RCT 223: Clinical Practice V
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1 West Virginia Northern Community College Lisa Ingram M.S. RRT 1704 Market Street 417 F - EC Wheeling, WV (304) lingram@wvncc.edu RCT223 Clinical Practice V Course Description This course is a continuation of RCT 218 and provides laboratory practice and clinical application of technical and professional skills utilized in critical care and specialty areas of respiratory therapy. Prerequisites: RCT 214, RCT 216 & RCT 218 Co-requisites: RCT Cr (0 lecture, 6 lab, 0 other) Course Focus This course provides the student with opportunities to enhance critical care skills and specialty area skills essential for Respiratory Therapists. Students are required to maintain all designated Competency Records, Daily Clinical Evaluations, DataArc database, and Site and CoARC evaluations. Text and References Persing, Respiratory Care Exam Review 3 rd edition White, Basic Clinical Lab Competencies for Respiratory Care, 4th edition DesJardins, Case Studies to accompany Clinical Manifestations and Assessment of Respiratory Disease, 4th edition Respiratory Care Clinical Manual / DataArc Software Kettering National Review Seminar National Board for Respiratory Care CRT, RRT (written and simulation) Exams Student Learning Outcomes 1. Review, collect and evaluate patient data in the critical care setting. 2. Select, assemble, and check equipment for proper function and cleanliness in preparation for the critical care setting. 3. Initiate, conduct, and modify prescribed therapies in the critical care setting. 4. Initiate, conduct, and modify respiratory care procedures in the alternate care setting. 5. Determine appropriateness of respiratory care plan and recommend modifications in the critical care setting. 6. Assist/observe the physician in performing special procedures. 7. Perform diagnostic procedures and interpret results. 8. Maintain records and communication concerning patient care.
2 Student Performance Objectives The student will: 1. demonstrate ethical behavior 2. demonstrate professional attitude 3. demonstrate professional development skills 4. discuss case management 5. demonstrate support of Respiratory Care profession 6. demonstrate critical thinking ability 7. demonstrate team work approach 8. perform community service activities 9. perform internet information gathering 10. utilize complete charting procedures 11. exhibit NBRC test-taking skills 12. review existing patient data 13. review patient's drug database 14. explain general pharmacological effects of drugs 15. detect inappropriate physician orders 16. assess overall cardiopulmonary patient status 17. assess patient status 18. assess artificial airway placement 19. perform patient interview 20. recommend additional data gathering procedures 21. recommend pharmacological agents 22. recommend discontinuing respiratory care procedures 23. recommend ventilator setting changes 24. assess lung mechanics 25. assemble ventilator circuits 26. assemble respiratory care equipment 27. determine equipment cleanliness 28. troubleshoot respiratory care equipment 29. assure equipment cleanliness 30. select appropriate respiratory care equipment 31. evaluate patient response 32. evaluate patient's subjective response 33. initiate inverse ratio ventilation 34. participate in physician rounds 35. initiate mechanical ventilation 36. adjust mechanical ventilation 37. adjust pressure control ventilation 38. measure lung compliance 39. initiate SIMV ventilation 40. measure airway resistance 41. initiate pressure support ventilation 42. initiate assist control ventilation 43. initiate pressure control ventilation 44. modify respiratory care procedures 45. adjust inverse ratio ventilation 46. perform weaning procedures
3 47. perform medication delivery procedures 48. perform therapist driven protocols 49. administer critical respiratory care procedures 50. perform ventilator weaning procedures 51. perform ventilator quality assurance procedures 52. perform BIPAP/CPAP therapy 53. perform bedside procedures 54. describe arterial line sampling technique 55. perform arterial blood gas puncture 56. perform patient extubation 57. perform quality control procedures 58. perform patient ventilatory transport 59. perform adult respiratory care procedures 60. perform sputum culture procedures 61. perform arterial blood gas analysis 62. perform hemodynamic calculations 63. perform inspiratory muscle training techniques 64. perform emergency respiratory care 65. perform cardiopulmonary testing procedures 66. perform CPR 67. perform co-oximetry analysis 68. perform bronchopulmonary secretion removal procedures 69. perform artificial ventilation procedures 70. perform airway maintenance procedures 71. perform manual resucitation 72. perform oxygenation procedures 73. perform EKG 74. perform ETCO2 monitoring 75. perform advanced critical care skills 76. perform pediatric respiratory care procedures 77. perform long term respiratory care 78. perform rehabilitative respiratory care 79. perform respiratory therapy home care 80. perform neonatal respiratory care procedures 81. perform acute level respiratory care 82. perform specialty area skills 83. perform emergency respiratory care techniques 84. interpret hemodynamic data 85. interpret bedside procedure results 86. interpret mixed-venous blood gases 87. interpret chest x-rays 88. utilize ventilator graphics 89. interpret ventilator graphics 90. interpret patient data 91. instruct therapeutic patient procedures 92. interpret ETCO2 monitoring 93. interpret EKG 94. observe operating room procedures 95. maintain sterile technique 96. observe surgical procedures 97. observe pleural drainage systems
4 98. observe anesthesia procedures 99. select appropriate endotracheal/trach tubes 100. perform endotracheal intubation 101. utilize liquid oxygen systems 102. utilize home respiratory care equipment 103. utilize portable oxygen delivery systems 104. utilize home oxygen concentrator systems 105. perform home care respiratory care procedures 106. operate home care ventilator 107. assure home care infection control procedures 108. modify home respiratory care procedures 109. assist physician with broncoscopy procedure 110. assist physician with tracheostomy tube changes 111. assist physician with thoracentesis 112. assist physician with transtracheal catheter insertion 113. assist physician with stress testing 114. assist with graded exercise program 115. participate in patient case management 116. develop respiratory care plan 117. explain patient goals 118. develop therapeutic patient goals 119. instruct patient/family education Student Contributions You are required to: Complete ALL assigned clinical hours, including self-arranged activities and assignments. Complete 8 hours of professional development (seminars,etc)---these hours must be approved by the instructor. Complete an additional16 hours of community service/professional development. Complete C&S computerized exams (3 total) Complete five assigned DesJardin Case Studies. Complete five patient care reviews. Attend the Kettering Review Seminar to be held at WVNCC April 22 through 25, Complete all requested assessments: including but not limited to Course evaluations, program evaluations, CoARC evaluations, DataArc surveys Respiratory Care Exit Interview. All course requirements must be met or the student will receive an incomplete for the course and be ineligible for graduation and credentialing. Attendance Policy Students are required to attend ALL scheduled rotations and shifts, including laboratory sessions. Students may not leave the hospital complex while on duty. Students are not allowed to trade shifts or rotations. Students are required to report all absences to the Clinical Director via phone or prior to the start of the assigned shift.
5 The supervisor or clinical instructor at the assigned clinical site must be contacted at least one hour prior to the beginning of the scheduled shift (Phone numbers are available in your clinical book). Please note: it is NOT acceptable to send the message with a fellow student. Students are allowed one absence from the clinic/lab (labs are considered clinical experiences so absences are treated the same) each semester. Absences in excess of that will be made up at the Clinical Director's and Clinical Sites discretion. *Some specialty rotations (NICU, homecare, etc.) will require make-up hours regardless of the number of absences accrued during the semester this is determined by the Clinical Director of Education. A physician's release to return to the clinical area is required when two consecutive clinical days are missed. EVERY clinical/lab absence will result in five points being deducted from your final overall clinical grade. This deduction will remain regardless of time made up. Additionally, after three total absences (lab/clinical), you may be withdrawn from the course at the discretion of program officials. Extenuating medical issues will be handled on an individual basis and in this instance discipline / grade deductions will be left to the discretion of the program officials. Students must notify the Director of Clinical Education via or phone prior to the scheduled start time for all lab days missed. Failure to follow any aspect of this policy may result in an administrative withdraw from the course. Clinical Tardy Prompt attendance is required in all clinical/lab courses. Tardiness is a trait considered undesirable by clinical staff as well as future employers. A tardy is defined as arrival of up to one (1) hour after the scheduled start time for clinical or lab. Any time in excess of one hour is considered an unexcused absence and will be subject to the same deductions as stated above. Additionally, three episodes of tardiness will equate to one unexcused absence (same deductions apply). Director of Clinical Education and the Clinical Site Supervisor must be contacted prior to the assigned shift start time if the student is going to be late. Student Responsibility The student is responsible for being aware of their status (grades) in class at all times. Additionally, it is the student s responsibility to be aware of withdraw dates and drop procedures and to institute this procedure if it becomes necessary for any reason. Classroom Conduct Students are expected to conduct themselves in a courteous, responsible, mature manner in the classroom. This includes: being prepared for class; informing the instructor if you are going to miss class; not coming late, leaving during class, or leaving early without prior announcement ; not engaging in side conversations or being disruptive in class, not harassing or distracting other students or the instructor, making offensive comments, and turning off cellular phones during class. If you have questions or concerns, please follow the proper chain of command and do not discuss program, clinical, or classroom issues outside of the institution. Clinical Site Conduct Your clinical handbook outlines expected behaviors, dress, and professional behaviors at the clinical site. No cell phones are to be carried and utilized at the clinical site, regardless of the policy for staff. Social Media The field you have chosen to enter mandates a high level of confidentiality and professionalism. Please remember this in regards to your use of social media. Future employers, clinical preceptors, faculty, classmates, etc. are often privy to your postings. Comments deemed derogatory in regards to faculty, program, college, clinical sites, etc. or the violation of any confidentiality (corporate, patient, etc.) will result in immediate dismissal from the program.
6 Academic Honesty Students are expected to conduct themselves in an adult, ethical, honest and professional way on assignments, research papers, and exams. Academic dishonesty includes: cheating (this includes helping or being helped on exams or other assignments that are to be done individually), putting your name on someone else's work and turning in it as your own, doing work that someone else is supposed to be doing, and plagiarism. If you are caught being dishonest you will fail the course and may be suspended or expelled from the College which will permanently affect your eligibility for financial aid. Social Justice WVNCC does not discriminate on the basis of race, gender, age, disability, veteran status, color, national origin, religion, or sexual orientation. Any suggestions as to how to further a positive and open learning environment in this class will be appreciated and given serious consideration. Disability If you have a physical or psychological disability and anticipate needing accommodations in order to succeed in this class, please notify me and contact the Office of Disability Services in Wheeling. Course Evaluation Grading Scale: Distribution of Grades Weighting A=93%-100% Midterm Progress Report: 30 % B=85%-92% Final Evaluation: 50 % C=75%-84% NBRC Exams (Scores for the three will be averaged) 20 % D=68%-74% F=67% or less *All late assignments will receive a ten point deduction from the final score. *Any written exam that is missed must be made up within one week of the scheduled exam or a grade of ZERO will be recorded. Any student not taking the exam at the scheduled time will receive a ten point deduction from the final score. Course Schedule This course will meet on Monday, Tuesday, and Wednesday during dayshift reporting times at the assigned clinical sites, unless otherwise noted. Some sites and rotations require other shifts and reporting times. The course will follow the attached weekly schedule and clinical rotation schedule. Course Communication All communication to students concerning course updates will be completed via WVNCC services. Students are required to keep their WVNCC active at all times. Syllabus I RESERVE THE RIGHT TO MAKE CHANGES TO THIS SYLLABUS AS NEEDED. ANY CHANGES WILL BE ANNOUNCED IN A CLASS WVNCC OR AS AN ADDENDUM PROVIDED IN CLASS.
7 CLINICAL PRACTICE V Spring 2013 Tentative Course Schedule WEEK DATE CLASS ACTIVITY ASSIGNMENT #1 1/14 Campus Lab Review Persing OR Etiquette Intubation/LMA #2 1/21 Campus Lab No class Monday Review--Persing #3-#8 1/28-3/4 Campus Lab/Clinical Practice Monday Lab Review Persing Clinical Schedule DesJardin Chapters 17,18,20,21,27 Midterm Evaluation- Dataarc due #9 3/11 Spring Break Enjoy the break! March 13 TB conference #10-#14 3/18-4/15 Campus Lab/Clinical Practice Monday Lab Review Persing Clinical Schedule #15 4/22 Kettering Review Seminars Meets Monday through Thursday 7:30am-5pm #16 4/29 NBRC Exams Times TBA #17 5/7 Finals Week Final Evaluations DataArc due Exit interview 5 Patient Care Reviews Final Surveys Graduation May 10th
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