & Wilkins. Webb,C. & Roe,B.(2007). Reviewing research evidence for nursing practice: Systematic reviews . Malden: Blackwell Pub.

7. Wk Lecture 1 1 2 2

Timetable Hrs 1 1 1 1 Wk Tutorial Hrs

Introduction to the module (Ambel) Process of EBP (Ambel) Formulating Research Question, Hypothesis, and Problem (Ambel) Literature Review - Search for evidence (step 2) (Ambel) Research Designs (Quantitative Studies) (GYS) Sampling, types of samples, sample size (Quantitative Studies) (GYS) Measurement Tools (Quantitative Studies) (GYS) Levels of Measurement and Data collection (Quantitative Studies) (e-Learning) Ethics in Nursing Research (e-Learning) Levels of measurement and data collection (Quantitative Studies) (e-Learning) Research critique - Appraising evidence (step 3) Tools (Iowa) - How to critique (Ambel) Systematic reviews (Dr Prema) Introduction to Qualitative Research, methodology, data

2 2

3 4 4 4 4 5 5

2 1 1 1 1 1 1

Introduction / PICO and Formulating research question Searching for evidence - As per exercises given - Related to research problem Literature Review (1 topic 4 studies read & compose)

2 1SDL 1 1 SDL 2

Selecting Research Design (Quantitative Studies)

Selecting appropriate Measurement Tool (Quantitative Studies) Research Critique - critique a selected research study Ethics in Nursing Research

6 7

2 1

6 6

1 SDL 2 1SDL

collection methods (Dr Chia) 7 Sampling, types of samples, sample size, data analysis (Qualitative Studies) (Dr Chia) 1 7 7 8 9 12 12 Descriptive/Inferential statistics (Rosy) Systematic reviews (Dr Prema) Meta-analysis (e-Learning) Writing a research proposal (Ambel) 2 2 1 1 12 15 How to write a research proposal Statistical Package for the Social Sciences (SPSS) 1 3 15 (SDL) 1 8 9 Selecting appropriate 1 Methodology and Methods (Qualitative Studies) Sampling, types of samples, 1 sample size (Qualitative Studies) Systematic Review 1 SDL 1 Data analysis (Qualitative Studies)

Contact: e-Learning: Total Hours

19hrs 3hrs 22hrs

SDL / Discussion with Research Supervisor 22 ICA Research Proposal Presentation (Group) 13 ICA submission: Research Critique (Individual Written Assignment) 24 ICA submission: Research Proposal for IRB submission (Individual Written Assignment) SDL/e-Learning: Contact: Total Hours

18 20 38hrs

MODULE CODE: MODULE DESCRIPTION: HOURS: 1. GENERAL AIM

HS8026 HEALTH ASSESSMENT & CLINICAL DECISION- MAKING 45

The module provides learners with an in-depth knowledge and skills of health assessment to develop their abilities to perform systematic assessment for clinical decisions and interventions. 2. LEARNER OBJECTIVES At the completion of this module, the learner will be able to: 2.1 2.2 2.3 2.4 2.5 2.6 2.7 3. develop a systematic approach to patient assessment ; utilise the concepts of anatomy and physiology to interpret assessment findings; modify the assessment process to meet age and diseasespecific needs of the patient; integrate and synthesize history and physical exam findings and communicate these findings orally and in writing; analyse the findings and make clinical decisions; interact with patients and peers in a professional manner; analyze critically the implications of findings to patient care.

CONTENT 3.1 3.2 Comprehensive and focus health history taking Focus examination and decision-making on: 3.2.1 HEENT disorders 3.2.2 Pulmonary disorders 3.2.3 Cardiovascular disorders 3.2.4 Abdominal disorders 3.2.5 Musculoskeletal disorders 3.2.6 Neurological disorders 3.2.7 Integrated physical examination 3.2.8 Focused examination of common to mental health conditions

3.2.9 Document case findings and present cases 4. LEARNING AND TEACHING PROCESSES Lectures and simulated laboratory practices. 5. ASSESSMENT 5.1 6. In-Course Assessment 100%

REFERENCES Bickley, L. S., & Szilagyi, P. G. (2009). Batesphysical examination and history taking (10th ed.). Philadelphia: Lippincott. Talley, N. J., & OConnor, S. (2006). Clinical examination : A systematic guide to physical diagnosis (5th ed.). New York: Elsevier Video-Recording Abdomen RC 76 VIS (Bates series) RC 76 ABD by Saunders Breasts & Axillae RC 76 VIS (Bates series) RC 76 BRE (Breast and regional lymphatics) by Saunders Cardiovascular : peripheral vascular system RC 76 VIS (Bates series) peripheral vascular system RC 76 CAR by Saunders peripheral vascular system and lymphatics Cardiovascular : neck vessels and heart RC 76 VIS (Bates series) RC76 HEA by Saunders Nose Mouth Neck RC 76 VIS (Bates series) RC 76 NOS by Saunders (covers NOSE MOUTH,THROAT , NECK) RC 76 EXA by State University of New York (covers exam of head and neck) Head,eyes and ears RC 76 (Bates series) RC 76 HEA- covers exam of head, eyes, ears RF 294ASS covers assessment of ears, and auditory system RE 75 EXA covers exam of eyes, visual system RC 76 EXA- covers exam of head and neck

Thorax and Lungs RC 76 VIS (Bates series) RC 76 THO by Saunders RC 733 PHY Saunders (covers physical exam of chest : principles and techniques) Neurologic system RC 76 VIS (Bates series) covers cranial nerves and sensory system RC 76NEU by Saunders covers cranial nerves and sensory system RC 76 EXA Mosby covers mental status, speech & cranial nerves RC 76 VIS (Bates series) covers motor systemand reflexes Musculoskeletal RC 76 VIS (Bates series) RC 76 MUS Saunders RD 734 PHY- covers exam of knees RD 734-PHY-covers exam of lumbar spine, nerve and exam of lower limbs RC 76 MOS Mosby (Red spot media) Genitalia RC 76 VIS (Bates series) covers male genitalia, rectum and hernias RC 76 MAL covers male genitalia, anus, rectum and prostate RC FEM-covers female genitalia, anus, rectum RC 76 (Bates series)-covers female genitalia anus and rectum Web site http://www.martindalecenter.com/MedicalPed.html

7. No 1 2 3

TIME-TABLE Lecture Introduction and comprehensive health history (Week 1) (SH) History of present illness (HPI) (Week 2) (SL) Assessment of cardiopulmonary system (Week 3) (SY) Assessment of neurological system (Week 4) (JN) Hr No Laboratory session Hr

1
1

1
2

HPI Seminar (Tutorial) (Week 2) Demonstration and Practice : Examination of the skin and HEENT (Week 3) Demonstration and Practice : Examination of the Thorax and lungs, breast and axilla (Week 4) Demonstration and Practice: Examination of the cardiovascular and peripheral vascular system (Week 5) Demonstration and Practice: Examination of the abdomen; male and female genitalias; anus and rectum (Week6) Demonstration and Practice: Examination of the musculoskeletal system (Week 7) Demonstration and Practice: Examination of the neurologic system (Week 8) Simulated Practice : Integrated physical assessment of an adult (Week 9) Simulated Practice : Focus physical assessment of an adult (Cardio-vascular) (WEEK 11) Laboratory session

2 3

1
3

1
5 Paediatric health assessment (e-learning) 4

1
6 Gerontological health assessment (e-learning)

No

Lecture

Hr

No

Hr

10

TOTAL HOURS LECTURE PRACTICAL PRACTICE (SDL) ASSESSMENT SUPP. / ALT

Simulated Practice : Focus physical assessment of an adult (Respiratory) (WEEK 12) 11 Simulated Practice : Focus physical assessment of an adult (Abdomen & HEENT) (WEEK 13) 12 Simulated Practice : Focus physical assessment of an adult (Neurological) (WEEK 14) 13 Simulated Practice : Focus physical assessment of an adult (Musculoskeletal) (WEEK 15) 14 Practical Exam TOTAL HOURS

1 39

: WEEK 1-4 : WEEK 3-9, 11-15 : WEEK 16, 20-22 (Self-schedule)* : WEEK 23-24 : WEEK 27-29

*Please book the Lab through Ms Janice Tan (Lab Technician)

MODULE CODE MODULE

: :

HS8029 ADVANCED EAR, NOSE & THROAT (ENT) NURSING I

HOUR : 90 _________________________________________________________________ 1. GENERAL AIM This module focuses on assessment and identification of significant problems associated with the ear, nose and throat and the development and evaluation of the care and rehabilitation of the clients and their significant others. 2. SPECIFIC OBJECTIVES At the completion of this module, the student will be able to: PART 1: FOUNDATION STUDIES AND HEALTH EDUCATION (45 HOURS) 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 discuss the historical evolution and current trends in ENT nursing; evaluate nursing models used in ENT nursing practice; discuss roles of the nurse and concept of case management and its application in the ENT clinical setting; discuss the nursing management of a client with impaired communication and hearing; discuss the perioperative considerations for ENT clients; analyse the multidisciplinary approach in the rehabilitation of ENT clients; demonstrate skills in health education and health promotion and organise and carry out a range of health education programmes and health promotions for clients with ENT problems, with minimal or no guidance.

PART 2: EAR AND NOSE DISORDERS (45 HOURS) 2.9 discuss the aetiology, pathophysiology, clinical findings, management, and complications of the clients with ear and nose disorders;

2.10 2.11 2.12 2.13

discuss the nursing management of clients with ear and nose problems; explain the preparation and care of clients undergoing related ear, nose procedures and diagnostic investigations; discuss the pre and post-operative management of clients undergoing ear and nose surgery; discuss the various strategies that can be adopted for health education and rehabilitation of clients with communication impairment and identify resources that are available for rehabilitation of clients and their significant others.

2.14 3.

CONTENT PART 1: FOUNDATIONS STUDIES IN ENT NURSING (30 HOURS) 3.1 Evolution of ENT nursing speciality Current trends 3.2 The application of models in ENT nursing Historical perspectives

Nursing models relevant to Ear, Nose and Throat Nursing 3.3 Case management

Concept and application 3.4 3.5 Management of the client with ear and nose procedures/diagnostic investigations Perioperative considerations for ENT clients:

Preoperative evaluation and preparation Anaesthetic agents Post-anaesthesia complications Immediate postoperative ENT care 3.6 ENT rehabilitation - a multidisciplinary approach

Hearing impairment Speech impairment Swallowing disorders Prosthetics and appliances 3.7 3.8 Develop instructional plans using different motivating teaching strategies; Write out detailed instructional guides for each topic and time frame;

3.9 3.10 3.11 3.12

Theoretical and practical aspects of methodology; Principles and approaches in critical thinking, problem solving and reflective learning; Strategies of health promotion; Clinical supervision and learning

PART 2: EAR AND NOSE DISORDERS (45 HOURS) 3.13 Aetiology, pathophysiology, clinical findings and management of children and adults with the following disorders:

3.13.1. Ear Common conditions affecting the external, middle & inner ear and facial nerve e.g.: Foreign bodies Otitis Externa Tinnitus Vertigo & imbalances Acute/Chronic Otitis Media (CSOM) Conductive / Sensori-neural hearing loss Congenital ear abnormalities Facial nerve paralysis 3.13.2. Nose Common conditions affecting the nose and paranasal sinuses e.g.: 3.14 Cranio-facial / Cleft palate Hearing impairment Speech impairment Prosthetics and appliances 3.15 Preparation and care of clients undergoing ear and nose procedures and / diagnostic investigations: Epistaxis Nasal obstruction Nasal allergy Sinusitis Foreign body

Congenital ENT abnormalities and multidisciplinary approach

3.15.1. Procedures of the ear Different type of hearing tests Universal newborn hearing screening Ear syringing / suctioning

Aural toilet Ear dressing 3.15.2. Procedures of the nose Nasal toilet Allergy test Nasal cautery Lavage of sinuses (Antral washout) Endoscopic examination Post-Nasal Space (PNS) biopsy 3.16 Management of client undergoing ENT surgery

Pre-operative evaluation and preparation Psycho-social implications of surgery Prosthetics, appliances and equipment used Anaesthetic drugs Post anaesthesia complications Immediate post-operative care Current research trends in ENT nursing practice 3.17 Rehabilitation Community resources Patients education Hearing Aid services Cochelar Implant programme Audio-verbal Therapy programme Nurses role
c

4.

TEACHING STRATEGIES Lectures, tutorials, discussions, presentations, e-learning, problem based learning, self-directed learning, practical; simulation based learning and audio-visual aids.

5.

ASSESSMENT In-course Assessment - 100%

6.

REFERENCES Bull P & Clarke R. (2007). Disease of the Ear, Nose and Throat (10th ed). Oxford: Black well Publishing. Meyer E N (2008). Operative Otolaryngology Head and Neck Surgery (2nd ed). Philadelphia: Saunders Elsevier Serra A M, Bailey CM & Jackson P (1986). Ear, Nose and Throat Nursing. London: Blackwell Scientific Publications.

Wilson W R, Nadol J B & Randolph G W (2002). The clinical handbook of Ear, Nose and Throat Disorders. London: The Parthenon Publishing Group. 7. Time-table: PART 1: Foundation Studies and Health Education (45Hrs) S/ N 1 2 LECTURE Introduction and overview of Advanced ENT nursing (Pre-test) Historical evolution and current trends and practices in ENT nursing Application of case management in ENT nursing Introduction to Audiology (Ext. Lecturer) Types of hearing tests audiogram, tympanometry, speech audiometry and vestibular balance tests (Ext. Lecturer) Tinnitus & devices use for adult in hearing rehabilitation(Ext. Lecturer) Management of hearing loss in children Audiological perspective (Ext, Lecturer) Habilitation for children with hearing impairment (Ext. lecturer) Hearing Impaired child in mainstream school (Ext. Lecturer) Reverse education therapy (Ext. Lecturer) HRS 2 1 The role and current trends & practices in ENT nursing (e-learning) The role of the ENT nurse in case management ( Students presentation & discussion) Instruments used in ENT examinations (Lab) Overview of clients undergoing ENT procedures and diagnostic investigations (Discussion) Ear structure & its functions (SDL) Ear structure & its functions (Students Presentation & Discussion) Preparing and assisting ear examination ( Lab) Nursing management of client with hearing and speech impairment (SDL) Nursing management of client with hearing and speech impairment (Student presentation & discussion) 1 TUTORIAL / LABORATORY HRS

4 5

2 2

1 1

8 9

10

11

Signing in hearing and speech impairment (Sign Language) (Ext. Lecturer)

12

Health promotion models

S/ N 13 14 15 16

LECTURE Health promotion & Health Education Theories and Principles Health education process Teaching strategies Developing Health Promotion programme Total

HRS 1 1 1 2

TUTORIAL / LABORATORY

HRS

Health promotion & education (SDL) Health promotion & education (Student presentation & discussion)

25

Total

20

PART 2: EAR AND NOSE DISORDERS (45 HOURS)

W K

LECTURE Conditions affecting middle and inner ear (Ext. Lecturer) the external,

HRS TUTORIAL / LABORATORY 1 Ear toilet & dressing (Lab )

HRS 1

Neoplastic / non-neplastic of the external, middle and inner ear Trauma/injuries of the external, middle and inner ear (Ext. Lecturer) Facial Nerve Paralysis (Ext. Lecturer) Vestibular disorders External disorders Nursing care of client with ear disorders Nursing care of client with ear surgery

Ear syringing (Lab )

Lab practices

1 2

ICA Case Presentation : Nursing management of client undergoing ear surgery ICA Case Presentation : Nursing management of client with Tinnitus

Paediatric Otology (Ext. Lecturer) Deafness & Congenital ear abnormalities in children (Ext. Lecturer) Overview of Nose & Sinuses structure and functions (SDL)

Instillations of ear & nose drops / spray (e-Learning) Preparing and assisting in nose examination (Lab.) /Nasal toilet /Nasal cautery procedure (lab)

W K

LECTURE Nasal Injuries and deformities (Ext. Lecturer) Epistaxis in adult (Ext. Lecturer) Neoplastic / non-neoplastic diseases of the nose

HRS TUTORIAL / LABORATORY 1 1 1 Preparing & assisting clients for Antral washout procedure (Lab) Removal of anterior Nasal packs procedure (Lab & Practice)

HRS 2 2

MODULE CODE

HS8030 ADVANCED EAR, NOSE & THROAT (ENT) NURSING II 75

MODULE DESCRIPTION : HOURS :

1.

GENERAL AIM This module provides the knowledge and skills to assess and identify significant problems associated with head and neck structures as well as children to enable management and care for ENT patients with complex needs.

2.

SPECIFIC OBJECTIVES At the completion of this module, the student will be able to: PART 1: THROAT/LARYNX AND NECK DISORDERS (30 HOURS) 2.1 discuss the aetiology, pathophysiology, clinical findings, management, and complications of the clients with throat/larynx and neck problems and disorders; discuss the nursing management of clients with throat/larynx and neck problems and disorders; explain the preparation and care of clients undergoing related throat/larynx and neck procedures and diagnostic investigations; discuss the pre and post-operative management of clients undergoing throat/larynx and neck surgery; identify resources that are available for rehabilitation of clients and their significant others and analyse updates and differences in the management of children and adult with throat/larynx and neck problems.

2.2 2.3 2.4 2.5 2.6

PART 2: NEOPLASTIC AND NON-NEOPLASTIC DISEASES (45 HOURS)

2.7

discuss the aetiology, pathophysiology, clinical findings, management, and complications of the clients with ENT neoplastic and non-neoplastic diseases; discuss the nursing management of clients with ENT neoplastic and non-neoplastic diseases; explain the preparation and care of clients undergoing ENT procedures and/diagnostic investigations for neoplastic and nonneoplastic disease; discuss the pre and post operative management of clients undergoing head and neck surgery; demonstrate competency in head and neck related advanced nursing skills; discuss the various strategies that can be adopted in health education and rehabilitation of clients with impaired communication; analyse updates in the management of ENT neoplastic and nonneoplastic disease

2.8 2.9

2.10 2.11 2.12

2.13 3.

CONTENT PART 1: ADVANCED ENT NURSING STUDIES: THROAT/LARYNX AND NECK (30 HOURS) 3.1 Aetiology, pathophysiology, clinical findings and management of children and adults with the following disorders: 3.1.1 Throat & Larynx 3.1.2 Neck 3.2 Neck trauma & injury Common disease conditions of neck swelling Common disorders of Thyroid glands Common disorders of Salivary glands Common diseases affecting the oral cavity, pharynx and larynx and oesophagus Airway obstruction Tonsillitis & adenoiditis Peritonsillar abscess Laryngeal papilloma Obstructive Sleep Apnea (OSA) Snoring Foreign body Pharyngeal pouch

Common procedures of throat & larynx

3.3

Direct & indirect laryngoscopy Endoscopic examination Flexible nasopharyngoscopy Incisional & drainage of oral cavity abscess Common procedures of the Neck Fine Needle Aspiration Tracheostomy dressing

3.4

Management of client undergoing throat/larynx and neck surgery Pre operative evaluation and preparation Psycho-social implications of surgery Prosthetics, appliances and equipment used Anaesthetic drugs Post anaesthesia complications Immediate post operative care Current research trends in ENT nursing practice

3.5

Rehabilitation Nurses role Patients education Prosthetics and appliances

PART 2: CARE OF ADULT WITH ENT NEOPLASTIC AND NONNEOPLASTIC DISEASE (45 HOURS) 3.6 Aetiology, pathophysiology, clinical findings and management of adults with the following disorders: 3.6.1 Ear 3.6.2 Nose Neoplastic & non-neoplastic diseases of the nose, sinuses & Post-Nasal Space (PNS) Neoplastic & non-neoplastic diseases of the external and middle ear

3.6.3 Throat & Larynx Neoplastic & non-neoplastic diseases of the oral cavity, larynx, pharynx, trachea and oesphagus

3.6.4 Head & Neck Neoplastic and non- neoplastic diseases of the head & neck

3.7 Common procedures of ENT neoplastic and non-neoplastic disease

 3.8

Fine Needle Aspiration for cytology (FNAC) Post-nasal space biopsy (PNS) Tracheostomy / laryngectomy dressing

Nursing management of Head and Neck surgery Preparation for Tumor Board meeting Psycho-social implications and altered body image after surgery Immediate post operative care of major head & neck surgery and reconstruction of flaps Maintaining airway & tracheostomy/laryngectomy care Maintaining hydration & nutrition Prosthetics, appliances and equipment used Care of client undergoing radiation therapy

3.9

Rehabilitation Nurses role Patients education Speech and voice rehabilitation Prosthetics and appliances Social reintegration

4.

LEARNING AND TEACHING PROCESSES Lectures, tutorials, e-Learning, presentation, simulation base learning, self directed learning and context-based learning

5.

ASSESSMENT 5.1 5.2 In-course assessment Semestral Exam 40% 60%

6.

REFERENCES Bull P & Clarke R. (2007). Disease of the Ear, Nose and Throat (10th ed). Oxford: Black well Publishing. Meyer E N (2008). Operative Otolaryngology Head and Neck Surgery (2nd ed). Philadelphia: Saunders Elsevier Serra A M, Bailey CM & Jackson P (1986). Ear, Nose and Throat Nursing. London: Blackwell Scientific Publications.

Wilson W R, Nadol J B & Randolph G W (2002). The clinical handbook of Ear, Nose and Throat Disorders. London: The Parthenon Publishing Group.

MODULE CODE: MODULE DESCRIPTION: HOURS:

HS8030 ADVANCED EAR, NOSE AND THROAT NURSING II 75

PART I : THROAT/LARYNX AND NECK DISORDERS (30 HOURS) S/N LECTURE Overview of Throat & Larynx structures and functions (SDL) Condition affecting the throat &larynx (Part I) (Ext. Lecturer) Condition affecting the throat &larynx (Part II) (Ext. Lecturer) Vocal Cord Disorders (Ext. Lecturer) Airway Obstructions and neck injuries in adult (Ext. Lecturer) Snoring & Obstructive Sleep Apnea (OSA) (Ext. Lecturer) Airway Obstructions in children (Ext. Lecturer) Paediatric cleft palate craniofacial abnormalities (Ext. Lecturer) and HRS TUTORIAL / LABORATORY 1 Preparing and assisting in endoscopic fibre-optic laryngoscopy examination (Lab) Preparing and assisting in Incisional & Drainage (I &D) of peritonsillar abscess (Lab) Preparing and assisting Post-Nasal Space biopsy (Lab) Preparing and assisting in Fine needle aspiration procedure (Lab) Paediatric - ear surgery care (Student presentation and discussion ) Paediatric - Adeno-tonsillectomy care (Student presentation and discussion ) Paediatric - counselling in nasal allergies (Student presentation and discussion ) Paediatric - Tracheostomy care (Student presentation and discussion ) HRS 1

2 2 2 2 2

1 1 1 1 1

Overview of Salivary & thyroid gland structure and function (SDL) Management of neck lump

1 2

(Ext. Lecturer) Thyroid glands disorders (Ext. Lecturer) Salivary glands disorders (Ext. Lecturer) Nursing management of client with Thyroid & Salivary gland disorders 2 2 1 8

TOTAL 22 TOTAL PART II: ADULT ENT NEOPLASTIC AND NON-NEOPLASTIC DISEASE (45 HOURS) WK LECTURE Non-neoplastic diseases of external, middle and inner ear (Ext. Lecturer) Neoplastic diseases of external, middle & inner ear (Ext. Lecturer) Non neoplastic diseases of the nose (Ext. Lecturer) Neoplastic diseases of the nose (Ext. Lecturer) Non -neoplastic tumors of the throat and larynx (Ext. Lecturer) Neoplastic diseases of the throat & larynx (Ext. Lecturer) Management of Head surgeries (Ext. Lecturer) & neck HRS 2 2 2 TUTORIAL / LABORATORY

HRS 4 1 1

Changing of tracheostomy tube (Lab & Practice) Tracheostomy dressing & suctioning (e-Learning) Nursing care of clients with tracheostomy tube (Student presentation & discussion) Laryngectomy dressing (Lab & Practice) Pre & Post-Operative Care of Laryngectomy Clients (Student presentation & discussion) Nursing management of major head & neck surgery with flap reconstruction (Student presentation & discussion) Preparation of client undergoing head and neck radiation therapy (Student presentation & discussion)

2 2

4 1

Reconstruction In Head & Neck surgery (Ext. Lecturer) Radiation therapy for head & neck cancers (Ext. Lecturer) Nursing management of Head & Neck surgeries (e-learning) Swallowing and speech rehabilitation following head & neck surgery (Ext. Lecturer)

2 2 1 2 Lab Practice 6

Voice restoration after laryngectomy (Ext. Lecturer) Psycho-social implications and altered body image after laryngectomy clients view (Ext. Lecturer) TOTAL

2 1

Consolidation Theory test

1 1

24

TOTAL

21

CLINICAL EDUCATION

MODULE CODE

HS8031 ADVANCED EAR, NOSE & THROAT (ENT) NURSING CLINICAL PRACTICE 420

MODULE DESCRIPTION: HOURS:

1.

GENERAL AIM This module enables the students to apply the theoretical concepts to clinical practice in a variety of ENT settings. The students will utilize the problem-solving approach in the assessment, planning and delivery of nursing care to the ENT patients as well as develop analytical and critical thinking through reflective practice.

2.

SPECIFIC OBJECTIVES At the end of this module, student will be able to: 2.1 2.2 2.3 2.4 2.5 2.6 2.7 apply theoretical knowledge of advanced ENT nursing to clinical setting; perform specialist care to patient with ENT conditions; demonstrate sound clinical decision making in the planning and delivery of nursing care in the ENT setting; evaluate roles, management techniques and practice observed in the clinical setting; observe and participate in the management of personnel and equipment in the ENT settings; describe the wide areas of function, knowledge and responsibilities of the extended role for the ENT nurse; collaborate with other members of the ENT care team in providing comprehensive care to the individual and family;

2.8

participate in a comprehensive range for treatments and therapeutic approaches for different types of problems throughout the lifecycle; utilise the nursing process in the planning and delivery of nursing care for ENT clients and

2.9 2.10 3.

apply case management skills and the nursing process in caring for individuals and families with ENT problems. CONTENT Part I comprises of field visits to the related ENT care facilities; Part 2 comprises of 378 hours of clinical experiences in a variety of community, hospital, ENT operating theatre and specialised outpatient settings. The students will be expected to apply the process of nursing to the management of client and families with ENT problems.

4.

ASSESSMENT In-course assessment 100%

In order to achieve a "Pass" grade during clinical education practice the student is required to obtain an aggregate score of 50 percentile points. Student will fail the clinical posting if the following are not observed when providing nursing care: - Safety of client - Confidentiality This will override all other assessments. Students are expected to be in the assigned clinical area for the duration of the rostered shift. Students who have no valid reasons for leaving before the end of their shift will be expected to replace the whole shift regardless of the time the students left the clinical area. Students will be expected to repeat a whole week of the clinical if the offence is repeated. The sponsoring hospitals will be notified of the students behaviour.

MISCELLEANOUS

SN Module No Module Name 1 2 3 HS8014 HS8015 HS8025 Leadership and Healthcare Management Professional Issues in Advanced Nursing Practice Research and Evidence-Based Practice

Module Formative Summative Hours 30 In-Course Assessment (ICA) 40% EXAM 60% (Presentation 40%) (Theory Paper 60%) 30 60 ICA 100% (Presentation 40%) (Assignment 60%) ICA 100% (Critique 20%) (Presentation 20%) (Proposal 60%) ICA 100% (History taking &CDM 20%) (Physical exam 60%) (Documentation 20%) ICA 100% (Test I 30%) (CAP 10%) (Test II 60%) ICA 40% (Presentation 40%) ICA 100% (Written Assignment 60%) (Test 20%) (Presentation 20%) ICA 40% - Theory Test I (20%) - (20%) ICA 100% -Presentation 20% -Case Study 20% -Cont. Assess 60% EXAM 60% (Theory Paper 60%)

HS8026

Health Assessment and Clinical Decision-Making

45

HS8027

Advanced Pathophysiology and Pharmacology in ENT Nursing Psychosocial Perspectives in ENT Nursing Advanced ENT Nursing I

60

6 7

HS8028 HS8029

30 90

EXAM 60% (Theory Paper 60%)

8 9

HS8030 HS8031

Advanced ENT Nursing II Advanced ENT Nursing Clinical Practice

75 420