KILGORE COLLEGE Department of Associate Degree Nursing RNSG Health Care Concepts II

KILGORE COLLEGE Department of Associate Degree Nursing RNSG 2362 Health Care Ccepts II Clinical Syllabus Summer 2017

KILGORE COLLEGE Associate Degree Nursing CLINICAL HEALTH CARE CONCEPTS II RNSG 1433 CLINICAL SYLLABUS Course: RNSG 1433 Clinical for Health Care Ccepts II A health-related work-based learning experience that enables the student to apply specialized occupatial theory, skills, and ccepts. Direct supervisi is provided by the clinical professial. Ctinued development in the knowledge of skills essential for client care. Applicati of principles of total patient care involving nursing theory, ccepts, and skills at an intermediate level. Helps students synthesize new knowledge, apply previous knowledge, and gain experience managing workflow. Practical experience is simultaneously related to theory. Close and/or direct supervisi is provided by the clinical professial (faculty or preceptor), generally in a clinical setting. Clinical educati is an unpaid learning experience. Ctent includes applicable DEC competencies. There will be a minimum of e hundred ninety two (192) hours of clinical in this course. Course Credit: (2-0-6) (2 hours credit, 6 hours clinical) Prerequisites: See RNSG 1433. Ccurrent enrollment in RNSG 1433 (Health Care Ccepts II Lecture and Lab), and RNSG 1126 (Professial Nursing Ccepts) is required. Successful completi of both RNSG 1433 Lecture, RNSG 1433 Lab, RNSG 2362 Clinical compents, and RNSG 1126 theory are required for progressi. Instructor: Julie Blundell, MSN, RN Office: HSC 207 Phe: 903.988.7498 E-mail: jblundell@kilgore.edu Office hours: Posted door Other Instructors that can use this syllabus: D. Bahr, J. Hobbs, J. Schneider, M. Hastie, Tracy Hicks Course Ratiale/WECM End of Course Objectives: The student will apply the theory, ccepts, and skills involving specialized materials, tools, equipment, procedures, regulatis, laws, and interactis within and amg political, ecomic, envirmental, social, and legal systems associated with the occupatis and the business/industry and will demstrate legal and ethical behavior, safety practices, interpersal and teamwork skills, and appropriate written and verbal communicati skills using the terminology of the occupati and the business/industry. Licensure Agency: Texas Board of Nursing

Educatial Materials: Required Textbooks: All of Level 1 Materials plus: Required For Level II RNSG 1433 Halter, M. J., Varcarolis RNSG 1433 Ignatavicius, D. & Workman, M. Required: Foundatis of Mental Health Nursing: A Clinical Approach (ebook) Required: Medical Surgical Nursing: Patient Centered Collaborative Care (ebook) 7 th Elsevier 8 th Elsevier RNSG 1433 Ignatavicius, D. & Workman, M. Required: Clinical Nursing Judgment Study Guide for Medical-Surgical Nursing: Patient-Centered Collaborative Care 8th ed. Elsevier RNSG 1433 McKinney Maternal child book?? Program Learning Outcomes: After completi of the program, students will be able to: Provide a safe and effective care envirment for their patients, through appropriate management of patient care and promoti of safety and infecti ctrol. Provide for patient s psychosocial integrity. Provide for patient s physiological integrity through basic care and comfort, pharmacological and parenteral therapies, reducti of risk potential, and physiological adaptati. Provide for patient health promoti and maintenance. Provide care for patient s utilizing the nursing process, including assessment, analysis, planning, implementati, and evaluati. Provide patient care utilizing critical thinking to prioritize, set goals, apply knowledge with inferential and interpretive reasing, and predict or evaluate outcomes.

Student Learning Outcomes: After completi of the program, students will be able to: 1. Use clinical reasing and knowledge based the nursing program of study, evidenced-based practice outcomes, and research based policies and procedures as the basis for decisi-making and comprehensive, safe patient care. 2. Demstrates skills in using patient care technologies and informati systems that support safe nursing practice. 3. Promotes safety and quality improvement as an advocate and manager of nursing care. 4. Coordinate, collaborate and communicate with diverse patients, families and the interdisciplinary health care team to plan, deliver, and evaluate care. 5. Adheres to standards of practice within legal, ethical, and regulatory frameworks of the professial nurse. 6. Demstrates knowledge of delegati, management, and leadership skills. 7. Demstrate behavior that reflects the values and ethics of the nursing professi. Math Calculati/Pharmacology Policy: The safe administrati of medicatis is e of the primary objectives of the A.D.N. program. Accurate mathematical computati and pharmacological knowledge are essential elements of safe medicati administrati. Therefore, accuracy of mathematical computatis/pharmacology will be assessed before each clinical course with the mastery (competency) level increasing from simple to complex during your course of study. Level I through Level IV must successfully pass the math/medicati exam with a score of 100%. (Attempts for each Level is as follows: Level I 5 attempts; Level II and Level III 4 attempts; and Level IV 3 attempts).after each attempt, if the student is unsuccessful they must meet with their Instructor and complete the assigned remediati/tutorials before the next math exam. However, if the student does not pass the exam with a score of 100% the final attempt, they will be required to withdraw failing from ALL clinical and theory courses. The student will not be eligible for readmissi unless a recommended math course has been taken and passed, with a grade of C or better. The student may then reapply to ctinue in the nursing program when space is available. Scholastic Requirements: Grades in each nursing course in the KC A.D.N. program will use the following standard with no rounding: A = 92-100 B = 82-91.9

C = 78-81.9 D = 60-77.9 F = 59.9 and below Nursing Students must successfully pass both theory and ccurrent clinical courses and achieve a grade of C or better to pass each course. An unsatisfactory grade in either theory or clinical practice will result in failure of the course, and both theory and clinical courses must be repeated. A student must pass both courses with a grade of C or better. Clinical Evaluati Criteria and Tool: Competency of clinical performance in the various health care settings is evaluated as the ability to perform a qualified duty or job skill of the ADN. The clinical evaluati is a ctinuous, systematic process of collecting data to determine whether the student has achieved the clinical objectives for a specific course. It also includes identificati of individual strengths and weaknesses by focusing competencies needed by the student to perform adequately as a registered nurse up graduati. *The progressive clinical evaluati tool is an evaluati tool which uses behavioral objectives that reflect progressi/maintenance through the four clinical levels of the KC ADN program. The secd level, RNSG 2362, will be evaluated through use of the behavioral objectives listed in Level 1-2. *The organizati of the objectives uses the four major roles of the practicing nurse: Member of the Professi, Provider of Patient-centered Care, Patient Safety Advocate, and Member of the Health Care Team. Faculty will use the clinical evaluati tool to evaluate a student s performance in the clinical setting. HCC2 CLINICAL GRADE SHEET Total of the Clinical Evaluati Tool The HCC2 Clinical Evaluati Tool has 44 items per to be graded with a 0, 1, or 2. This allows for a possible of 88 points per clinical. Each student has 5 s assigned to a unit with your clinical instructor, not including observati s. The top 4 grades for paperwork will be counted, for a possible grade of 352 points total. ulati Evaluati Tool The HCC2 SIM Evaluati Tool has 25 items per to be graded with a 0, 1, or 2. This allows for a possible of 50 points per SIM. Each student has 4 SIM s for a possible grade of 200 points total.

GRADED ITEMS POINTS POSSIBLE STUDENTS POINTS Clinical Day 1 total score. 88 pts. pts. Clinical Day 2 total score. 88 pts. pts. Clinical Day 3 total score. 88 pts. pts. Clinical Day 4 total score. 88 pts. pts. Clinical Day 5 total score. 88 pts. pts. Add highest four daily clinical scores Total of the Clinical Evaluati Tool Scores 352 pts. pts. SIM Day 1 total score 50 pts. SIM Day 2 total score 50 pts. SIM Day 3 total score 50 pts. SIM Day 4 total score 50 pts. Total of the SIM Evaluati Tool Scores.. 200 pts. Average of Post SIM Quizzes. 100 pts. pts. pts. pts. pts. pts. pts. Total Number of Skills Performed Clinical Skills List. FINAL CLINICAL SCORE 652 pts. pts. **Students who are placed a clinical ctract will have their grade lowered by e (1) letter grade. *** As outlined in the clinical syllabus, unsafe clinical practice may result in suspensi or failure at any point during the semester. A minimum of 192 clinical hours as outlined in the clinical schedule must be course. completed to pass the Clinical Policies: Dress Code: The student is respsible for adhering to the dress code as outlined in the student handbook. Attire for the clinical envirment is addressed by the handbook. Student Professial Code of Dress and Hygiene: The student is respsible for adhering to the dress code as outlined in the student handbook.

Attire for the clinical envirment is addressed by the handbook. Full uniform will be required in the clinical facility at this time. The Kilgore College School of Nursing navy polo and Khaki pants with white tennis shoes is required for assigned clinical facility activities not requiring direct patient care. Please refer to the Kilgore College Associate Degree Nursing Program Student Handbook. Whenever you are in uniform, you need to adhere to the Dress Code Policy whether campus or clinical. ** Kilgore Picture ID s must be worn at all times when campus and in the clinical facility.** Appearance in Clinical: Khaki pants and the KCADN polo shirt, with the KC ADN patch, and all white, leather shoes (no clogs or open toed shoes allowed), will be the official n-clinical hospital uniform. White shirts (short sleeve, lg sleeve or turtleneck) may be worn under the polo shirt. White shirt tails should not hang below the polo shirt. (This uniform is to be worn whenever student goes to the facility the night before clinical to obtain prep work, in other situatis that do not require actual patient care situatis.) The KC ADN uniform is royal blue top, royal blue skirt or slacks, and all white, leather shoes (no clogs or open toed shoes allowed). The KC ADN patch is placed the upper left chest above the students nametag. A waist length royal blue scrub jacket with the KC ADN patch the upper left chest above the nametag may be worn for warmth. Or a white shirt (short sleeve, lg sleeve, or turtleneck) may be worn under the uniform top. White shirt tails should not hang below the uniform top. (This uniform is to be worn whenever student goes to the facility to do actual patient care.) Please remember that as a student you are representing the KC ADN program. Attendance Policy: Clinical is an essential part of the nursing program. Because the total number of clinical hours per semester for each nursing course is mandated by WECM and ACEN, the Kilgore College Attendance Policy does not apply as outlined in the KC catalog. If a student is unable to attend an assigned activity, they are expected to call and report their absence as listed in each course syllabus. Absent students are respsible for all announcements, assignments, and course ctent. The total number of hours mandated for this course (192) must be met to pass the clinical. Make up time for missed clinical will be arranged at the discreti of the instructor. Clinical Absence & Make-up Policy: For absence notificati clinical s, the student is to call the clinical instructor and call the assigned unit of assigned facility at least 1 hour before designated clinical time. The student is to give his/her name, assigned divisi, reas for absence, and get the pers's name spoken to. There will be no make up for hours missed in the sim lab, unless approved by the instructor prior to absence. Clinical Make-up Policy: Any time missed from a clinical course must be made up before the cclusi of that clinical course in order to fulfill state requirements and in order to pass the course and progress in the nursing program. Only e make-up for clinical will be allowed. Makeup clinical will be used ly for completing hours, not used to calculate

points for grade or for completing assigned skills. Make-up clinical time will be arranged at the discreti of the instructor. Clinical Call in Procedure: For absence notificati clinical s, the student is to call the clinical instructor and call the assigned unit of assigned facility at least 1 hour before designated clinical time. The student is to give his/her name, assigned divisi, reas for absence, and get the pers's name spoken to. A no call or no show for clinical will be an automatic ctract for the student. Tardiness: Students should arrive at the clinical setting at or before the designated time. Any student arriving after report is given will be sent home and an absence will be counted. ADA Statement: Kilgore College is committed to making reasable accommodatis to assist individuals with disabilities in reaching their academic potential. If you choose to request accommodatis for a documented disability which may impact your performance, attendance, or grades in this course, you must first register with the Office of Disability Services. Please note that classroom accommodatis cannot be provided prior to your instructor s receipt of an accommodati letter from the Office of Disability Services. For more informati about accommodatis, please ctact the Disability Services office the secd floor of the Devall Student Center: (903) 983-8206. Civility Policy: Per the Kilgore College Catalog, under Academic Policies, the college reserves the right to withdraw a student from e or more classes if, in the judgment of the college officials, such acti is deemed to be in the interest of the student/and or the college. Examples of some reass for administrative withdrawal are failure to provide accurate informati, excessive absences or unacceptable student behavior. The Civility Statement in the Kilgore College catalog states that students are expected to assist in maintaining a classroom envirment that is cducive to learning. Inappropriate or disruptive classroom behavior is prohibited in order to assure that everye has the opportunity to gain from time spent in class. Should a disruptive classroom incident occur the faculty member, in charge, may remove the student either a temporary or permanent basis. If the Kilgore College Nursing Program receives complaints against your cduct, you may be withdrawn from the nursing program. Unprofessial cduct/unacceptable student behavior in this circumstance indicates: 1. Threatening instructors, hospital staff, patients or other students. 2. Slanderous accusatis against faculty, Kilgore College, hospital staff or other students. 3. Disrupti of the classroom or clinical envirment. (This includes use of electric devices during class or clinical such as texting, ipods, cell phe, computer for other than specified class activities, etc.). 4. Being disrespectful to instructors, hospital staff, patients or other students (i.e. te of voice, rolling eyes, body language, arguing with instructor). 5. Speaking while faculty or other students are speaking.

6. Demanding to discuss persal academic issues in a public forum. 7. Spreading of unfounded rumors Sexual Harassment Policy Statement: Please refer to the Kilgore College Associate Degree Nursing Program Student Handbook Policy for Social Networking Sites: Students in the A.D.N. Program at Kilgore College are expected to adhere to the high standards of the Nursing professi with regard to maintaining cfidentiality. This not ly includes guarding patient cfidentiality at a clinical site, but, also in the classroom at home and -line. The following guidelines are for behavior involved with cell phe use, FACEBOOK, Twitter, MySpace, and any other social networking site. Guidelines: It is the students respsibly to keep their site appropriate and profiles clean. Do not post threats or derogatory remarks about anye associated with the A.D.N. Program. This includes fellow students, faculty, staff, college administrati, clinical affiliates, and above all, patients. This is a violati of the Kilgore College Board policy and will be reported to the police and disciplinary acti, such as dismissal is likely. Posting photos of other students, faculty staff, etc. without their permissi is forbidden Taking photos of patients, their body parts, or body fluids, or exudate, is strictly forbidden. Cell phe use at the clinical site is strictly forbidden. If cell phes are discovered they will be cfiscated for the remainder of the class or clinical. DAILY CLINICAL EXPECTATIONS YOU MUST COME TO CLINCAL PREPARED! Failure to arrive time prepared to give care for the patient you are assigned reflects unsafe clinical practice. You will have failed a critical course competency and will be asked to leave the clinical setting. It is the respsibility of the student to meet with the course coordinator and the clinical instructor prior to returning to the clinical setting. Being sent home from clinical will count as a clinical absence and result in a ctract which will lower the clinical grade. PREPARATION WILL INCLUDE BUT IS NOT LIMITED TO THE FOLLOWING: (All prep work should be complete prior to clinical; if not student will go home ctract which will lower the clinical grade) 1. Complete Prep Sheet 2. Medicati List (for ALL po meds, IM, subq, topical ; po prn meds and IV meds (when you are checked off IV meds) (0630 to 1700) 3. Nursing Diagnoses List 4. Lab Value Sheet 5. Ccept Map (grading rubric for each ccept map) 6. Bring folder with side pockets and three brads each clinical. To be included in the

folder area the following: a. In the brads: (in the following order) 1. Your picture in the frt of the folder 2. HCC2 Skills Check-off list 3. Paperwork Grading Tool 4. Progressive Clinical Evaluati Tool 5. Weekly Clinical Comment Sheet 6. Clinical Shift Assessment Check-off Sheet 7. Clinical Medicati Administrati Check-off Sheet 8. Final Grading Scale 9. Final Evaluati Form b. In the left hand pocket put all of the materials being utilized during the current week. This will include your prep sheet, nursing diagnoses list, medicati list, lab values sheets, ccept map with grading rubric, etc. c. Also, the clinical skills check off folder that will include your Level 1 skills check-off sheet and page 2 (level 2, 3, 4, skills check-off sheet) you will need to bring that folder to clinical but not in the folder that you turn into your instructor. Because you will need to bring this folder to IV skills check off lab. Patient Jeopardy: Any time a student jeopardizes a patient s physical or emotial envirment, violates safety or asepsis, the instructor can require the student to leave the premises. Practice in skills lab will be required and arranged by the student with the Lab Assistant using the Skills Referral form which defines the deficiency. This practice will help overcome deficiencies with skills. This must be de satisfactorily by the next clinical, or the student will not be allowed to return to the clinical facility. The student will bring the Skills Referral form signed by the Lab Assistant showing that the student has met the minimal competency or better in that skill. If, however, the skills laboratory practice does not promote a safer or more health-promoting envirment, that student cannot meet the clinical objectives and will fail to pass Nursing 1261. All assigned criteria must be met a competent level before the final exam or the student fails Nursing 1261. It is the student s respsibility to make arrangements with the appropriate instructor(s) when the clinical has not been completed satisfactorily. Student Ctract Policy: Students may be placed ctract in any class, lab, or clinical setting. A student s final grade, in a course, will be lowered by a letter grade for each ctract issued. Students who receive a third ctract will be expelled from the program at that time. Students may apply for readmissi to the program. The student will be required to appear before the Admissi/Readmissi/Progressi Committee. Readmissi will be reviewed an individual basis.

Academic Integrity: Students are expected to assume full respsibility for the ctent and integrity of all academic work submitted as homework and examinatis. Students found guilty of violati of academic integrity may fail the course and/or be dismissed from the nursing program. The school of nursing reserves the right to dismiss students from the program for any serious infractis of a legal, moral, social or safety nature, pursuant to the procedures detailed in the Nursing Student Handbook. Good Professial Character Policy (Excerpt, Texas Board of Nurse Examiners) Good professial character is the integrated pattern of persal, academic and occupatial behaviors, which, in the judgment of the faculty, indicates that an individual is able to csistently cform his/her cduct to the requirements of the Nurse Practice Act, and generally accepted standards of nursing practice including, but not limited to, behaviors indicating: hesty, accountability, trustworthiness, reliability, and integrity. A pers who seeks to obtain or retain a license to practice professial nursing shall provide evidence of good professial character which, in the judgment of the Board of Nurse Examiner s (BON) is sufficient to insure that the individual can csistently act in the best interest of patient/patients and the public in any practice setting. Such evidence shall establish that the pers: 1. is able to distinguish right from wrg; 2. is able to think and act ratially; 3. is able to keep promises and hor obligatis; 4. is accountable for his/her own behavior; 5. is able to practice nursing in an automous role with patients, their families and other significant others, and members of the public who are or who may become physically, emotially, or financially vulnerable; 6. is able to recognize and hor the interpersal boundaries appropriate to any therapeutic relatiship or health care setting; and, 7. is able to promptly and fully self-disclose facts, circumstances, events, errors and omissis when such disclosure could enhance the health status of patients or the public or could protect patients or the public from unnecessary risk or harm. Disciplinary Sanctis for Lying and Falsificati (Excerpt, Texas Board of Nurse Examiners) The Board of Nurse Examiners for the State of Texas, in keeping with its missi to protect the public health, safety, and welfare, believes it is imperative to take a strg positi regarding the licensure of individuals who have engaged in decepti in the provisi of health care. This decepti includes falsifying documents related to patient care, falsifying documents related to employment, and falsifying documents related to licensure. The Board is also ccerned about perss who have been cvicted of a crime involving decepti to the extent that such cduct may affect the ability to safely care for patients. The Board s positi applies to all nurse license holders and applicants for licensure. The Board adopts the following assumptis as the basis for its positi: 1. Patients under the care of a nurse are vulnerable by virtue of illness or injury, and the dependent nature of the nurse-patient relatiship.

5. Hesty, accuracy and integrity are persal traits valued by the nursing professi, and csidered imperative for the provisi of safe and effective nursing care (rule 213.27). 7. Falsificati of documents regarding patient care, incomplete or inaccurate documentati of Patient care, failure to provide the care documented, or other acts of decepti raise serious ccerns whether the nurse will ctinue such behavior and jeopardize the effectiveness of patient care in the future. Lying/Falsificati to an Employer, Nursing Educati Program, or other Nursing Training Program (Excerpt from the Texas Board of Nursing). A student nurse who falsifies patient records or engages in other dishesty in patient care gives the Board reas to suspect that he or she will ctinue the same dishest acts after licensure. If the Board is made aware of acts committed as a student, an investigati will be cducted ce the student makes applicati for licensure. The Board will csider the same factors as described above for lying and falsificati within the practice of nursing. Scholastic/Clinical Dishesty: Since the value of an academic degree depends the absolute integrity of the work de by the student for the degree, it is imperative that the student maintains a high standard of individual hor in his or her scholastic/clinical work. Any student who commits an act of scholastic/clinical dishesty is subject to discipline. Scholastic/clinical dishesty includes but is not limited to cheating, plagiarism, collusi, falsifying academic records, falsifying patient records, the submissi for credit of any work or materials that are attributable in whole or in part to another pers, taking an examinati for another pers, any act designed to give unfair advantage to a student or the attempt to commit such act. Cheating includes, but is not limited to: 1. Copying from a test paper or assignment of another student; 2. Possessi during a test of materials or objects which are not authorized by the pers giving the test, such as class notes or crib notes. The presence of textbooks and notes cstitutes a violati if they have been specifically prohibited by the pers administering the test; 3. Using, buying, stealing, transporting, or soliciting in whole or part the ctents of an unadministered test, test key, homework soluti, or computer program; 4. Collaborating with or seeking aid from another student during a test or other assignment without authority; 5. Discussing the ctents of an examinati with another student who will take the examinati; 6. Substituting for another pers, or permitting another pers to substitute for e s self, to take a test;

7. Paying or offering mey or any other valuable to obtain, or coercing another pers to obtain an un-administered test, test key, homework soluti, or computer program, or informati about an un-administered test, test key, homework soluti, or computer program; 8. Falsifying research data, laboratory reports, clinical data, and/or other academic work offered for credit; Plagiarism includes, but is not limited to, the appropriati, buying, receiving as a gift, or obtaining by any means another s work and the submissi of it as es own academic work offered for credit. Collusi includes, but is not limited to, the unauthorized collaborati with another pers in preparing academic assignments offered for credit or collaborati with another pers to commit a violati of any secti of the rules scholastic/clinical dishesty. Falsifying academic/clinical records includes, but is not limited to, the altering of grades or other falsificati of academic/clinical records. The Kilgore College ADN faculty members support the above excerpt from the BON Rules & Regulatis relating to Professial Nurse Educati. Failure to demstrate competency in the above criteria can result in a rating of unsafe clinical performance and not meeting professial cduct standards, as defined in the syllabus of each clinical nursing course. Regulati Awareness: It is the respsibility of the student to become familiar with the regulatis of Kilgore College and to satisfy them in the proper way. Drop Date: The Drop Procedure per KC Catalog will be announced the first of class. DISCLAIMER: The instructor reserves the right to make modificatis in ctent and schedule as necessary to promote the best educati possible within prevailing cditis affecting this course.

STATEMENT OF UNSAFE CLINICAL PRACTICE Any act of omissi or commissi, which may result in harm to the client, is csidered unsafe clinical practice. Students must be aware that certain nursing behaviors place the client at risk. It is the student s respsibility to practice safe client care. During the clinical practicum, unsafe clinical practice is defined as any e of the following: 1. Violates or threatens the physical, psychological, microbiological, chemical, or thermal safety of the client/patient. This includes, but is not limited to: a. Leaving clients with limited sensorium, strength or coordinati, unattended in an unsafe situati. b. Failure to report errors or that an ordered/required client procedure was not carried out. c. Failure to recognize and report a serious change in a client s cditi, or a serious hazard in the client s immediate envirment. d. Failure to use therapeutic communicati. e. Arrives at a clinical setting unprepared to provide safe client care. f. Arrives at clinical setting too late to provide safe care. 2. Violates previously mastered principles/learning/objectives in carrying out nursing care skills and/or delegated medical functi. This includes, but is not limited to: a. Medicati administrati b. Vital signs c. Therapeutic communicati d. Invasive/n-invasive procedures 3. Assumes inappropriate independence in acti or decisis. This includes, but is not limited to: a. Medicati administrati (Oral medicatis, gastric tube medicatis, and IV piggyback medicatis may be given with an instructor or a nurse after the student has been checked off; IV pushes and ANY injecti must be given with an instructor; there will be NO chemotherapy or blood products given by a student.) b. Nursing procedures c. Use of equipment 4. Does not adhere to current CDC Guidelines for Infecti Ctrol. 5. Fails to recognize own limitatis, incompetence and/or legal respsibilities. 6. Fails to accept moral and legal respsibility for his/her own actis. 7. Violates professial integrity as expressed in the ANA Code for Nurses. This includes, but is not limited to: a. Willful dishesty regarding informati given to faculty, students, hospital staff, or clients. b. Willful dishesty regarding client documentati. c. Stealing medicati, equipment, books, etc. d. Failure to keep client informati cfidential. e. Destructi of a client s cfidence in other health care team members. 8. Inability to practice safely demstrati of actual or potential inability to practice with reasable skill and safety to clients by reas of illness, use of alcohol, drugs, chemicals, or any mood altering substance or as a result of any mental or physical cditi. 9. Unprofessial cduct that is ctrary to professial standards or ethics or not befitting members of the nursing professial with language, behavior or cduct.

Unsafe clinical practices will be documented by the clinical instructor. An act or omissi which, in the judgment of the clinical instructor, cstitutes an unsafe clinical practice may be csidered e of the following levels: 1st Degree: Csists of paperwork issues, such as, lack of preparati, turning in paperwork late, inappropriate charting, etc. Such an infracti could result in a written reprimand to/or ctract with the student. Repeated infractis could result in failure of the course. 2nd Degree: Csists of repeated poor performances in previously mastered skills or theory applicati, such as, but not limited to: breaks in sterile technique, lack of medicati knowledge, omissi of medicati administrati, omissi of care, etc. Such an infracti could result in a written reprimand to/or ctract with the student, failure of the course, or terminati from the Kilgore College ADN program, or reported to the T-BON as unfit to practice. 3rd Degree: Csists of any single acti or omissi that places a patient s life in immediate jeopardy. Incidents of alcohol or drug abuse, manifestatis of mental illness or unprofessial cduct will be csidered a 3rd degree offense. Such an infracti could result in immediate suspensi from the clinical practicum, failure of the course, or terminati from the Kilgore College ADN program, or reported to the T-B as unfit to practice. The student will be notified immediately of any infracti. The Director of the Associate Degree Nursing Program will be notified as so as possible of a 1st or 2nd Degree infracti. The Director and the Dean will be notified immediately of a 3rd Degree infracti. While there is no absolute rule to determine what respse, if any, may be necessary to address an unsafe clinical practice, the appropriate respse in each individual case for a 1 st or 2 nd Degree infracti is left to the informed discreti of the instructor, guided by experience, educati and training. The appropriate respse in a 3 rd Degree infracti will be determined by the instructor after csultati with the Director and the Dean who are guided by a combinati of different types of experiences in leadership, educati, and in training. Students who have failed from a course for unsafe clinical practice may return to the program if approved by the Admissi/Readmissi/Progressi Committee. The student would return under strict ctract if allowed to be re-instated in the program. Unsafe Clinical Practice Failure for: 1 st Degree Infracti: Student will attend counseling for time management and tutorials for paperwork improvement. 2 nd Degree Infracti: Student will return to the skills lab to practice and repeat the check off the skills in questi, review skill ctent in text and computer assisted programs.

3 rd Degree infracti: Student, if allowed to return, must come before the Admissi/Readmissi/Progressi committee to appeal for reinstatement. They must cvey full knowledge of the risk to the patient and a full review of the skill or ctent involved. This review will be with a tutor and computer assisted programs. The student must be re-checked in the skills up completi of the review. Unprofessial Cduct towards faculty or staff will be referred to counseling and student will be expected to follow counseling recommendatis. Unprofessial Cduct towards patients or families will not be tolerated. Students who have been failed due to Unprofessial Cduct will be reviewed for readmissi an individual basis. Impaired status will be cfirmed by drug screen or cfessi. Positive drug screen or cfessi of drug use will be referred to the Texas Peer Assistance Program for Nurses and students must be under their protocol to return to the program. Displays for psychiatric instability or cfessi of such will be referred to a Psychiatrist and student must have a release by a psychiatrist to return to the program. Sleep Deprivati, with resulting inability to functi, will result in student s being sent home, given an un-satisfactory for the clinical, and placed ctract. Secd occurrence will result in failure of the course. The student must appear before the Admissi/Progressi/Readmissi Committee to appeal return to the program. Failure, with no return, will occur at the 3 rd occurrence.

STUDENT LEARNING OUTCOMES: 1. According to the Texas Board of Nursing Differentiated Essential Competencies for Associate Degree Nursing (DECs) the student will up successful completi of this course be able to: I. Member of the Professi: A. Functi within the nurse s legal scope of practice and in accordance with the policies and procedures of the employing health care instituti or practice setting. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms. (SCANS: 1, 2, 4, 5, 6, 7, 8) (PLO: 1-6) (IOM: 2-6) B. Assume respsibility and accountability for the quality of nursing care provided to patients and their families. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms. (SCANS: 1-8) (PLO: 1-6) (IOM: 1-5) D. Demstrate respsibility for ctinued competence in nursing practice, and develop insight through reflecti, self-analysis, self-care and lifelg learning. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms.(scans: 1-8) (PLO: 1-6) (IOM: 1-6) II. Provider of Patient Centered Care: A. Use clinical reasing and knowledge based the associate degree nursing program of study and evidence-based practice outcomes as a basis for decisi making in nursing practice. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms. (SCANS: 1-8) (PLO: 1-6) (IOM: 1-6) B. Determine the physical and mental health status, needs and preferences of culturally, ethnically and socially divers patients and their families based up interpretati of comprehensive health assessment findings compared with evidence-based health data derived from the associate degree nursing program of study. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms.(scans: 1, 4-7) (PLO: 1-6) (IOM: 1-6) C. Analyze assessment data to identify problems, formulate goals/outcomes and develop plans of care for patients and their families using informati from evidence-based practice in collaborati with patients, their families and the interdisciplinary health care team. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms.(scans: 1-2, 4-7) (PLO: 1-6) (IOM: 1-6)

D. Provide safe, compassiate, comprehensive nursing care to patients and their families through a broad array of health care services. Expectatis: Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms.(scans: 1-2, 4-7) (PLO: 1-6) (IOM: 1-6) E. Implement the plan of care for patients and their families within legal, ethical and regulatory parameters and in csiderati of disease preventi, wellness, and promoti of healthy lifestyles. Expectatis: Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms.(scans: 1-2, 4-7) (PLO: 1-6) (IOM: 1-6) F. Evaluate and report patient outcomes and respses to therapeutic interventis in comparis to benchmarks from evidence-based practice and plan follow-up nursing care. Expectatis: Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms.(scans: 1-2, 4-7) (PLO: 1-6) (IOM: 1-6) G. Develop, implement, and evaluate teaching plans for patients and their families to address health promoti, maintenance, and restorati. Expectatis: Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms.(scans: 1-2, 4-7) (PLO: 1-6) (IOM: 1-6) H. Coordinate human, informati, and material resources in providing care for patients and their families. Expectatis: Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms.(scans: 1-2, 4-7) (PLO: 1-6) (IOM: 1-6) III. Patient Safety Advocate: A. Demstrate knowledge of the Texas Nursing Practice Act and the Texas Board of Nursing Rules that emphasize safety, as well as all federal, state, and local government and accreditati organizati safety requirements and standards. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms. (SCANS: 1-8) (PLO: 1-6) (IOM: 1-6) B. Implement measures to promote quality and a safe envirment for patients, self and other. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms. (SCANS: 1-8) (PLO: 1-6) (IOM: 1-6) C. Formulate goals and outcomes using evidence-based data to reduce patient risks. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms. (SCANS: 1-8) (PLO: 1-6) (IOM: 1-6)

D. Obtain instructi, supervisi or training as needed when implementing nursing procedures or practices. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms. (SCANS: 1-8) (PLO: 1-6) (IOM: 1-6) IV. Member of the Health Care Team A. Coordinate, collaborate and communicate with patients, their families and the interdisciplinary health care team to plan, deliver, and evaluate patient-centered care. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms. (SCANS: 1-8) (PLO: 1-6) (IOM: 1-6) D. Communicate and collaborate in a timely manner with members of the interdisciplinary health care team to promote and maintain optimal health status of patients and their families. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms. (SCANS: 1-8) (PLO: 1-6) (IOM: 1-6) 2. According to the Workforce Educati Course Manual (WECM) the student will up successful completi of this course be able to: A. Apply the theory, ccepts, and skill involving specialized materials, tools, equipment, procedures, regulatis, laws, and interactis within and amg political, ecomic, envirmental, social, and legal systems associated with the occupatis and the business/industry. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms. (SCANS: 1-2, 4-8) (PLO: 1-6) (DECs: I, II, III, IV) (IOM: 1-6) B. Demstrate legal and ethical behavior, safety practices, interpersal and teamwork skills. Assessment: demstrati of skills in clinical, Quizzes, and appropriate use of clinical forms. (SCANS: 1-7) (PLO: 1-6) (DECs: I, III, IV) (IOM: 1-6) C. Use appropriate written and verbal communicati skills using the terminology of the occupati and the business/industry. Activities: clinical setting Assessment: skills lab quizzes, clinical forms using the nursing process, and documentati of client assessment and interview. (SCANS:1-8) (PLO:1-6) (DECs: IV)(IOM:1-6)

3. General Student Learning Outcomes the student will up successful completi of this course be able to: A. Apply basic nursing knowledge, ccepts and theory involved in evidence based nursing practice for: patient safety, infecti preventi and ctrol, hygiene, activity and exercise, nutriti, oxygenati, fluid, electrolyte, and acid-base balance, pain management, bowel and urinary eliminati, mobility and immobility, skin integrity and wound care, sensory alteratis. Assessment: demstrati of skills in clinical, quizzes, clinical forms and patient assessment documentati. (SCANS: 1-8) (PLO: 1-6) (DECs: I, II, III, IV) (IOM: 1-6) SCANS MATRIX LEGEND (Competency References) 1 Reading 2 - Writing 3 - Arithmetic or Mathematics 4 Speaking and Listening 5 Thinking Skills 6 Persal Qualities 7 Workplace Competencies 8 Basic Use of Computers PLO- Program Learning Outcomes in the Kilgore College Associate Degree Nursing Program Student Handbook. 1. Provide a safe and effective care envirment for their patients, through appropriate management of patient care and promoti of safety and infecti ctrol. 2. Provide for patient s psychosocial integrity. 3. Provide for patient s physiological integrity through basic care and comfort, pharmacological and parenteral therapies, reducti of risk potential and physiological adaptati. 4. Provide for patient health promoti and maintenance. 5. Provide care for patients utilizing the nursing process, including assessment, analysis, planning, implementati and evaluati. 6. Provide patient care utilizing critical thinking to prioritize, set goals, apply knowledge with inferential and interpretive reasing and predict or evaluate outcomes. IOM Institute of Medicine Core Competencies 1. Patient Centered Care 2. Teamwork and Collaborati 3. Evidence-based Practice 4. Quality Improvement 5. Safety 6. Informatics Schedule of Clinical: The clinical schedules below may change at the discreti of the Instructor or the facility.

All clinical site hours are subject to change depending of the facility. Tues Clinical Grid Student Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10 Week 11 Week 12 Week 13 Mandry, Cassand ra E3S S4 GSMC S3 E3S S4 MH S3 McMilla n, Jamie E3S S4 S3 GSMC E3S S4 S3 MH Meraz, Erin S3 MH S4 E3S S3 GSMC S4 E3S Morales, Dora S3 GSMC E3S S4 S3 MH E3S S4 Perez, Araseli S3 MH S4 E3S S3 GSMC E3S Pharris, LaRda E3S/T ele S4 LRMC S3 E3S/T ele S4 MH S3 Pickle, Lisa E3S/T ele ER-Kg. MH S3 E3S/T ele S4 GSMC S3

Rice, Jami S3/Me d S4 GSMC S4 S3/Me d MH S4 Rodrigu ez, Brittany S3/Me d GSMC S4 S3/Me d MH S4 ER-Kg. s, Britnee S3/Me d Alleg. S4 E3S S3/Me d GSMC S4 E3S Smith, Brenda S4/Sur g E3S S3 MH S4/Sur g E3S S3 GSMC Snort, Sam GSMC E3S S3 MH S4/Sur g E3S S3 Vaughn, Rebecca MH S3 E3S S4 LRMC S3 E3S S4 Washing t, Takiah S4/Sur g S3 E3S S4 GSMC MH E3S S4 Whitele y, Seth MH S3 S4 E3S LRMC S3 S4 E3S Witcher, Adam ER-Kg. LRMC MH

Week 1 Jan. 17 & 19 Orientati at KC 15 May 4 Situatial Assessments Week 14 Jan. 27 Wild Card Skills Drill in SIM Lab Week Clinical Grid Kilgore College RNSG 2362 LEVEL 2 CLINICAL/SIM GRID THURSDAY GROUP SPRING 2017 Student Name Orient. 01/17 Jan. 19 Jan. 26 Feb. 2 Feb. 9 Feb. 16 Feb. 23 Mar 2 Mar 9 Mar 23 Mar 30 Apr 6 Apr 13 A Allis, Hannah ALL ALL SIM Alleg Kg. ER SIM MS IMC SIM MS IMC SIM MS P Alvarado, Marilyn STUD- ENTS STUD- ENTS SIM Alleg IMC SIM MS MS SIM IMC IMC SIM OR/ PACU Arthur, Kaitlyn SIM Kg. ER Alleg SIM MS IMC SIM OR/ PACU IMC SIM MS Avila, Hannah Room Room SIM MS Alleg SIM IMC MS SIM OR/ PACU IMC SIM Kg. ER Bazaldua, Gloria?? SIM MS IMC SIM OR/ PACU IMC SIM MS MS SIM Alleg K Bowman, Kathy 0800 0800 IMC SIM MS Alleg SIM MS IMC SIM MS OR/ PACU SIM Campbell, Mackenzie until until IMC SIM MS Alleg SIM IMC MS SIM OR/ PACU Kg. ER SIM Chandler, Krista 1600 1600 IMC SIM MS Kg. ER SIM Alleg IMC SIM OR/ MS SIM

PACU Collins, Casey Math Ck offs IMC SIM MS OR/ PACU SIM Alleg IMC SIM Kg. ER MS SIM Davis, David Test Assessments IMC SIM IMC MS SIM Kg. ER Alleg SIM MS IMC SIM P Lazarin, Rey then SIM Kg. ER MS SIM IMC MS SIM Alleg IMC SIM IMC OR/ PACU Lewis, Nikamiah By LAB MS IMC SIM MS IMC SIM Kg. ER Alleg SIM OR/ PACU MS Repress, Keisha Clinical MS OR/ PACU SIM IMC Kg. ER SIM MS Alleg SIM IMC IMC Rey, Jasmine Orienta -ti MS OR/ PACU SIM IMC MS SIM MS IMC SIM Alleg IMC Salazar, Bianca MS IMC SIM OR/ PACU IMC SIM MS Kg. ER SIM Alleg IMC Focus For Clinical See Below *** Comf. Elimin. Comf. Elimin. Nutr. Cogn. Coping Immu nity Metab olism Gas Ex Fluids Elect Acid Base Clotting Blood Produ cts Perfus i P GSMC Marshall 5 Spots in IMC & 5 spots Med-Surg (MS) Cference Blackboard Shifts from 0630-1500 + Post PRECEPTOR FORM NEEDS TO BE FILLED OUT AND SIGNED AT THE BEGINNING OF THE SHIFT, FOR THE FOLLOWING: Kilgore ER 1 Spot (Shift from 0630-1900) Allegiance 2 Spots (Shift from 0630-1900) CU at LRMC Shifts from 0630-1900 If all surgical patients are through for the, follow the last patient to the floor they are admitted to and complete assignment.

*** Here is a list of Exemplars we are covering in class, alg with the medicatis we are focusing. Please have students seek patients with these problems if possible. Discuss these Exemplars in Post Cference and review the associated medicatis. Comfort: all types of pain/discomfort, Pancreatitis, Sickle Cell, Post-op Pain, Renal Calculi, Peripheral Vascular Disease; Opioids, analgesics, IV Fluids, TPN, Pancreatic Enzymes, Amylase, Antianxiety, Sedatives, Antiemetics, Neurtin, Anticoagulants Eliminati: Diverticulitis, Paralytic Ileus, Crohn s Disease, Neurogenic Bladder; Analgesics, antibiotics, IV Fluids, Aminosalicylates, Antimicrobials, corticosteroids, Immunosuppresants, biologic and targeted therapies, Sulfasalazine, Sulfapyridine Nutriti: Heart Healthy Diet, Diabetic Diet, Malnutriti, Peptic Ulcer Disease, Malabsorpti Syndrome Infant & Elderly, Starvati, Infant Nutriti; Antihypertensives, Diuretics, Statins, Insulin, Antidiabetic Drugs, TPN, Carafate, H2 Blockers, Prot Pump Inhibitors, IV Fluids, Fat & Soluble Vitamins Cogniti: Alzheimers, Dementia, Delirium; Anxiolytics, Sedatives, Appetite Stimulants, Antidepressants, Carbidopa-Levodopa, Cholinesterase Inhibitors, Muscle Relaxants Fluids & Electrolytes: Dehydrati (Gastroenteritis in Elderly & Pediatrics), Extracellular Fluid Volume Excess, Electrolyte Imbalances; Isotic Fluid, Antiemetics, Diuretics, Calcium Supplements & Reducers, Potassium, Kalexalate, Insulin, Hypertic Fluids, Diuretics, Declomycin, IV Fluids, ADH, Potassium phosphate, Magnesium phosphate Acid Base: Diabetic Ketoacidosis (DKA), Hyperventilati (Birthing mother, Panic Attack), Gastointestinal Losses, Drug Overdose with Hypoventilati; Potassium, Insulin, Antiemetics, IV Fluids, Anxiolytics, Sedatives, Antidiarrheal, Narcan, Brchodialators, Romazic Perfusi: Basic ECG Rhythms, Cgestive Heart Failure, Hypertensi, Gestatial Hypertensi, Mitral Valve Prolapse, Corary Artery Disease, Peripheral Vascular Disease; Antihypertensives, diuretics, Beta blockers, Antianxiety, Statins, Antiplatelets, Pentoxifylline, Cilostazol, Thrombolytics, Anticoagulants Clotting: Hemophilia, Deep Vein Thrombosis; Factor VII, Factor IX, ADH/Vasopressin, Antifibrolytics, Blood Products, Anticoagulants, Direct Thrombin Inhibitors, Factor Xa Inhibitor Gas Exchange: Asthma, Chric Obstructive Pulmary Disease (COPD), Pneumia (Aspirati), RSV/Brchiolitis Pediactric, Tracheal Esophageal Fistula (pedi/newborn); Brchodilators, Decgestants, Antitussives, Anticholinergics, Theophylline, Antipyretics, Leukotrienes, Antibiotics Immunity: Vaccines, Otitis media, Urinary Tract Infectis, Cellulitis, Osteomyelitis, Pneumia, Appendicitis, Trauma-sprain; NSAIDS, Antibiotics, Vaccines, Cephalosporin, Sulamethoxazole & Trimethoprin Metabolism: Diabetes Types 1 & 2, Gestatial Diabetes, Grave s Disease (Hyperthyroidism), Hypothyroidism, Addis s Disease (Hypocortisolism/Chric Adrenal Insufficiency), Cushing s Disease (Hypercortisolism); Insulin, Antidiabetic Drugs-Oral, Antithyroids, Beta-blockers, Synthroid, Thyroid Horme, Corticosteroids, Nizoral, Lysodren, Metopire