UNIVERSITY OF ALBERTA COLLABORATIVE BACCALAUREATE NURSING PROGRAM Grande Prairie Regional College Keyano College Red Deer College University of Alberta University of Alberta Collaborative Baccalaureate Nursing Program At Red Deer College NURSING 391 COURSE OUTLINE 2014-2015 Originally developed by the Clinical Experience Development Committee Revised by the Learning Experiences Committee, April 2013 UNIVERSITY OF ALBERTA COLLABORATIVE BScN PROGRAM, 1999 All rights reserved. No part of this module may be reproduced in any form or by any means without the publisher s written permission. Approved: May 2013 Acting Chairperson: Date: June 27, 2014
Course Outline CALENDAR STATEMENT: NURS 391 Nursing Practice V *7 (fi 14) (either term, 3-26c-2 in 7 weeks). Practice focuses on restoration, rehabilitation, and support (including health promotion and disease prevention) of patients experiencing more acute variances in health across the life span. Practice occurs in primary-, secondary-, and tertiary-level acute care settings. Prerequisites: NURS 215, 274, 381, 384, 385. COURSE HOURS: LEC: 0 SEM: 21 CLINICAL: 182 LAB: 15 COURSE DESCRIPTION: Opportunities will be provided for students to develop advanced skills in health assessment, intervention, and communication with patients across the life span. The focus of this clinical course will be the patient and their families with more acute variances in health. Students will continue to utilize health promotion and all levels of prevention in nursing practice. Nursing practice over a continuous block of time will occur in various acute care settings. COURSE OBJECTIVES: Levels of Independence In evaluating objectives, the following levels of independence will be used: With assistance: The student requires direction and information. With minimal assistance: The student requires occasional direction and information. With guidance: The student requires clarification, prompting, and confirmation. With minimal guidance: The student requires occasional clarification, prompting, and confirmation. Independently: The student works mostly on his or her own and seeks information, clarification, and consultation as appropriate. Direction: Clinical tutor tells the student what to do, about what steps to take. Information: Clinical tutor tells the student specifics about a concept or topic. Clarification: Clinical tutor, through questioning and feedback, assists the student to state their information in a different and clearer way, often with more details. The student asks questions to increase their understanding; questions asked demonstrate a sound knowledge base. Prompting: Clinical tutor provides the student with a cue that answer is incomplete or incorrect and how to resolve the lack of information. A prompt is broader than a hint. Prompting is generally used to add breadth or depth. Confirmation: Clinical tutor provides positive feedback for correct information and direction provided by the student. Consultation: The student provides clinical tutor with information and/or direction and asks specific questions about the information or direction which the instructor confirms. 3
Occasional: The clinical tutor provides input every now and then. OVERARCHING STATEMENTS: Students are responsible to familiarize themselves with Graduate Competencies and Year Outcomes (with Cross Reference to courses) 2014-2015. Attention must be given to the competencies that are identified as being relevant to NURS 391. Students must regularly refer to the document entitled Graduate Competencies and Year-End Outcomes Condensed Version 2014 2015. Attention must be given to the Year 3 Column. This document serves as the basis for the evaluation of students clinical practice. This course may be eligible for Prior Learning Assessment. Students should refer to the RDC Course Calendar for a list of excluded courses Learning resources may be available to students in alternative formats. It is the student s responsibility to discuss learning needs with their instructor. It is the student s responsibility to be familiar with the information contained in the Course Outline and to clarify any areas of concern with the instructor. Students should be aware that Personal Counselling, Career, Learning and Disability Services are provided at RDC. Inquire about locations at Information Desk. It is the student s responsibility to discuss their specific learning needs with the appropriate service provider. RDC offers several learning support services: course-based peer tutoring, the Math Learning Centre, the Writing Skills Centre, and help with general learning strategies (e.g., time management, study skills, exam preparation and writing). RDC also offers services for students with disabilities. To access any of these services, visit the Learning Support desk in the Library, call (403) 357-3629, or email either help_learn@rdc.ab.ca or disabilityservices@rdc.ab.ca. Students should refer to the Appeals: Formal Policy, Appeals: Informal Resolution Policy and Student Misconduct: Academic and Non-Academic Policy should they have questions or concerns about the Course Outline that cannot be resolved with the instructor. Note that the following policies are in effect in this course: Appeals: Formal Policy Appeals: Informal Resolution Policy Student Misconduct: Academic and Non-Academic Policy 4
OBJECTIVES All students must practice in a manner that is consistent with: CARNA Practice Standards for Regulated Members (2013) and all other CARNA standards The CNA Code of Ethics for Registered Nurses (2008). 1. Demonstrate, independently, the processes of self-directed learning, critical thinking, and group process in utilizing context-based learning, in all learning activities. 2. Demonstrate, independently or with guidance, the ability to practice in accordance with Year 3 competencies, as described in the document entitled: Graduate Competencies and Year-End Outcomes 2014-2015. 3. Demonstrate, with guidance, the ability to manage restoration, rehabilitation, and support activities for patients experiencing more acute variances in health. 4. Demonstrate, with guidance, the ability to provide evidence-based, competent nursing care to patients experiencing more acute variances in health, in a variety of settings (primarily, secondary and/or tertiary level acute care settings). 5. Demonstrate, with minimal guidance, the ability to manage health promotion and prevention activities using advanced therapeutic/interpersonal communication skills, health counseling skills, and teaching and learning principles. 6. Demonstrate the ability to integrate knowledge into clinical practice. REQUIRED RESOURCES 1. Map of Theoretical Labs, Clinical Labs, and Clinical Seminars 2. Graduate Competencies and Year-end Outcomes 3. Grade Descriptors 4. Other site-specific resources 5
REQUIRED LEARNING EXPERIENCES In order to pass NURS 391, students must demonstrate safe ethical nursing practice, professional behavior, and complete the following experiences and assignments. Students are expected to implement previously learned nursing skills. Please pick up your lab manual from the bookstore and do the independent review (Lab 1). You will benefit from reviewing cardiac and respiratory assessment, oxygen therapy, medication administration, IV therapy, sterile technique for dressings, medication calculations and catheterizations prior to the first day of class. Students are expected to be proficient in these skills prior to the first day of clinical. Please see your lab manual for assistance in reviewing this content. 1. During this course, students will have a continuous experience in an acute care setting. Experiences will include nursing care of patients and families experiencing increasingly complex and more acute variances in health. These experiences will take place within the Red Deer Regional Hospital Centre. Setting options may include: Unit 22, 31, and 32. 2. Where the clinical setting allows, and bearing in mind the characteristics of specific placement settings such as patient acuity level, students will co-ordinate care for 2-3 patients. The emphasis should be on learning depth and breadth of student learning, and patient safety. 3. Participate in site-selected lab activities (see Map of Theoretical Labs, Clinical Labs, and Clinical Seminars ). 4. Using a nursing model, assess and intervene with patients and their families. 5. Participate in patient and family education. 6. Collaborate with patient, family, community, nurses, and members of other disciplines. 6
Seminars: There are several clinical seminars in this course. The purpose of clinical seminars is for students to bring relevant research on and to discuss topics relevant to the units on which students are practicing. Several of the seminars have predetermined topics, while for others the topics may be determined by consensus within each clinical group about special interest topics generated by student s experiences during clinical. Seminars will run like tutorials, with leaders, motivators, agendas, etc.. However, the requirements for resources will be one to two articles, texts, etc.. Please note that guest speakers, lab content review, and exam review are not considered appropriate for seminar discussions. SUGGESTED OPTIONAL LEARNING EXPERIENCES (Alternative Experiences) 1. Participate in a follow-through experience with a more complex patient having a medical or surgical procedure. 2. Participate in discharge planning/referral from institutional settings. 2.1 Liaise with home care nurse where possible. 2.2 Follow-up visits with patient where the patient lives. May include a telephone follow-up or home visit. 3. Involvement with specific projects within institutional-based practice. 4. Observe and/or participate in a family conference. 5. Observe and/or participate in an off unit experience (for example, dialysis, ICU, hospice, etc.). OTHER ALTERNATIVE EXPERIENCES: 1. Students from various units may have a variety of alternative experiences available to them. Your clinical instructor will discuss these options with you and will determine the learning objectives that correspond to each of these prior to your experience. No scents are to be worn and professional dress (uniforms/scrubs/name tags) is expected to be worn at all alternative placements. 2. Preparation for alternative experiences is required. Please refer to materials found in the lab manual. 7
Important Dates Fall I Sept. 8 last day to add or drop courses for Fall I Oct. 16 last day to withdraw without academic penalty for Fall I Fall II Oct. 24 last day to add or drop courses for Fall II Dec 3 last day to withdraw without academic penalty for Fall II Winter I Jan. 8 last day to add or drop courses for Winter I Feb. 13 last day to withdraw without academic penalty for Winter I Winter II Feb 27 last day to add or drop courses for Winter II Apr 10 last day to withdraw without academic penalty for Winter II Spring May 8 last day to add or drop courses for Spring June 17 last day to withdraw without academic penalty for Spring Changes to the course outline will occur in conjunction with consultation with students. Changes will be reviewed by the Nursing Department Chairperson for consistency with College policies. It is the student s responsibility to be familiar with the information contained in the Course Outline and to clarify any areas of concern with the instructor. Materials and Special Fees: When you paid your tuition, you also paid Material and Special Fees. The Nursing 391 fee is $50.00. Please refer to your student handbook for details. Clinical Instructors Fall I A Mike Metzger Office: 1507-D Phone: 403-342-3501 B Brenda Query Office: 2219 Phone:403-342-3223 C TBA Office: TBA Phone: TBA 8
Fall II D Geraldine Whittaker Office: 1506-D Phone: 403-314-2487 E Brenda Query Office: 2219 Phone: 403-342-3223 Winter I G Lynn Parker Office: 1232 Phone: 403-342-3410 H Mike Metzger Office: 1507-D Phone: 403-342-3501 I Geraldine Whittaker Office: 1506-D Phone: 403-314-2487 Winter II J Carly Burdziuk Office: TBA Phone: TBA K Shona Jurak Office: 1506-F Phone: 403-356-4950 L Brenda Query Office: 2219 Phone: 403-342-3223 Spring M TBA Office: TBA Phone: TBA Office Hours of Faculty Since instructors are in clinical full-time and their schedules vary depending on the particular clinical group they have, office hours will vary. Students are to contact their instructor by phone to set up meeting dates and times to discuss any issues that cannot be resolved during clinical hours. Textbooks and Resources Please note: All texts used in Years One and Two of the Nursing Program are also required for N391. In addition, the following are also Required: Adams, M.P., Holland, L.N., Bostwick, P.M., & King, S.L. (2010). Pharmacology for nurses: A pathophysiological approach (Canadian ed.). Toronto, ON, Canada: Pearson. (Access code to My Nursing lab included.) American Psychological Association. (2009). Publication manual of the American Psychological Association (6 th ed.). Washington, DC: Author. College and Association of Registered Nurses of Alberta. (2013). Practice standards for regulated members with the Canadian Nurses Association Code of Ethics for Registered Nurses. Edmonton, Alberta, Canada: Author. Retrieved from http://www.nurses.ab.ca/carna- Admin/Uploads/Practice_Standards_Code_Ethics_2013.pdf Canadian Nurses Association. (2008). Code of ethics for registered nurses. (Centennial Edition). Ottawa, Ontario, Canada: Author. Retrieved from http://www2.cnaaiic.ca/cna/documents/pdf/publications/code_of_ethics_2008_e.pdf Perry, P. & Potter, P. (2009) Clinical nursing skills & techniques (7th ed.). Toronto, Ontario, Canada: Mosby. 9
Pagana, K.D., & Pagana, T.J. (2010). Mosby s manual of diagnostic and laboratory tests (4 th ed). St. Louis, MO: Elsevier Mosby Pickar, G., Pickar Abernethy, A., Swart, B., Graham, H., Swedish, M. (2015). Dosage calculations (3rd Canadian ed.). Toronto, ON, Canada: Nelson Education Ltd. Wagner, K. D., & Hardin-Pierce, M. (2014). High acuity nursing (6 th ed.). Upper Saddle River, NJ: Pearson Education Inc. Also required: Nursing 391 Lab Manual Assessment text (Jarvis or Jensen) Pathophysiology text (Hannon, Pooler, & Porth) Drug handbook: Select your own (please use a handbook that has sufficient information about nursing care and assessment). Examples: Stephen, T., Skillen, L., Day, R., & Jensen, S. (2013). Laboratory manual for Canadian Jensen s nursing health assessment: A best practice approach. Philadelphia, PA: Wolters Kluwer/ Lippincott Williams & Wilkins. (Access to The Point Learning System included.) Turkoski, B. B., Lance, B. R., & Tomsik, E. A. (2012). Drug information handbook for nursing (12 th ed.). Hudson, OH: Lexi-Comp. Wilson, B. A., Shannon, M. T., & Shields, K. M. (2014). Pearson nurse s drug guide 2014. Upper Saddle River, NJ: Prentice Hall. Dictionary: select your own Medication Calculations/Safe Administration: e-dose and/or select your own Optional Resources: Alligood, M. R., & Marriner Tomey, A. (2010). Nursing theory: Utilization and application (7th ed.). St. Louis, MO: Elsevier Mosby. Austin, W., & Boyd, M. A. (2010). Psychiatric nursing for Canadian practice (2 nd Canadian ed.). Philadelphia, PA: Lippincott. Boyd, D., Bee, H., & Johnson, P. (2011). Lifespan development (4 th Canadian ed.). Toronto, Ontario, Canada: Pearson. Miller, C. A. (2011). Nursing for wellness in older adults: Theory and practice (6th ed.). Philadelphia: Lippincott. 10
Health Canada Website: http://www.hc-sc.gc.ca/ (nutrition) Johnson, M., Bulechek, G., Butcher, H., McCloskey Dochterman, J., Maas, M., Moorhead, S., & Swanson, E. (2006). NANDA, NOC, and NIC linkages: Nursing diagnoses, outcomes, & interventions (2nd ed.). St. Louis, MO: Mosby. Unit specific texts are available but are not a requirement For students on Unit 22: Aehlert, B. (2013). ECGs made easy (5 th ed.). Maryland Heights, MO: Elsevier. Woods, S., Sivarajan Froelicher, E., Underhill Motzer, S., & Bridges, E. (2010). Cardiac nursing (6 th ed.). Baltimore, MD: Lippincott Williams & Wilkins. For students on Unit 31: Daugirdas, J. T., Blake, P. B., Ing. T. S. (2006). Handbook of dialysis (4 th ed.). Philadelphia: Lippincott Williams & Wilkins. For students on Unit 32: Langhorne, M. E., Fulton, J. S., & Otto, S. E. (2007). Oncology nursing (5 th ed.) St. Louis, MO: Mosby. Zerwekh, J. (2005). Nursing care at the end of life: Palliative care for patients and families. Philadelphia, PA: F.A. Davis. Recommended Electronic Resources: Electronic resources that you may find useful include programs on drugs, laboratory and diagnostic tests, nursing skills, nursing diagnosis, diseases, health assessment, dictionaries etc.. Please be sure and order one that will work with the platform you are using (i-phone, Android, Windows, etc.). Examples: Lexi-Comp Resources: www.lexi.com PEPID. (n.d.). PEPID RN: Student clinical companion suite [Computer software]. Retrieved from http://www.pepid.com/products/rnscc/ MEDSCAPE. (n.d.). Retrieved from http://www.medscape.com 11
REQUIRED EVALUATION: To successfully complete N391, students must complete ALL of the following assignments and assessments. In addition, students must achieve a passing grade (36/60) in the Evaluation of Nursing Practice (ENP) and successfully complete the Clinical Calculation Assessment. Students will be evaluated by means of the following: 1. N391 Lab Quiz 15% (of Final Grade) Fall I October 16, 2014 0900 1050 Fall II December 3, 2014 0900-1050 Winter I February 13, 2015 0900-1050 Winter II April 10, 2015 0900-1050 Spring June 15, 2015 0900-1050 2. Comprehensive Patient Review 25% (of Final Grade) Fall I September 29, 2014 0800 Fall II November 17, 2014 0800 Winter I February 2, 2015 0800 Winter II March 23, 2015 0800 Spring May 25, 2015 0800 This assignment is to be submitted as TWO word documents in Blackboard in Safe Assign. Note: There will be a draft Safe Assign set up for students to submit and review their assignment for any concepts that may be inadvertently plagiarized. It is strongly recommended that students use this tool to review their document for appropriate acknowledgement of concepts, etc.. Note: The assignment must be submitted as scheduled in the course outline. Three (3) marks/25 (10%) will be deducted for each day that the assignment is late without an approved extension. Extensions require a minimum of 24 hours notice. The assignment is to be completed and submitted through Safe Assign. 12
3. Clinical Performance: 60% (of Final Grade) This will be accomplished through observation and evaluation of the student during nursing practice in the clinical setting. See term schedules for days and hours of classes. Observations and evaluations will be made by the instructor and may be supplemented with input from peers, the staff of the clinical setting, and the patient/family. Students need to show evidence and rationale that they have met or are meeting the course objectives. This will be accomplished through weekly submission of the ENP to the instructor through Blackboard with detailed, specific, and concise examples of how they are meeting or planning to meet objectives by the end of the course. Note that this is a professional document, and students must use appropriate spelling and grammar. In addition, at both the midterm and final evaluation, students will be expected to identify three strengths and three areas that they need to work on, with strategies outlining how they will address these three areas. The student and the instructor will complete a verbal midterm and a written evaluation at the end of the term. A written midterm evaluation MAY be required from the student. It is an expectation that students actively participate in labs and seminars. This includes coming to the lab and seminar having done the required preparation. Lab and seminar time is considered to be a part of the clinical experience and will be evaluated as such on the ENP. The pass mark for the ENP is 60% (36/60). Students must achieve a passing grade on the ENP to pass the course. 4. Medication Administration Safety Screen/Quiz Note: All quizzes are during seminar time see term schedules for room and time. Fall I September 12, 2014 Fall II October 31, 2014 Winter I January 16, 2015 Winter II March 6, 2015 Spring May 15, 2015 As part of safe medication administration, a medication assessment will be written to provide the student and instructor information about strengths and possible areas for growth with respect to medication calculations in the clinical area. Students will write an assessment within the first one to two weeks of the course. The pass mark for this quiz is 90%. If the student fails the assessment quiz the student, in consultation with the clinical instructor, will determine the extent of and the content of the remedial work. Following this, the student will be provided with an opportunity to write a supplemental, to be completed within 7 days from the first medication calculations assessment. The pass mark for the supplemental is also 90%. NOTE: The student MUST demonstrate the ability to safely, competently, and in a timely manner administer medications (including calculations) in the clinical setting in order to pass and successfully meet the objectives of this course. 13
Attendance Requirements The faculty of the RDC Nursing Department believe that students are committed to their program and learning experiences. However, it is understood that there are times when students may be absent from those experiences. Any absence can be viewed as a potentially serious disruption of the learning process and necessary achievement of the learning objectives. Attendance is required in all lab, seminar, and clinical experiences. Any student who, due to extenuating circumstances, will be late or absent for a lab, seminar, or clinical must notify the instructor or the hospital unit (ONLY if unable to contact the instructor) at least one hour prior to the beginning of the lab, seminar, or clinical. Missed clinical time will be made up. Failure to notify the instructor/unit indicates a serious breach of professional and ethical conduct. A decision regarding make up of any extended absences will be formulated with the student, instructor, and the Chairperson of the Nursing Program. Seminars: Make up experiences for missed seminars will be arranged on an individual basis, and may include written assignments, in addition to other experiences. It is an expectation that students come prepared and actively participates in seminars. Labs: It is an expectation that students actively participate in labs. This includes coming to the lab having done the required preparation. Lab time is considered to be a part of the clinical experience and will be evaluated as such. Lab time provides students the opportunity to learn and practice nursing skills related to clinical practice. CARNA Nursing Practice Standards require all nurses to practice professionally and with competence. Make up lab time is required to obtain experience in nursing skills/assessments and to ensure students practice with confidence and competence. Demonstration of knowledge of missed content will be required before a skill can be practiced in clinical, as determined by the instructor. The lab must be made up within 7 days of the student s return to clinical. A student will have restrictions placed on practice and be given an incomplete grade until he/she has followed the lab makeup time process. Student process for lab makeup time: 1. The student s instructor will notify the lab coordinator of the required lab content/topic the student will be practicing and demonstrating. 2. The student will notify the lab coordinator to arrange for practice time. 3. The student will be required to prepare for the lab and to demonstrate the skill. 4. The lab coordinator will communicate to the student and instructor to inform both of the satisfactory, competence lab skill(s) the student demonstrated in the makeup lab. 14
Dress Code Students uniforms must comply with the Red Deer College Nursing Department policy and the dress code of the agency to which they are assigned. See the RDC Student Handbook for the Red Deer Regional Hospital Center dress code. Technology Guidelines The Nursing Department at Red Deer College recognizes that the use of technology in nursing has the potential to enhance learning and communication. We also recognize our obligation to use this technology responsibly and in a way that complies with the standards outlined by Red Deer College and by professional organizations such as CARNA and UNA. We are also aware of our obligation to represent nursing in a professional manner outside of the Red Deer College context. Students are asked to review the new technology guidelines that are included in their student handbook. In addition, all students should be aware of Alberta Health Services Code of Conduct as it applies to nurses: http://www.albertahealthservices.ca/pub-code-ofconduct.pdf Blackboard Communication Course information, important notices, course content, and correspondence relating to all students in the course will be posted on the Nursing 391 Central Blackboard site. Each group will also have access to their own clinical group blackboard site to enable students to send their weekly ENP s, to correspond with their clinical instructor and other students in their particular group. It is the student s responsibility to be familiar with the use of Blackboard and to regularly access the site (at least daily) to receive information. Failure to do so may result in students missing important course-related information, resources, messages, instructor feedback and announcements. If students are unable to access Blackboard to receive and send their weekly ENP s, correspondence, etc., it is the student s responsibility to immediately contact the Computer HELP desk at RDC to address this issue. 15
Grading Policy Red Deer College Marking and Grading Policy Grading Processes - BScN Program Years 1 to 3 April 2008 For Final Calculations Raw Score Marks Grade Grade Point Descriptor Range 95-100 A+ 4.0 Exemplary 90 94.95 A 4.0 Excellent Performance 85-89.95 A- 3.7 80.5-84.95 B+ 3.3 76-80.45 B 3.0 Good Performance 71.5-75.95 B- 2.7 67-71.45 C+ 2.3 62.5-66.95 C 2.0 Satisfactory Performance 58-62.45 C- 1.7 53.5-57.95 D+ 1.3 50-53.45 D 1.0 Pass <50 F 0 Fail 16
Plagiarism Policy: Refer to Red Deer College calendar for the policy complete policy available at http://rdc.ab.ca/sites/default/files/uploads/documents/2132/student-misconduct-academicnon-academic-policy_0.pdf Consequences: Nursing Faculty considers plagiarism/cheating as serious offenses and related directly to the graduate outcome of demonstrating integrity. A student charged with plagiarism may: Be given a reduced mark or no mark (i.e. a mark of 0) Be expelled from the course and given a grade of F In either case, the instance of academic dishonesty will be recorded on the student s academic file and the nursing student file, and further occurrences of any dishonesty may lead to expulsion from the College. Note: a plagiarism detection tool is used in this course http://wiki.safeassign.com/download/attachments/37191706/safe_assign_powerlink_student. pdf?version=1&modificationdate=1230913794537 CLINICAL PREPARATION: An essential component of nursing practice is the preparation students complete on their assigned patients prior to the time they provide care. Students should dress professionally and expect to spend approximately 1 hour (between 1600 and 1800) on the nursing unit collecting patient information (e.g. reading patient charts, Kardex, and medication records) the day prior to clinical. Care must be taken when collecting assigned patient data to maintain confidentiality of individual s private health and personal information. This includes, but is not limited to using initials, keeping identifying information separate from clinical information, properly disposing of confidential information on the assigned nursing unit, and writing all information (DO NOT photocopy any portion of the chart). Approximately 2-3 hours additional time will be spent at home on in-depth, thorough preparation using resources and reference materials. Please bring all of this preparation with you to clinical. Expectations of the pre-conferences are as follows: Brief review of patient information, identification of patient priorities, and a nursing care plan for your patient (diagnosis, goal, intervention, rationale, and evaluation). Post conference time is an opportunity to point out applications of theory to practice, for analyzing the outcome of hypothesis testing, for group problem solving, and for evaluation of nursing care. Head to Toe Assessment: Students will be assessed on their head to toe assessment within the first two weeks of clinical any areas of concern will be discussed with the student and the student is expected to address these during assessments of patients throughout the rest of the practicum. Students will then be assessed on their head to toe assessment again during the last week of clinical. It is expected at that time that students will be proficient in doing their assessment and have appropriately responded to feedback provided in the first two weeks of clinical. 17
Medications: Medications will be discussed with the instructor prior to administration. In order to facilitate this process, students are expected to have researched and have knowledge of ALL medications that their patient is receiving. Given the large number of medications that many of the patients will be receiving, it is acceptable for students to bring in resources. These could include preprinted drug cards or medication books that are underlined in pencil by students. Students may also use a PDA program or drug handbook for additional information. It is expected that students will have reviewed and be able to quickly retrieve the following information: Name of the drug Classification Indications (why is YOUR patient on the drug) Contraindications and cautions (any that apply to YOUR patient) Dosage (what is the typical dosage and what is YOUR patient s dosage) Pharmacokinetics (peak, duration) Action (where does it work, where is it metabolized and excreted) Side effects (critical for YOUR patient) Effect on lab values Interactions (given YOUR patient s medications) Nursing assessments Critical patient teaching * Important note: Students who are unable to demonstrate preparation for clinical practice will not be allowed in the clinical area until such time as they have sufficient preparation completed for the provision of safe care to patients. 18
Nursing 391: Comprehensive Patient Review % Description of Expectations Comments 10% Assessment Data: Includes subjective (behavioral and non-verbal observations, patient s/family s perception of abilities/disease process/beliefs/health care needs/available resources, assessments of support systems/readiness for learning) and objective data (relevant physical assessments). Strengths and potential problems are identified throughout. Data should be concise and specific and a systematic process used. 15% Mindmapping/Concept Mapping: Includes comprehensive health history & health assessment according to chosen theoretical model; pertinent anatomy & physiology (with citations); discussion of the Determinants of Health that are evident in this patient s situation; impact of culture on patient s health practices and health care needs; patient s/family s expectations of hospitalization; medications and reason pt is on medications; key lab values and reason why lab values are abnormal; treatments; & test results. Identifies 5 6 key relevant nursing diagnoses pertinent to this patient should include physiological, psychological, spiritual, family and educational factors. Identifies the discharge planning considerations for this patient: patient s/family s hopes and desires for future health, appropriate goals for discharge (three in total) each should have one long term and one short term goal, and links discharge considerations for patient to principles of Primary Health Care. 5% Formatting: Concept map is four 8 ½ x 11 pages; data forms clusters or patterns; consists of a central topic (the patient); placement of key ideas are either mind mapped (branches) or concept mapped (top to bottom); use color, boxes &/or circles to highlight or categorize ideas; main concepts are grouped and links identifiable with numbering and colors; explain your perceived connections on a separate page (linkages). Do not laminate. Minimum size font is Time New Roman 8. All components of the assignment must be typed. Maximum one page per nursing diagnosis. 25% Critical Thinking/Linkages: Identifies a variety of relevant biopsychosocial and physiological links. Each link contains only two concepts and a statement clearly indicates how and why the concepts are linked. Links are numbered with further explanation of connections provided on one page. All links supported with references. Minimum of ten links required. All links must fit on one 8 ½ x 11 page. 6% Nursing Diagnoses: Chooses 3 relevant priority problems to focus on and diagnoses are prioritized. Are patient focused and the nurse can treat independently. Based on assessment data. Contain 3 clauses: response or problem; related to, and as (or would be) evidenced by. Supported by assessment data. Diagnoses are correctly prioritized. 3% Goals: Identify 3 goals derived from each of the 3 nursing diagnoses that are patient centered not what nurse will do - one goal per diagnosis. Are short term and state what observable behavior will occur and within a certain time frame. Are (S) single, specific; (M) measurable and observable, (A) achievable, (R) realistic, and (T) timely (include time frame). 9% Interventions: State what is to be done specifically. Two interventions per diagnosis. Interventions must: relate to the contributing factors; help to meet the outcome criteria; include when and how intervention is to be done; be specific to patient/family situation; be comprehensive; provide for patient/family participation in health promotion, maintenance and restoration; include teaching activities. 9% Rationale: Rationale for each intervention should be stated and each must be supported with a citation to a reference from a text or article (minimum of one article for each diagnosis); primarily nursing references are used. 9% Evaluation: Include date for each of the evaluations. State if goal met? Reviewed? Resolved? or Revised? What measure or observe in patient that tells you if goal met or not. If unmet or partially met discuss why not met. Briefly indicate how plan could be modified to meet goals in future. 9% APA: Title page, running head (all pages), and reference page(s) included. Citations and references are in standard APA format 6th edition. Appropriate grammar & spelling. 100% Total: = /25 19
Nursing 391 Evaluation of Nursing Practice Student: (print) Placement: Clinical Instructor: (print) Date: Facility: Section: Semester Dates (yy/mm/dd) Days absent/sick 0 1 2 3 Provide Student with photocopy or PDF email copy of Clinical Evaluation Final Total Mark: /60 57-60: Exemplary 52-56: Excellent 47-51: Very Good 42-46: Good 36 41: Satisfactory less than 36: Fail *Student s overall performance will be assessed in each of the six categories. Excellent Student meets the objectives at a Level of Independence greater than identified on the ENP, all of the time. Very Good Student meets the objectives at a Level of Independence greater than identified on the ENP, the majority of the time. Good Student meets the objectives at a Level of Independence greater than identified on the ENP, some of the time. Expected/Satisfactory Student meets the objectives at a Level of Independence required on the ENP. Fail Student fails to meets the objectives at a Level of Independence required on the ENP RC = Relevant Competency Please refer to the Graduate Competencies and Year End Outcomes 2014-2015 20
LEVEL OF INDEPENDENCE In evaluating (clinical performance) objectives, the following levels of independence will be used: With assistance: The student requires direction and information. With minimal assistance: The student requires occasional direction and information. With guidance: The student requires clarification, prompting and confirmation. With minimal guidance: The student requires occasional clarification, prompting and confirmation. Independently: The student works mostly on his or her own and seeks information, clarification. * The student must demonstrate progression in levels of independence in meeting the requirements as outlined in the ENP during this clinical experience. Definition of terms: Direction: tutor tells student what to do, about steps to take Information: tutor tells student specifics about a concept, topic Clarification: tutor, through questioning and feedback, assists the student to state their information in a different and clear way, often with more details. Student asks questions to increase their understanding; questions asked demonstrate a sound knowledge base Prompting: tutor provides student with a cue that answer is incomplete or incorrect and how to resolve the lack of information. A prompt is broader than a hint. Prompting is generally used to add breadth or depth. Confirmation: tutor provides positive feedback for correct information and direction provided by the student Consultation: student provides tutor with information and/or direction and asks specific questions about the information or direction which the instructor confirms. Occasional: indicates that input is provided by tutor now and then 21
RELATED COURSE OBJECTIVE: Demonstrate, with assistance the ability to practice in accordance with Year 3 competencies, as described in the document entitled: Graduate Competencies and Year-End Outcomes 2014-2015. RC 1. PROFESSIONAL RESPONSIBILITY AND ACCOUNTABILITY [/15] 1.3 1.1 Independently presents a professional image. 1.3 1.2 With minimal guidance, demonstrates accountability for making decisions and the outcomes of those decisions. 2.3 3.3 1.3 3.3 4.3 16.3 1.3 With guidance, uses effective time management strategies in coordinating care, organizing workload, and setting priorities. 1.4 With guidance demonstrates the ability to practice safely and within the limits of own competence and knowledge. 1.5 With guidance demonstrates initiative and responsibility to accurately assess and meet own learning needs and implements learning goals to maximize and or improve nursing care. 1.6 Independently understands and ensures personal, client and colleague safety by practicing within the policies and procedures of the agency/organization. 22
RELATED COURSE OBJECTIVES : Demonstrate, with assistance, the ability to conduct selected assessments with healthy individuals across the lifespan in the context of family within a community. Demonstrate, with assistance, the ability to use professional and therapeutic communication skills to collaborate with clients across the lifespan. Demonstrate, with assistance, the ability to engage in health promoting activities with clients. Demonstrate, with assistance, the ability to engage in evidence-based practice. Demonstrate the ability to integrate knowledge into clinical practice. RC 2. KNOWLEDGE - BASED PRACTICE [/20] 10.3 2.1 With guidance, applies a critical thinking approach to nursing. 5.4 2.2 With guidance, identifies, develops and engages in strategies for social and political action. 10.3 2.3 With guidance, uses credible and evidence informed theory and resources to provide competent care. 18.3 19.3 2.4 With guidance, identifies appropriate nursing diagnoses from relevant assessment data, sets goals, develops 20.3 plans for care, and evaluates outcomes in complex and rapidly changing client situations. 21.3 23.3 21.3 2.5 With guidance, manages multiple nursing interventions in complex, rapidly changing unstable patient conditions. 20.3 2.6 With guidance, recognizes and seeks help in rapidly changing unstable client conditions. 15.3 2.7 With guidance, uses principles of primary health care to anticipate client health problems to manage complex problems and promote continuity of care. 15.3 2.8 With guidance, collaborates with other members of the interprofessional team in the delivery of care to the 27.3 client. 18.3 2.9 With guidance, makes appropriate judgments and sound decisions in management of care based on clear and accurate understanding of rationale for care, best practice guidelines and research 7.3 2.10 With guidance, applies a knowledge base from nursing and other disciplines concerning current health care 8.3 issues in adult acute care. 2.11 With guidance, uses appropriate lines of communication to report significant issues or concerns related to 24.3 delivery of nursing care and patient / client outcomes. 24.3 2.12 With minimal guidance, produces clear, timely, relevant, and thorough charting /documentation. 27.3 2.13 Independently establishes and maintains effective working relationships and open communication with colleagues. 23
RELATED COURSE OBJECTIVE Demonstrate, independently or with guidance, the ability to practice in accordance with Year 3 competencies, as described in the document entitled: Graduate Competencies and Year-End Outcomes 2014-2015. Demonstrate, with assistance, the ability to establish a helping relationship with clients. RC 3. ETHICAL PRACTICE [/10] 25.3 26.3 3.1 With guidance, provides nursing care that respects professional boundaries, and individual rights such as informed consent, confidentiality, client autonomy, and advocacy. 25.3 26.3 25.3 3.2 Demonstrates respect for cultural, spiritual, and individual values, beliefs, and opinions of peers, colleagues, and clients. 3.3 With guidance, identifies potential effect(s) of own values, beliefs, and experiences on relationships with clients, and uses this self-awareness to provide competent care. 25.1 3.4 Establishes therapeutic and caring relationships with clients. RELATED COURSE OBJECTIVE Demonstrate, with guidance, the ability to manage health promotion and prevention activities using advanced therapeutic/interpersonal communication skills, health counselling skills, and teaching and learning principles. RC 4. SERVICE TO PUBLIC [/5] 27.3 28.3 29.3 4.1 With minimal guidance applies principles of therapeutic and professional relationships in establishing rapport with clients / staff and terminating these relationships. 4.2 With guidance, demonstrates leadership, management, and administration skills. RELATED COURSE OBJECTIVE: Demonstrate, with assistance the ability to practice in accordance with Year 3 competencies, as described in the document entitled: Graduate Competencies and Year-End Outcomes 2014-2015 RC 5. SELF-REGULATION [/5] 31.3 5.1 Independently demonstrates understanding of the CARNA practice standards and competencies in relation to the RELATED COURSE OBJECTIVE: development of own nursing practice. Demonstrate, with assistance, the processes of self-directed learning, critical thinking, and context-based learning in a variety of community settings. RC 6. CONTEXT BASED LEARNING [/5] 33.3.1 6.1 Independently directs own learning. 33.3.2 6.2 Independently uses critical thinking skills to facilitate learning of the group. 33.3.3 6.3 Independently effectively uses group process to facilitate learning of the group. 34 6.4 With guidance selects, and empowers clients to choose, appropriate strategies to deal with ambiguity and diversity. 24
Final Evaluation: Student s Name Tutor s Name Signature Date Signature Date Please Note: Student signature on this document denotes that the student has read the evaluation. It does not mean that the student necessarily agrees with all of its content. 25
Numerical Ranges for Evaluation of Nursing Practice marks: Mark Descriptor Mark Descriptor 60 A+ 47 B Very Good 59 A+ 46 B 58 A+ 45 B 57 A+ Exemplary 44 B- 56 A 43 B- 55 A 42 B- Good 54 A 41 C+ 53 A- 40 C+ 52 A- Excellent 39 C+ 51 A- 38 C 50 B+ 37 C 49 B+ 36 C Satisfactory 48 B+ <36 F Fail 26