39553 - Advanced Seminars 1 (RN)

Learning outcomes

At the end of the training activities the student have: knowledge about welfare/educational/organizational aspects of specific and/or particular illness and nursing care.

Course contents

The course is organized into topic-based sessions and divided into the following eight seminar modules, aimed at deepening knowledge and competencies in patient safety and the management of complex nursing care.

1. Clinical Risk Management 

• Understand and explore the main regulatory and clinical aspects of patient safety relevant to nursing practice.
• Understand approaches that consider errors and near misses as opportunities for learning and quality improvement.
• Present and discuss strategies for risk prevention and reduction.
• Learn methods and tools for risk identification, analysis, and management.

2. Blood Components Management

• Understand the different phases of the transfusion process.
• Blood component requests: completion of request forms, blood sampling procedures (double blood group determination), submission of samples and requests, and collection of blood units.
• Transportation and storage of blood and blood components.
• Blood transfusion procedures: patient identification, blood unit verification, and administration.
• Management of transfusion reactions.
• Administer blood and blood components in accordance with current legislation and good transfusion practices, minimizing transfusion-related risks.
• Monitoring the transfusion pathway through computerized systems.

3. Management of Risks Related to Drug Therapy and Controlled Substances

• Understand the phases of safe medication management, including common errors, associated risks, and preventive strategies.
• Pharmaceutical cabinet management: procurement, inventory control, storage, and expiration date monitoring.
• Safe handling of concentrated electrolyte solutions, medications, medicinal samples, and patients’ own medications.
• Management of High-Alert Medications (HAMs) and Look-Alike/Sound-Alike (LASA) medications.
• Proper maintenance of controlled substances registers, including storage, procurement, and disposal procedures.

4. Care of Patients with Complex Wounds: Vascular Ulcers and Diabetic Foot 

• Holistic approach to patients with chronic skin lesions.
• Etiological assessment of diabetic foot ulcers (neuropathic, ischemic, and neuro-ischemic).
• Wound management: cleansing, debridement, biofilm management according to the TIME/WBP framework.
• Use of advanced wound dressings and Negative Pressure Wound Therapy (NPWT/VAC).

5. Nursing Care of Patients Undergoing Dialysis (3 hours)

Develop planning and management skills for the care of patients with acute and chronic renal failure, with particular focus on:

• Hemodialysis and peritoneal dialysis: principles, differences, advantages, disadvantages, and patient selection criteria.
• Vascular access for hemodialysis: nursing management of arteriovenous fistulas (AVF) and dialysis central venous catheters (CVCs).
• Monitoring intradialytic complications, particularly hypotension.
• Patient education in dialysis care, with special attention to dietary management.

6. Nursing Care of Patients with Cancer and Palliative Care

• Nurse–patient relationship in oncology care.
• Differences among chemotherapy, immunotherapy, and targeted therapies.
• Chemotherapy management: handling procedures, side effects, and extravasation management.
• Ethical and professional issues in end-of-life care, including the principles established by Italian Law 38/2010.

7. Principles of Nutrition: Choosing an Individualized Diet Plan 

Acquire knowledge regarding nutrition principles and healthy lifestyles, with particular focus on:

• Nutritional assessment and malnutrition screening.
• Disease-specific dietary management for diabetes mellitus, liver cirrhosis, cardiovascular diseases, renal failure, inflammatory bowel diseases, neurological disorders, geriatric patients, and dysphagia.
• Appropriate use of Oral Nutritional Supplements (ONS).
• Personalized hospital diets.

8. Connected Care: Digital Technology in Healthcare 

• Challenges of digital transformation and the impact of Artificial Intelligence on proactive healthcare models.
• Identification of emerging needs related to “digital vulnerability”.
• Professional accountability and responsibilities in the use of telecare, telehealth services, and emerging healthcare technologies.

Readings/Bibliography

Required Readings

• Lecture slides and multimedia materials provided by the lecturers and uploaded to the Virtuale platform.
• AUSL Romagna institutional procedures and policies discussed during the seminars.
• Additional references and readings recommended by lecturers during class.

Recommended Readings

Clinical Risk Management

• Italian Law No. 24 of 8 March 2017 (Gelli-Bianco Law) on patient safety and professional liability.
• Vincent C. Patient Safety. Springer, Milan, 2011.
• Martini M., Pelati C. Clinical Risk Management. McGraw-Hill, Milan, 2011.
• Italian Ministry of Health. Patient Safety and Clinical Risk Management: Training Manual for Healthcare Professionals.
• Additional recommended readings: Italian Ministry of Health Manual Patient Safety and Clinical Risk Management (2017) and AUSL Romagna Procedure PA 04 on the reporting of adverse events and near misses.

Blood Components Management

• Badon P., Canesi M., Monterosso A., Pellegatta F. Nursing Procedures. Zanichelli, 2018. Card 65.
• Brunner & Suddarth. Textbook of Medical-Surgical Nursing. 5th Italian Edition, CEA, 2017. Chapter 32.
• AUSL Romagna Procedures: PA 09 (Informed Consent) and PA 139 (Transfusion Therapy).

Management of Risks Related to Drug Therapy and Controlled Substances

Italian Ministry of Health Recommendations:

• Recommendation No. 7: Prevention of death or serious harm resulting from medication errors.
• Recommendation No. 1 (2008): Safe use of concentrated potassium chloride solutions.
• Specific recommendations regarding LASA (Look-Alike/Sound-Alike) and High-Alert Medications.

Care of Patients with Complex Wounds: Vascular Ulcers and Diabetic Foot

Guidelines and Position Documents:

• European Wound Management Association (EWMA) documents (2006, 2008, 2013, 2022) on holistic wound care, management of infected wounds, and educational curricula.
• Registered Nurses’ Association of Ontario (RNAO) Best Practice Guidelines on pressure injury prevention and management.
• World Union of Wound Healing Societies (WUWHS). Position Document on Biofilm Management (2016).
• Emilia-Romagna Region. Advanced Dressings for the Treatment of Acute and Chronic Wounds (2016).
• Brunner & Suddarth. Textbook of Medical-Surgical Nursing. 5th Italian Edition, CEA, 2017. Chapter 61.

Nursing Care of Patients Undergoing Dialysis

• Brunner & Suddarth. Textbook of Medical-Surgical Nursing. 5th Italian Edition. Chapter 54.
• FADOI Guidelines (2015): Identification and Management of Chronic Kidney Disease.
• AUSL Romagna Procedure PA 238 (Advanced Chronic Kidney Disease Care Pathway).
• Italian Ministry of Health. Guidance Document on Chronic Kidney Disease.

Nursing Care of Patients with Cancer and Palliative Care

• Italian Law No. 38/2010 on palliative care and pain management.
• Brunner & Suddarth. Textbook of Medical-Surgical Nursing. Chapters 15 and 16.
• Italian Society of Palliative Care (SICP). Core Curriculum for Nurses in Palliative Care (2012).
• AIOM Guidelines (2017) on antiemetic therapy, cancer pain management, and psychosocial support.
• Technical procedure: Classification of antineoplastic drugs according to toxicity (IRST Procedure S02/PA21).

Principles of Nutrition: Choosing an Individualized Diet Plan

Nutritional Guidelines:

• SINPE Guidelines (2022) for Hospital Artificial Nutrition.
• CREA Guidelines (2018) for Healthy Eating.
• AMD/SID Guidelines for the Management of Patients with Diabetes.

Connected Care: Digital Technology in Healthcare

Professional and Regulatory References:

• FNOPI Position Statement: Digital Health (September 2024).
• AGENAS. Reference Model for the Delivery of Telecare Services.
• Italian Law 42/1999 and National Guidelines for Telemedicine (2020).

Additional recommended readings: World Health Organization (WHO) reports and studies on equitable access to digital health technologies

Teaching methods

The course adopts interactive lectures integrated with guided discussions of real clinical cases in order to promote active learning and student engagement.

Assessment methods

Assessment is designed to certify the achievement of the intended learning outcomes.

Attendance requirement: Students are required to attend at least 66% of the seminar hours.

Assessment type: The assessment leads to a pass/fail result.

Format: Written test consisting of 30 multiple-choice questions.

Duration: 30 minutes.

Passing criteria: Students pass the assessment by correctly answering at least 21 out of 30 questions. The pass result is valid only for the current examination session.

Use of Artificial Intelligence: Limited, declared, and non-substantive use of Artificial Intelligence is permitted for study support activities, such as summarization, rephrasing, and self-assessment. The use of AI during the written examination is not permitted.

Students with Specific Learning Disorders (SLD), disabilities, or temporary/permanent impairments: Students requiring accommodations should contact the University Office for Students with Disabilities and Specific Learning Disorders (https://site.unibo.it/studenti-con-disabilita-e-dsa/it ) to arrange appropriate support measures. Any accommodations must be submitted for the instructor’s approval at least 15 days before the examination date.

Teaching tools

To promote accessibility, teaching activities make use of multimedia presentations, technical videos illustrating clinical procedures, and a digital learning platform (Virtuale) for accessing course materials and recommended readings.

Links to further information

https://corsi.unibo.it/laurea/Infermieristica-Rimini/laboratorio

Office hours

See the website of Martina Borgogelli