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- Working in Partnership to Support People with Long-Term Conditions
This module has been developed in response to the skills required of practitioners across a range of disciplines to meet the needs of the increasing number of people with long term conditions (Department of Health 2013) and consultation with individuals with long term conditions, stakeholders and clinicians across the health and social care economy. The module acknowledges the students clinical background and develops a whole systems approach to supporting the individual and their family/carer. This is enhanced by the provision of an inter-professional learning environment. A blended learning approach is utilised including Keele Learning Environment (KLE) delivered by a combination of classroom and web based activities and resources. This module can be studied as an alternative module to NUR 30160 Supporting People with Long Term Conditions which attracts 30 credits at Level 6. depending on the needs of the students i.e. stand alone module, or specific degree pathway.
To enhance evidence based knowledge and analytical skills in assessing, planning, implementing and evaluating care that the individual person, family/carer receive to the management of long term condition(s).
Candidates must normally hold a professional registration with an appropriate body and be working within a care setting relevant to the module. Evidence of level 2 academic work or equivalent.
Epidemiology of long term conditions.
The principles and application of models of managing people with long term condition(s): to include the management of people for supported self care, disease-specific case management, and high intensity users of unplanned secondary care (DH 2007; NSF’s; NICE guidelines; Kaiser Permante).
Awareness and critical evaluation of the evidence and current research supporting the management of long term conditions; specific NSF’s coronary heart disease (CHD), heart failure, stroke and transient ischemic attack (TIA), hypertension, diabetes, chronic obstructive pulmonary disease (COPD), epilepsy, cancer, severe mental health conditions, asthma, and other acknowledged long term conditions (DH 2007) chronic kidney disease, dementia, depression, multiple sclerosis, parkinson’s disease, to include NICE guidelines, DH publications and other sources of evidence.
Recognition and appropriate response to management of people with long term conditions; to include understanding of risk prediction tools , physiological and psychosocial observations dependant upon discipline and/or role, effective referral and communication with individuals, families and the multi-disciplinary team, timely referral and co-ordination to areas of least invasive care in the least intensive settings, supporting effective primary care and necessary secondary care (Skills for Health 2008).
Physiology and recognition of related pathophysiology of specific long term conditions.
Bio-psychosocial care of the individual requiring management of long term condition(s); to include identification, assessment, planning, implementation and evaluation of the physical, psychological and social needs of the person with long term condition(s) dependant upon discipline and/or role communicating within the multi disciplinary team across primary and secondary health and social care settings. (NSF’s; NICE guidelines; Skills for Health).
Empowerment of people to manage self care of long term condition(s); individual budgets, assistive technology, patient experience programme, expert patient and NHS Direct.
Medicines management and the Pharmacy contract.
The interface of management of long term condition(s) and end of life care.
Ethical, legal and professional issues related to care of the patient requiring management of long term condition(s); to include professional accountability, clinical governance, risk management, &relevant legislation and the implications for multi-disciplinary, inter-agency working across health and social care settings.
Service development recognizing and exploring collaborative and integrated ways of working.
The interface of health and social care and primary/secondary care.
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