Caregiver Course

The Caregiver Course Manual

Landspítali's caregiver course serves as teaching material for Registered Nurses and Licensed Practical Nurses who guide and instruct staff hired to work in caregiving. The course is not designed for self-study; students always require guidance and instruction from professionals. Instructors for the course are, therefore, either Registered Nurses (hjúkrunarfræðingar) or Licensed Practical Nurses (sjúkraliðar).

During the course, employees gain insight, education, and training in specific aspects crucial for providing care to individuals. The course utilizes recorded lectures, a handbook provided to students, discussions with instructors, practical demonstrations, and hands-on experience under professional guidance.

Aim
The aim of this course is to prepare staff for providing bedside care while working under the guidance of Registered Nurses and Licensed Practical Nurses.

About the Content of the Course
The course content is derived from previous lectures presented during the Caregiver Course, which was offered to care workers at Landspítali's geriatric wards between 2018 and 2020. Lecturers were Guðrún Dóra Guðmannsdóttir, Clinical Nurse Specialist; Ingibjörg Hjaltadottir, Clinical Nurse Specialist; Jakobína Rut Daníelsdóttir, Licensed Practical Nurse; and Sigurlaug Björk J Fjeldsted, Licensed Practical Nurse.

In addition to various academic sources (see the bibliography on the website), this course is based on content from the book "Þetta þarf ég að kunna" , translated from Norwegian by Farsæl öldrun and Landspítali, with a grant from the Ministry of Health. The book was translated by Skopos Translation Agency, and Berglind Indriðadóttir, occupational therapist, oversaw the translation and adaptation to Icelandic conditions. Others involved in the translation and adaptation of the material were Guðrún Dóra Guðmannsdóttir, Clinical Nurse Specialist; Ingibjörg Hjaltadóttir, Clinical Nurse Specialist; and Sigrún Huld Þorgrímsdóttir, Clinical Nurse Specialist.

About Teaching Methods
The caregiver course has now been updated, and lectures and a handbook are available on the Landspítali website. The course adheres to the standards recommended for digital courses according to the ABC Learning Design Method (Clive Young and Nataša Perović, 2020) . The teaching method involves students familiarizing themselves with the content by watching digital lectures and then discussing specific topics outlined in the handbook, which serves as a guide for the student and instructor. They then undergo practical training where they observe or familiarize themselves with specific tasks specified in the handbook.

In the assignments, certain tasks are also assigned for the student to carry out under the supervision of their instructor. This way, the student learns and reinforces what they have observed in lectures, both through discussion and practical implementation. The handbook also functions as a progress log, allowing the student and instructor to note which lectures have been watched, which topics have been discussed, which tasks have been demonstrated, and which tasks have been completed. This ensures that the student has covered crucial aspects related to caregiving.

Finally, the student receives a certificate indicating the completion of the course. It is recommended that students do not watch recordings for more than 40-60 minutes at a time but instead engage in discussions with their instructor and review relevant assignments. Additionally, students are advised to take approximately 3 weeks to complete the course material. However, it is essential to evaluate individually how quickly one can cover the content to ensure a thorough understanding. Consideration should be given to the fact that a staff member starting to work in a hospital or healthcare system for the first time is learning more than what is covered in the course.

Acknowledgments
Finally, I want to express my gratitude to everyone who contributed to the content of this new course. I would especially like to mention Guðrún Dóra Guðmannsdóttir, Clinical Nurse Specialist for her support, and Sara Rebeca Ambriz Cervantes, Registered Nurse for assisting with translating to English. I also want to thank all other professionals who have contributed to the lectures for the course or have content on the Landspítali website that we utilize.

Moreover, I would like to express my gratitude to the group of Licensed Practical Nurses and Registered Nurses at Landakot who will embark on using the course in English in their teaching starting in spring 2024. They have familiarized themselves with the course material, collaborated with me in its implementation, and provided valuable feedback.

Ingibjörg Hjaltadóttir, Clinical Nurse Specialist in Geriatric Nursing

The content of the caregiver course is based on previous lectures from a 30-hour course called "Umönnunarskóli öldrunardeilda," which was offered to staff in geriatric units at Landspítali from 2018 to 2020. The name was later changed to "Umönnunarnámskeið öldrunardeilda," while the goals and content remained the same. The purpose of the caregiver course was primarily to enhance the quality of service provided to patients in geriatric units and reduce the workload on Registered Nurses and Licensed Practical Nurses who provided guidance to the care assistants on the units.

The idea for this course emerged during a meeting of department managers in the autumn of 2017, where the high workload on the units was discussed. Part of this workload included constant orientation for new care assistants. Experienced Licensed Practical Nurses play a significant role in this aspect, making it desirable to ease their responsibilities to some extent. However, teaching and guidance should still be present within the unit. Initially, the plan was to instruct newly hired care assistants in caregiving, but it was later decided to invite all care assistants involved in caregiving to participate. The experience gained from one-day spring courses held for summer replacement staff in the geriatric units several years before also contributed to the preparation of the course.

The course was taught in 10 sessions, each lasting 2 hours, totaling 20 hours, which counted as 30 instructional hours and spanned over 10 weeks. The language of instruction was Icelandic, and attendance was mandatory at 90%. The course concluded with an exam and a formal graduation, although completion did not impact salary. However, participants could often accumulate points for salary increases through union agreements, and students were encouraged in this regard. Department managers were enthusiastic about the project, and upon graduation, they celebrated with their staff. It is essential to maintain an encouraging learning environment within the department for ongoing education and optimal quality.

The main innovation of the caregiver course was the collaboration between Licensed Practical Nurses from the units and Clinical Nurse Specialists. This collaboration involved determining collectively what content should be taught and how. Typical teaching sessions consisted of brief lectures, practical demonstrations, and hands-on exercises. In most cases, the Clinical Nurse Specialists prepared and delivered the lecture content, while the Licensed Practical Nurses organized the practical demonstrations and practical exercises. The teaching took place in a meeting room at Landakot.

In total, 33 students graduated from the caregiver course in the units from the beginning of 2018 until October 2020. This included staff involved in caregiving without formal education in the field, both newcomers and those with extensive experience in caregiving. Just over half of the participants were immigrants living in Iceland for various periods. A minimum proficiency in Icelandic was required, but efforts were made to support those facing language difficulties.

It is noteworthy that this course appeared to empower individuals both personally and professionally. We believe that it is crucial to continue such courses in some form, benefiting the staff and the quality of care in geriatric units.

Guðrún Dóra Guðmannsdóttir, Clinical Nurse Specialist in Geriatric Nursing
Ingibjörg Hjaltadóttir, Clinical Nurse Specialist in Geriatric Nursing

Alzheimersamtökin [e. Alzheimer's Association]. (n.d.). . https://www.alzheimer.is

Guðrún Dóra Guðmannsdóttir, Ingibjörg Hjaltadóttir, Jakobína Rut Daníelsdóttir og Sigurlaug Björk J. Fjeldsted (2020) Umönnunarnámskeið öldrunardeilda Landspítala [kennsluefni].

Líknarráðgjafateymi Landspítala (2017). Klínískar leiðbeiningar um Líknarmeðferð (2. Útgáfa). Sótt í mars 2023 af:https://www.landspitali.is/library/Sameiginlegar-skrar/Gagnasafn/BRUNNURINN/Kliniskar-leidbeiningar/Liknarmedferd/Liknarmedferd.pdf

Landspítali (n.d.) Falls and Fall Prevention [i. Byltur og byltuvarnir]. Retrieved in March 2023 from: https://www.landspitali.is/fagfolk/reglur-leidbeiningar-handbaekur-og-frettabref/byltur-og-byltuvarnir/

Landspítali (n.d.) Body Mechanics and Transfer Techniques in Patient Care [i. Líkamsbeiting og færslutækni við umönnun sjúklinga]. Retrieved in March 2023 from: https://vimeo.com/groups/527560

Landspítali (n.d.) Delirium is Delirium [i. Óráð er óráð]. Retrieved in March 2023 from: https://www.landspitali.is/fagfolk/reglur-leidbeiningar-handbaekur-og-frettabref/orad-er-orad/

Landspítali (n.d.) Pressure Ulcer Prevention [i. Þrýstingssáravarnir]. Retrieved in March 2023 from: https://www.landspitali.is/fagfolk/reglur-leidbeiningar-handbaeku r-og-frettabref/thrystingssaravarnir/

Líknarráðgjafateymi Landspítala [e. Palliative Care Team of Landspítali] (2017). Clinical Guidelines on Palliative Care (2nd Edition) [i. Klínískar leiðbeiningar um Líknarmeðferð (2. Útgáfa)]. Retrieved in March 2023 from: https://www.landspitali.is/library/Sameiginlegar-skrar/Gagnasafn/BRUNNURINN/Kliniskar-leidbeiningar/Liknarmedferd/Liknarmedferd.pdf

Røsvik, J., Brønstad, A., Lepperød, T., Stegen, A., Taranrød,  L. B. og Øverland, L. (2016). Dette Må Jeg Kunne: introduksjon til helse- og omsorgsarbeid (3. útgáfa). Sem, Noregi: Nasjonal kompetansetjeneste for aldring og helse.

Touhy, T., og Jett, K. (2021).  Ebersole and Hess’ Gerontological nursing & healthy aging (6. útgáfa).  Louis: Elsevier, Mosby.

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