Unit CLINICAL NURSING IN THE CHRONICITY AND DISABILITY

NURSING END OF LIFE CARE

Code	50146701
CFU	1
Teacher	Paola Sarchielli
Learning activities	Caratterizzante
Area	Scienze infermieristiche
Academic discipline	MED/45
Type of study-unit	Obbligatorio (Required)

Canale A

CFU

1

Teacher

Cinzia Venturi

Teachers

• Cinzia Venturi

Hours

• 15 ore - Cinzia Venturi

Language of instruction

Italian

Contents

In Italia nel tempo si è sviluppato un dibattito e riflessione, anche da
parte dei nostri legislatori, sul tema delle cure di fine vita, dell'utilizzo
della medicina palliativa e del consenso informato e di disposizioni
anticipate di trattamento.
Nei diversi contesti di cura, l’infermiere è il professionista che dedica più
tempo accanto alle persone e alle famiglie. Con una visione olistica si
prende cura della persona dalla nascita fino alla fine della vita, con la
coscienza che l’uomo per esistere deve nascere e una volta nato dovrà
morire.
E’ quindi necessario acquisire conoscenze e competenze atte ad offrire
un’idonea assistenza infermieristica e poter permettere alla persona, nel
rispetto della propria autonomia, di fare le scelte migliori sulla propria
salute, sulla malattia, sul fine vita e non solo.
E’ necessario far acquisire allo studente le competenze necessarie
per essere in grado di affrontare le tematiche del fine vita con un
approccio professionale e non personale, saper valutare la qualità della
vita e la qualità della morte anche in riferimento alla normativa vigente.
L'insegnamento proposto concorre a fornire gli elementi fondanti lo
sviluppo del percorso formativo in Infermieristica, orientando lo studente
al fine di garantire un approccio assistenziale nel fine vita mirato ad
accogliere le esigenze, e i bisogni della persona assistita in merito a:
- applicazione del processa di assistenza nel fine vita
- La morte e il morire
- Il dolore e gli altri sintomi
- Core curriculum delle cure palliative
- Il concetto di qualità di vita e di morte

Reference texts

Prandi C., Infermieristica in cure palliative, Ed. Endra, 2015
Vernocchi S., Le cure palliative. La gestione del fine vita e del lutto. Ed.
Primiceri, 2019.
Un caso letterario: La morte di Ivan Il’ic di Lev Tolstoj

Educational objectives

Gli studenti dovranno essere in grado di affrontare le tematiche del fine
vita con un approccio professionale:
Saper valutare la qualità della vita e la qualità della morte.
Acquisire conoscenze teoriche e applicate circa la salute e la malattia dal
punto di vista etico. Le cure palliative, il dolore, il malato terminale, il
care giver, l'assistenza infermieristica nel fine vita.
Acquisire una specifica conoscenza sul ruolo dell’infermiere nell’ambito
del fine vita.
Acquisire competenze associate al ruolo dell’infermiere in Cure Palliative.
Acquisire competenze associate al processo decisionale clinico e psicosociale
volte ad assicurare il controllo del dolore, la qualità di vita dei
pazienti e delle famiglie in Cure Palliative, nel fine vita e nel lutto.
Acquisire competenze associate all’uso appropriato di interventi, attività
e abilità psico-socio-sanitarie finalizzate a fornire un’assistenza ottimale
ai pazienti e alle famiglie in Cure Palliative, nel fine vita e nel lutto.
Acquisire conoscenze in riferimento alla normativa vigente e articoli
Codice Deontologico in riferimento allo specifico argomento.

Prerequisites

Al fine di saper comprendere e saper affrontare il corso lo studente deve
essere in possesso di un bagaglio di pre-conoscenze in riferimento a
competenze relazionali ed empatiche acquisite nel primo anno di studi
universitari, ciò è necessario allo studente che voglia seguire il corso con
profitto e che aspiri ad un concreto successo formativo.

Teaching methods

Il corso è organizzato nel seguente modo:
- lezioni frontali che verteranno su tutti gli argomenti del corso,
videoproiezioni e analisi/discussione di alcune narrazioni.

Other information

Contatti con la docente:
lorella.bacci@unipg.it
maildilory@gmail.com

Learning verification modality

L’esame prevede una prova scritta finalizzata ad accertare il livello di conoscenza e
capacità di comprensione raggiunto dallo studente sui contenuti teorici e
metodologici indicati nel programma.

Extended program

Presentazione del modulo
La morte e il morire: ll concetto di qualità di vita e di morte
Umanizzare il morire: etica di fine vita, il dolore e la sofferenza:
esperienza complessa
Richiamo al codice deontologico
La carta dei diritti dei morenti
Gli stadi psicologici del morire
I luoghi del morire e i bisogni del morente
Applicazione del processo di assistenza nel fine vita
Il dolore e gli altri sintomi
Morire con dignità: Dat e donazioni
La continuità delle cure di fine vita e i modelli di riferimento:
programma hospice, le cure palliative domiciliari, ambulatoriali.
Lavoro in equipe e il ruolo degli operatori sanitari e strumenti di
valutazione delle cure del fine vita
Cure palliative - Bambini
Lutto e cordoglio
Riferimenti normativi: Legge 38 del 15 Marzo 2010: “
Disposizioni per garantire l’accesso alle cure palliative e alla terapia del
dolore” e Legge 219/2017 “Norme in materia di consenso informato e di
disposizioni anticipate di trattamento”

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Canale B

CFU

1

Teacher

Cinzia Venturi

Teachers

• Cinzia Venturi

Hours

• 15 ore - Cinzia Venturi

Language of instruction

Italian

Contents

The contents will be aimed at the culture of palliative care and assistance in the end of life, with particular attention to the ethical aspect linked to the end of life.
Organizational issues, rules related to pain therapy and advance treatment directives will be discussed.

Reference texts

material produced by the teacher

Educational objectives

Ensure that assistance is respectful of human dignity.
Support living in a meaningful way
Scale care planning to achieve individual goals of care.
Recognize the individual with life-threatening disease and their family as a unit of care.
Support the family in coping with loss and grief during illness and bereavement.
Respect individuals' personal, cultural and religious values, beliefs and practices in the provision of care.
Valuing the ethical principles of autonomy, charity, non-maleficence, justice, sincerity and confidentiality.

Prerequisites

no

Teaching methods

frontal lesson, narration, group work

Other information

no

Learning verification modality

written and oral exam

Extended program

-Presentation of the form and administration of a questionnaire
- Reference to the code of ethics and the professional profile
- Epidemiological aspects, principles, philosophy and assistance in the end of life
-Teamwork and the role of health professionals and evaluation tools for end-of-life care
-Control measurement and treatment of pain and symptoms associated with chronic degenerative diseases in the elderly
-Nursing at the end of life
-death in children
- the continuity of end-of-life care and the reference models:
hospice program, home palliative care, outpatient.
- Treatment of symptoms at the end of life.
-Ethics of the end of life
-Death and dying

Obiettivi Agenda 2030 per lo sviluppo sostenibile

5-6-10

GERIATRICS

Code	50014001
CFU	1
Teacher	Paola Sarchielli
Learning activities	Caratterizzante
Area	Interdisciplinari e cliniche
Academic discipline	MED/09
Type of study-unit	Obbligatorio (Required)

Canale A

CFU

1

Teacher

Carmelinda Ruggiero

Teachers

• Carmelinda Ruggiero

Hours

• 15 ore - Carmelinda Ruggiero

Language of instruction

Italian

Contents

Demography of aging. Principles of biology and physiology of aging. Elderly patients and geriatric patients. Main geriatric syndromes. Recurring clinical issues in geriatric medicine. Aspects of physical therapy and assistance in the elderly. Ethical controversies in geriatric medicine

Reference texts

- Paziente anziano. Paziente geriatrico. Medicina della complessità. Fondamenti di Gerontologia e Geriatria. Senin Umberto, Polidori Maria Cristina, Cherubini Antonio, Mecocci Patrizia, 4th Edition EdiSes Napoli (Italy), 2020.

Educational objectives

The course aims to acquaint the student with the principles of Gerontology and Geriatrics, a completely autonomous discipline, with its own cultural and professional area. Discussed topics should bring to light the originality of the elderly patient, which differs from the adult in terms of anatomy, physiology, pathology, and clinical care; the relationship between evidence-based medicine, medical complexity and geriatric medicine; the frail elderly; the geriatric syndromes; the main recurrent diseases in geriatrics; behavioral principles in geriatric medicine. Upon this knowledge the student must be able to recognize the unique aspects of aging, atypical presentation of many systemic and organic diseases and the complexity of multimorbidity, interactions between psychic and organic conditions able to amend the prognosis of diseases, the risks associated with polypharmacy, the value of multidimensional geriatric assessment in different health care settings.

Prerequisites

Basic Knowledge of Pysiology of Nervous and Muscular Systems.

Teaching methods

Frontal lessons

Other information

Calendar of educational activities:
Available at http://www.med.unipg.it/infermieristica//Perugia/indexinfPG.htm

Learning verification modality

The exam includes a written test consisting of an open answer elaborate to two questions on neurological diseases treated in the course. The test lasts for an hour and a half and is designed to verify the knowledge of the main clinical aspects of the neurological diseases object of the questions as well as their nursing management in the different stages of severity

Extended program

- Aging: demographics in Italy, in Europe and outside Europe: implications in clinical practice
- Principles of Biology and Physiology of aging
- Chronic diseases, polypathology and disability; concept pertaining to active life
- The concept of geriatric syndrome, atypical presentation of diseases in the elderly
- “Frail Elderly”
- Multidimensional geriatric rating: concepts, methods and instruments;
- Brain aging, cognitive disorders in the elderly, dementia in elderly; delirium
- Heart failure in the elderly
- Postural instability, dizziness, sarcopenia, osteoporosis, falls and fractures in the elderly
- Nutritional problems in the elderly
- Immobilization; bedsores
- Urinary Incontinence
- Geriatric medicine as medicine of complexity
- Principles of geriatric treatment. Risk of iatrogenic disease in peculiar conditions (elderly, polypharmacy, drug abuse, etc.)
- Depression in the elderly
- Sensory deficits and related clinical and practical complications
- The role of physical activity and lifestyle changes in the treatment and prevention of diseases
- Ethical controversies in geriatric medicine

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Quality education

Canale B

CFU

1

Teacher

Virginia Boccardi

Teachers

• Virginia Boccardi

Hours

• 15 ore - Virginia Boccardi

Language of instruction

Italian

Contents

Demography of Aging. Principles of Aging Biology and Physiology. Older Patient and Geriatric Patient. Major Geriatric Syndromes.
Recurrent Clinical Issues in Geriatric Medicine. Care Aspects in the Older Persons.

Reference texts

- Paziente anziano. Paziente geriatrico. Medicina della complessità. Fondamenti di Gerontologia e Geriatria. Senin Umberto, Polidori Maria Cristina, Cherubini Antonio, Mecocci Patrizia, 4^ Edizione EdiSes Napoli (Italia), 2020- Paziente anziano. Paziente geriatrico. Medicina della complessità. Fondamenti di Gerontologia e Geriatria. Senin Umberto, Polidori Maria Cristina, Cherubini Antonio, Mecocci Patrizia, 4^ Edizione EdiSes Napoli (Italia), 2020

Educational objectives

The course aims to introduce students to the following concepts:

• Principles and methodology of multidimensional assessment.
• Professional tools necessary to adequately manage older patients in various healthcare settings.
• The importance of understanding the unique aspects of older patients, the complexity of approaching and managing frail patients, geriatric syndromes, and common geriatric diseases.
• The need for a multidisciplinary approach for effective management.

In light of this knowledge, students will be able to:

• Identify and report elements suggesting clinical and care complexity.
• Implement strategies to reduce the risk of adverse events within personalized care plans.

Prerequisites

Basic knowledge of internal medicine pathophysiology

Teaching methods

Interactive classroom lectures.

Other information

The schedule of educational activities will be published on the Nursing Degree Course website. I am available to meet students for any needs by appointment.

Learning verification modality

The exam will aim to assess the student's ability to understand the structure and organization of the geriatric field, both within the hospital and in the community context. Additionally, the knowledge of specific tasks and activities will be evaluated. The student will need to demonstrate the capability to thoroughly discuss the most common and frequent geriatric syndromes, as well as the skill in interpreting and comprehending management planning in the geriatric context

Extended program

• Demography and epidemiology of aging
• Biology and physiology of aging
• Older patient and geriatric patient
• Chronic diseases, comorbidity, and disability; concept of healthspan and diseasespan
•Multidimensional geriatric assessment and care network for frail geriatric individuals
• Geriatric syndromes
•Polypharmacotherapy, pharmacological review, and the concept of deprescribing in the elderly
• Delirium
• Depression
• Cognitive decline
• Nutritional issues in the older population
• Fluids and electrolytes
• Management of older diabetic patients and oldest diabetic patients
• Functional decline, immobility, and immobilization syndrome
• Urinary incontinence
• End-of-life care

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Quality education

CLINICAL AND REHABILITATIVE NURSING IN THE CHRONICITY AND DISABILITY

Code	50363402
CFU	2
Teacher	Paola Sarchielli
Learning activities	Caratterizzante
Area	Scienze infermieristiche
Academic discipline	MED/45
Type of study-unit	Obbligatorio (Required)

Canale A

CFU

2

Teacher

Giovanna Gori

Teachers

• Giovanna Gori

Hours

• 30 ore - Giovanna Gori

Language of instruction

Italian

Contents

approach to the person suffering from chronic pathology and disability

Reference texts

Principi fondamentali dell'assistenza infermieristica
di Ruth F. Craven
Mappe concettuali per l'assistenza infermieristica.Casi clinici per migliorare la comunicazione, la collaborazione e l'assistenza
di Barbara L. Yoost
Piani di assistenza infermieristica. Diagnosi infermieristiche, risultati di salute e interventi infermieristici
di Meg Gulanick

Educational objectives

Acquire technical, relational and educational competence in order to promote the maximum possible autonomy of the chronic or disabled patient and his caregivers through the implementation of therapeutic education interventions, self-care training and rehabilitation for an improvement in the quality of life.

Prerequisites

Knowledge of the nursing care process

Teaching methods

frontal lessons

Other information

Learning verification modality

multiple choice questionnaire

Extended program

1. Definitions, epidemiology and characteristics of disability., International Classification of the Functioning of Disability and Health (ICF).
2. Definition of chronicity: the objectives of health 21 for the xxi century, the national plan of chronicity.

5. The management of the "assistance and educational" path of the person suffering from stroke in the post-acute phase.
6. The management of the "welfare and educational" path of the person with COPD

Obiettivi Agenda 2030 per lo sviluppo sostenibile

Canale B

CFU

2

Teacher

Giovanna Gori

Teachers

• Giovanna Gori

Hours

• 30 ore - Giovanna Gori

Language of instruction

Italian

Contents

approach to the person suffering from chronic pathology and disability

Reference texts

Principi fondamentali dell'assistenza infermieristica
di Ruth F. Craven
Mappe concettuali per l'assistenza infermieristica.Casi clinici per migliorare la comunicazione, la collaborazione e l'assistenza
di Barbara L. Yoost
Piani di assistenza infermieristica. Diagnosi infermieristiche, risultati di salute e interventi infermieristici
di Meg Gulanick

Educational objectives

Acquire technical, relational and educational competence in order to promote the maximum possible autonomy of the chronic or disabled patient and his caregivers through the implementation of therapeutic education interventions, self-care training and rehabilitation for an improvement in the quality of life.

Prerequisites

Knowledge of the nursing care process

Teaching methods

frontal lessons

Other information

Learning verification modality

multiple choice questionnaire

Extended program

1. Definitions, epidemiology and characteristics of disability., International Classification of the Functioning of Disability and Health (ICF).
2. Definition of chronicity: the objectives of health 21 for the xxi century, the national plan of chronicity.

5. The management of the "assistance and educational" path of the person suffering from stroke in the post-acute phase.
6. The management of the "welfare and educational" path of the person with COPD

Obiettivi Agenda 2030 per lo sviluppo sostenibile

NEUROLOGY

Code	50099301
CFU	1
Teacher	Paola Sarchielli
Teachers	Paola Sarchielli
Hours	15 ore - Paola Sarchielli
Learning activities	Caratterizzante
Area	Interdisciplinari e cliniche
Academic discipline	MED/26
Type of study-unit	Obbligatorio (Required)