Care of the Hospitalized Adult 2

This is the second course in a four-course Certificate in Hospital & Acute Care for Nurse Practitioners.

The certificate builds upon the foundational knowledge acquired through entry-to-practice education and the acquisition of entry-to-practice competencies. The certificate will equip Nurse Practitioners with the knowledge and tools to confidently assess, diagnose and develop a treatment plan for the acutely ill adult patient, hospitalized with a broad range of conditions, and facilitate a foundation for advanced nursing care of the ill or critically ill patient.

This 8-week online course consists of 7 weeks of course material and one week for a final short answer exam. Participants will focus on developing diagnostic reasoning and therapeutic planning skills in the context of managing acute patient presentations in hospital settings in the following clinical areas: respirology, acid-base and electrolyte abnormalities, renal dysfunction (acute and chronic), gastrointestinal issues (GI bleeding, hepatic issues and severe nausea and vomiting), mental health and substance use.

An interactive and case-based approach is utilized to review acute clinical problems with an emphasis on diagnostic reasoning and therapeutic planning skills. Clinical experts will discuss the differential diagnosis, relevant pathophysiology, identification of assessment findings, the relevant diagnostic approach, the therapeutic plan of care, and the red flags that require intervention or consultation.

Prerequisites:

Currently registered as a Nurse Practitioner or a student in a nurse practitioner program.

Audience

Nurse Practitioners who wish to further develop their competency, knowledge, skill and clinical acumen in the care of clients with mental health and addictions issues. Course participants must hold current registration as a Nurse Practitioner in their jurisdiction or be a student in a nurse practitioner program.

Learning Objectives:

At the completion of the 4-course certificate program, learners will be able to:

A. Articulate the role and competencies of a Nurse Practitioner working with hospitalized adult patients.

  • Discuss key role and scope issues relevant to the NP role in hospitals.
  • Identify accountabilities and necessary skills of NPs in the most responsible provider role.
  • Demonstrate confidence to practice independently and collaboratively.

B. Display sound diagnostic reasoning skills by successfully developing a broad differential diagnosis & diagnostic and treatment plan for selected patient conditions.

C. State the clinical care requirements and management for a wide variety of acute clinical conditions in adult hospitalized patients including the ability to: 

  • Conduct the appropriate advanced health assessment strategy.
  • Develop an appropriate differential diagnosis.
  • Recognize red flags and how to triage patients who may require a higher level of care and/or patients that are rapidly deteriorating.
  • Choose an appropriate diagnostic testing strategy.
  • Identify a treatment strategy and an evaluation plan.
  • Select appropriate technical interventions and treatments (if relevant).
  • Describe indications for necessary consultations and referral.
  • Identify accountabilities for communication at transitions in care and for safe discharge.
  • Communicate relevant priorities for secondary prevention.

Registration Now Open

Registration closes September 10th, 2024

Course Format

This course is a fully online asynchronous course through the University of Toronto Learning Portal – QUERCUS. Each week, participants will view e-learning modules, review required readings and resources and actively engage with learning activities that will focus on the application of learning. Learning activities and assignments will provide an opportunity to apply learnings and receive feedback.

Participants can expect to allocate a minimum of 5-10 hours a week for completion of a weekly module and will need to allocate additional time for assignments. The time spent on any one module will vary from student to student based on your learning needs and style of learning.

Each week will consist of a recorded lecture by faculty who are expert clinicians in their field. Faculty will be available for questions through discussion board during the scheduled week for the module.

Each module focuses on one or more health systems or clinical themes, discussion of the appropriate health assessment, relevant differential diagnoses, pathophysiology, red flags, diagnostics and diagnostic sensitivity/specificity, therapeutic plan of care, selection of appropriate technical interventions and treatments, and indications for referral and/or consultation, considerations in transitions in care/discharge, and relevant role and scope issues.

Additional clinical resources will be provided such as clinical practice guidelines, relevant practice standards and clinical tools for practice.

Most weeks will include an application exercise such as a learning activity.

Care of the Hospitalized Adult 1

This is the first course in a four-course Certificate in Hospital & Acute Care for Nurse Practitioners. The certificate builds upon the foundational knowledge acquired through entry-to-practice education and the acquisition […]

Care of the Hospitalized Adult 3

This is the third course in a 4-course Certificate in Hospital & Acute Care for Nurse Practitioners. The certificate builds upon the foundational knowledge acquired through entry to practice education and […]

Care of the Hospitalized Adult 4

This is the fourth course in a four-course Certificate in Hospital & Acute Care for Nurse Practitioners. The certificate builds upon the foundational knowledge acquired through entry to practice education and […]

TimeDescriptionEvaluative Components

Week 1

Respirology Part 1

By the end of this module, participants will be able to recognize the clinical care requirements and successfully manage a patient presenting with acute dyspnea and hypoxia:

  • Understand the approach to history-taking and physical examination for a patient presenting to hospital with a new or chronic respiratory complaint
  • Be able to apply the differential diagnosis of acute dyspnea and hypoxia to a hospitalized patient
  • Understand the mechanisms of hypoxia and respiratory failure and apply them to common patient presentations
  • Identify the key history and examination findings in patients with acute pulmonary embolism
  • Review the clinical utility of common diagnostic tests in ruling in & out acute PE
  • Discuss the management strategy for PE in the hospital setting
  • Understand the approach to common bacterial pneumonia syndromes including bacterial community acquired pneumonia, hospital acquired pneumonia, ventilator associated pneumonia; and common and life-threatening viral pneumonias including influenza and COVID-19 pneumonia 
  • Understand the differential diagnosis and workup for a patient presenting with a new pleural effusion and the management principles for pleural effusions based on Light’s Criteria and pleural studies
  • Become familiar with the principles of management of a pneumothorax

Week 2

Respirology Part 2

By the end of this module, participants will be able to recognize the clinical care requirements and successfully manage a patient presenting with COPD and asthma exacerbations and pulmonary edema:

  • Understand the key investigations to diagnose the exacerbation and rule out alternate or comorbid disease
  • Recognize patients with severe presentations
  • Be able to initiate a pharmacologic management plan
  • List the indications for mechanical ventilation
  • Recognize pulmonary edema as a cause of respiratory symptoms and failure
  • Be able to describe an approach to pulmonary edema and list the causes based on underlying pathophysiology
  • With respect to cardiogenic pulmonary edema, ARDS, TRALI, and TACO, be able to diagnose and distinguish them clinically and radiographically

By the end of the session on CXR, the learner will have improved their ability to utilize chest x-rays as an adjunct to clinical assessment and:

  • How to undertake a systematic approach to CXR interpretation
  • Be able to identify the difference between an AP and PA CXR
  • Be able to identify the normal anatomy in an AP and PA CXR
  • Be able to diagnose/identify common cardio respiratory abnormalities (atelectasis, pneumonia, pleural effusion/hemothorax, pulmonary edema, pneumothorax and rib fractures)

Live interactive learning session at (or alternate activity for those unable to attend)

Week 3

Acute Electrolyte Abnormalities

By the end of this module, participants will be able to:

  • Understand the two main mechanisms of maintaining blood pH (respiratory and metabolic)
  • Interpret acid/base lab investigations
  • List a differential diagnosis for common acid and base disorders
  • Review cases of acid base disturbances
  • Identify life threatening electrolyte disorders (hyponatremia, hypernatremia, hypokalemia and hyperkalemia)
  • Develop a differential diagnosis for common electrolyte disorders
  • Understand the management of acute and chronic, mild and severe electrolyte imbalance
  • Order diagnostic tests to identify the cause and monitor response to treatment
  • Recognize when to refer patients to consulting services such as nephrology, critical care and endocrinology

Case Study #1

Week 4

Acute and Chronic Kidney Disease

By the end of this module, participants will be able to recognize the clinical care requirements and successfully manage and understand:

  • Chronic kidney disease
  • Pharmacologic considerations
  • Acute kidney injury, including contrast-induced nephropathy
  • Indications for dialysis
  • Management of PD and HD patients in the acute care setting
  • Issues related to chronic dialysis – anemia, acid/base balance, phosphate in the acute care setting

TimeEvaluative Components

Week 5

Gastroenterology

By the end of this module, participants will be able to recognize the clinical care requirements and successfully manage:

  • Develop a differential diagnosis for upper and lower gastrointestinal (GI) blood loss
  • Learn how to manage GI bleeding in a hospitalized patient
  • Understand how to interpret tests of liver function and liver damage
  • Identify causes and complications of acute & chronic liver disease
  • List common GI motility disorders
  • Manage nausea and vomiting in the hospitalized patient
  • Recognize common indications for GI referral

Live interactive learning activity: Electrolyte imbalances and medical GI issues

Week 6

Mental Health

By the end of this module, participants will be able to recognize the clinical care requirements and successfully manage:

  • Mood Disorders with a focus on major depressive disorder
  • Suicidal ideation/intent
  • Anxiety/Severe agitation
  • Acute psychosis

Case Study #2

Week 7

Substance Use Disorders

By the end of this module, participants will be able to regcognize the clinical care requirements and successfully manage a patient presenting with:

  • Substance related and addictive disorders with a focus on alcohol and opioids including screening, assessment, management and follow-up
  • Concurrent disorders (mental illness and substance use)
  • Polysubstance use disorders
  • Stimulant and benzodiazepine use disorders

Discussion Board Reflection Exercise

Week 8

Exam Week

Exam

Course Directors

Marnee Wilson

Assistant Professor, Teaching-Stream, Bloomberg Faculty of Nursing, Centre for Professional Development, University of Toronto
Professional Practice Leader for Nurse Practitioners and Nurse Practitioner, Cardiovascular Surgery, St. Michael’s Hospital/Unity Health Toronto

Faculty

Shahnawaz Ali

Nurse Practitioner, Canadian Mental Health Association Peel, RAAM Clinic
Adjunct Lecturer, Lawrence Bloomberg Faculty of Nursing, University of Toronto

Alex Cressman

PGY6 General Internal Medicine Fellow
Division of General Internal Medicine
Temerty Faculty of Medicine, University of Toronto

Elizabeth Hendren

PGY6 Nephrology
Department of Medicine, University of Toronto

Cindy Pritchard

Nurse Practitioner, Psychosis Disorders/Prompt Clinic
Ontario Shores Centre for Mental Health Sciences
Adjunct Lecturer, Lawrence Bloomberg Faculty of Nursing, University of Toronto

Kieran McIntyre

Assistant Professor, Department of Medicine, University of Toronto, Division of Respiratory Medicine

Alison Thomas

Nurse Practitioner, Hemodialysis, St. Michael’s Hospital/Unity Health Toronto
Adjunct Lecturer, Lawrence Bloomberg Faculty of Nursing, University of Toronto

Susan Chernenko

Associate Graduate Lecturer, Lawrence Bloomberg Faculty of Nursing, University of Toronto

Registration Information

Fees

$870 + HST
$970 + HST
$825 + HST
$825 + HST
$825 + HST

Site Groups

A group discount rate of 15% is available for site groups of three or more people. To book please contact pd.nursing@utoronto.ca.

Please Note

  • Refund Policy – To withdraw from a course, send a written request to pd.nursing@utoronto.ca by August 9, 2024.  No refunds will be given after this date. All refunds are subject to an administrative fee of $100 + tax. Alternatively, a colleague may attend in your place. Please send your substitution request at least 3 days prior to the course to pd.nursing@utoronto.ca.
  • Registration Deadline: September 9, 2024.
  • *U of T Nursing Alumni discount is available to participants who hold a BScN, MN, PMNP Diploma, MScN or PhD from the Lawrence Bloomberg Faculty of Nursing, University of Toronto.
  • **U of T Nursing Faculty discount is available to participants who hold a current (at time of registration) faculty position, an adjunct appointment or a status appointment to the Lawrence Bloomberg Faculty of Nursing, University of Toronto
  • ***NPAO (Nurse Practitioner Association of Ontario) members may register at the NPAO rate which is 15% off the regular rate. NOTE: All submissions will be checked and verified for current NPAO membership status using the registrant’s name.
  • Applicable taxes (13% HST) will be added to the registration fees.
  • Course Cancellation Policy – The Centre for Professional Development reserves the right to cancel courses due to circumstances. The decision to cancel a course is normally made 15 days prior to the course. If you are enrolled in a course which is subsequently cancelled, you may apply your fee to another course, or receive a full refund. The Centre is not responsible for any travel or other expenses incurred by you.

Contact Us

Centre for Professional Development
Lawrence Bloomberg Faculty of Nursing
University of Toronto
155 College Street, Suite 130
Toronto, ON, Canada
M5T 1P8