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Student Population, Topic, and Modalities
The audience for the course includes the oncology unit nurses who will be tasked with taking care of patients with Cytarabine. The audience for this lesson is synchronous since learners will be expected to attend lessons and meet face to face with their teacher producing interaction and engagement between the audience and the facilitator.
The topic to be covered will be Effects of High-dose Cytarabine on Patients: Industry Standards. One of the standards requires nurses to be able to apply their scientific knowledge in the improvement of nursing (Grealish, 2014). This means that as much as they will have the freedom to practice their profession, they must be informed by scientific knowledge in every undertaking. Another standard requires authorities to develop curriculums that should help provide attitudes, skills, and abilities that can improve the way nursing is practiced (Russell, 2012). The standard further requires nursing to be defined by health risk assessment, effectiveness in treatment, patient education, and nutrition (Makic, Martin, Burns, Philbrick, & Rauen, 2013). Therefore, all nurses must observe these standards to give adequate services to their clients.
The contents of the course will include evaluating the required clinical skills for nurses who will be taking care of nurses receiving high doses of Cytarabine in the Oncology Unit. During the course, the nurses will also be taught how to properly administer Cytarabine as well as its contents. The proper management of information when caring for the patients will also be reviewed. After the cover course is completed, it will be expected that the learners will be in a position to investigate the risks associated with the administration of high levels of Cytarabine on the patients. The nurses will recognize the necessity of a new assessment strategy that can help to establish the deficiencies of the existing ones. The students will also learn to estimate the challenges that practitioners face in handling the effects of high-dose Cytarabine and identify the needs of the patients involved.
The unit will include several modalities to ensure that the content is well covered and the learners meet the intended objectives. Leaners will spend some time assessing the patients to identify the existing problems. In order to increase the participation of the learners, the facilitator will use the question and answer method to ensure that the nurses in the unit are able to exchange knowledge on how to manage patients on Cytarabine. The teacher will present through media (videos and pictures) the effects of high doses of Cytarabine on patients to increase engagement through and active participation and check existing knowledge and attitudes towards change. Tabulated information will be illustrated through flow charts how high-dose Cytarabine moves in the body. The materials that will be used during the unit include drugs (Cytarabine), diagnostic apparatus, charts, and flow diagrams, pictures, and videos. At each stage of the learning process, the facilitator will ask the students an oral question about the effects of Cytarabine so an assessment can be done and determine the effectiveness of methods, designs, and strategies implemented and the need to change approach or materials to reach the audience properly. The final evaluation will include a report on the students findings during the course.
Topics and Objectives
The course is aimed at educating the participants in new neurological assessment tools for patients receiving high doses of Cytarabine (chemotherapy). According to the latest researches, the patients who get high-dose Cytarabine while undergoing chemotherapy run a risk of experiencing neurotoxicity. Consequently, identifying the corresponding signs and symptoms is essential to the current health care setting as it would allow knowing which triggers the health care specialists can reduce to eliminate the risk of permanent neurologic damage among such patients. The curriculum implementation strives for the students understanding and ability of further practical implementation of such tools. The objectives of the course include that the students will:
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investigate the risks of high-dose Cytarabine;
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recognize the necessity of a new assessment strategy knowing the deficiencies of the existing ones;
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estimate the challenges.
After the completion, the participants will be able to:
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identify the needs of the patients involved;
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apply the tools in practice and estimate the accuracy and consistency of the information obtained;
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come up with the most effective solutions to the current healthcare problem.
The content outline implies that the course will be divided into two sections, which are problem evaluation and tool development. The outline consists of the three domains including:
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clinical skills and therapeutic management
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practice administration and development
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information management
Upon the course completion, the participants are expected to present their evidence-based assessment tools for the identification of signs of neurotoxicity.
As the goals, aims, and objectives of the course have been defined, further curriculum development will be concerned with organizing the learning activities and related experiences, and the estimation of the extent to which the course aims, goals, and purposes have been fulfilled (Hunt, 2012).
Tests, Didactic and Evaluation Techniques
The evaluation is effective in assessing the patients on high-dose Cytarabine. Patients receiving high doses of Cytarabine are susceptible to several toxicities and as a result, the oncology nurses are required to assess side effects of the drugs prior to the administration of each dose.
Romberg Test
The patients will be subjected to the Romberg test. The test serves to assess if the patients can maintain their balance which is one of the critical neurological functions. The test is classified as a neurological assessment, and it seeks to assess if a patient has proprioception which refers to the ability to be conscious of their position in space (Brown, 2010). The test also seeks to determine the vestibular function which is the capacity to determine ones position in space. The test also aims to determine if the patient can change their vision based on the body position. The test is reported as either balance maintained or balance not maintained.
The Romberg test was chosen since most patients who get a high-dose of Cytarabine tend to present with drowsiness and confusion. Without administering the tests, patients who are drowsy can end up having other accidents in the ward such as falling from their beds which may further complicate their illnesses as it interferes with the healing process. The test was also chosen since it is an effective test that is easy to administer and requires minimal resources hence reduces the costs of care incurred by the patients.
The Romberg test is well aligned with the objects and contents of the unit that will be taught to the Oncology Nurses on how to manage patients who are receiving high doses of Cytarabine. The tests will enable the nurse to meet the objective of making a determination of the challenges that the patients are facing during the process of care. Nursing care for patients who are receiving high doses of Cytarabine may be complicated when patients end up in hospital-related accidents. As a result, carrying out the Romberg test helps the nurse to take extra caution for patients who are unable to maintain balance especially during the process of providing assistance to meet their vegetative functions such as toileting needs. The tests will also help the nurse in the unit to be in a position to practice their skills for information management and learn how to make informed decisions during care.
Handwriting and Speech Pattern Evaluation
One of the didactic evaluations that will be used for the patients will seek to evaluate the patients handwriting and speech. Patients who receive a high dose of Cytarabine tend to suffer from primary progressive aphasia where they present with cognitive loss of language function as a result of the side effects of the drugs (Brown., 2010). The dizziness that impacts the patients also contributes towards the prolonged syllables that are seen as well as a deviation of the handwriting from the previous versions that they present. The results are reported as either having a clear speech or using prolonged syllables when communicating. In regard to the handwriting, it is reported based on whether it has deviated from what the patient had written down during the previous assessments, in the situation that it has not deviated, the results nurse states that the handwriting is unchanged.
Compared to other didactic tests that can be used to evaluate dizziness among patients who receive a high dose of Cytarabine, the speech and handwriting tests were chosen based on their ability to give conclusive results. The didactic test was also preferred as it is easy to administer and requires minimal resources hence it presents a lesser burden of the medical costs that the patients will incur at the end of their stay while still guaranteeing them the required quality of care.
The didactic tests will serve the fundamental role of meeting some of the objectives of the unit. For example, by learning how to carry out a speech and a handwriting assessment, the nurses will be able to recognize the necessity of carrying out didactic assessments on patients in the oncology unit. The assessment will also enable the nurses to be in a position to estimate if the patients are facing some challenges during care and institute the necessary measures to contain the situation and avert unwarranted suffering which in turn improves the quality of care received.
Clinical Assessment
The patients who receive high doses of Cytarabine must frequently be monitored due to the side effects that may arise during the treatment process. The platelet count, leucocyte count, and bone marrow evaluations are required for all the patients who receive high doses of Cytarabine (Brown, 2010). The importance of these clinical assessments is based on the risks of suppressed bone marrow that these patients face due to the drug side effects. Patients who experience suppressed bone marrow function end up having their therapy withdrawn to allow for time to recover.
The test was a clinical assessment for the levels of platelet, leukocytes, and bone marrow levels were chosen for various reasons. First, the tests have been identified as mandatory since high levels of Cytarabine experience low blood counts which could be fatal if they are left unchecked during the treatment period. The test has also been chosen since it is a comprehensive indicator of the effects of the drugs on the patients as well as their ability to cope with the adverse effects that arise during the treatment process.
The clinical assessment will offer the nurses in the oncology unit an opportunity to apply the tools of practice and estimate the accuracy and consistency of the information that they obtain. Aside from learning how to interpret the results of the different tests, the nurses will acquire clinical and therapeutic skills as they will be required to provide the required therapeutic management for each of the outcomes that will be obtained during the process. Another objective that will be met by using the clinical assessment tests during the training is to demonstrate to the nurses how they are supposed to manage patients information which is necessary for guaranteeing the continuity of care through the period. The clinical assessment will also enable the nurses to recognize the challenges the practitioners when managing patients who receive the high-dose of Cytarabine.
Content Development and Delivery Process
Since the content that will be taught will be developed from the review of journals, the information provided will be up-to-date and peer-reviewed. As a result, it will impact the students on the importance of adopting evidence-based information during the management of patients, which is a skill that they will retain during their professional lives and enable them to continually provide quality care for the patients (Adams & Valiga, 2009). The development of videos that will be used to provide content during the learning process will also enable the facilitator to reflect on the different materials for the course and make a determination as to whether it meets the objects. The process will also enable the facilitator to make a decision on the different questions that the learners might present and prepare reliable answers that will ensure that learning takes place.
The methods adopted for the development and delivery of the contents to the nurses working in the oncology unit are efficient and will make sure that all the laid out objectives are met. For example, the use of videos and pictures is critical in that it allows the nurses to visualize how to carry out the different exams that are required for the patients (Adams & Valiga, 2009). Videos are effective methods for teaching the assessments as they allow the learners to be in a position to review the videos to ensure that they are confident before they can start carrying out the tests on the different patients. The use of pictures also serves the same function as the videos as they allow the learners to visualize well the content that is being delivered.
Having the charts and flow diagrams as part of the content delivery methods is also an important illustrative method. The charts and flow diagrams will enable the nurses to have a better understanding of the stages that patients are receiving the high-dose of Cytarabine undergo, enabling them to be well prepared to offer quality management and make informed decisions (Adams & Valiga, 2009). Presenting the different diagnostic apparatus is critical as the nurses will be in a position to familiarize themselves with the tools involved before they start using them on the patients. The inclusion of the diagnostic tools during the delivery of the content will also be critical in that it will enable the learners to be able to develop an understanding of the challenges that the practitioners undergo when managing the patients that receive high-dose of Cytarabine.
References
Adams, M., & Valiga, T. (2009). Achieving excellence in nursing education. New York: National League of Nursing.
Brown., C. (2010). Cerebellar assessment for patients receiving high-dose Cytarabine: A standardized approach to nursing assessment and documentation. Clinical Journal of Oncology Nursing, 14(3), 371-373.
Grealish, L. (2014). How competency standards became the preferred national technology for classifying nursing performance in Australia. Australian Journal of Advanced Nursing, 30(2), 30-31.
Hunt, D. (2012). The new nurse educator. New York, NY: Springer.
Makic, M., Martin, S., Burns, S., Philbrick, D., & Rauen, C. (2013). Putting evidence into nursing practice: Four traditional practices not supported by the evidence. Critical Care Nurse, 33(2), 28-43.
Russell, K. (2012). Nursing Practice Acts guide and governs nursing practice. Journal of Nursing Education, 3(3), 36-42.
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