CHESAPEAKE COLLEGE/MGW NURSING PROGRAM COURSE OF STUDY SPRING 2013 Course Number and Title: NUR 120, Dimensions of Nursing Instructors: Mrs. Crystel L. Farina, MSN, RN, CNE, Co- Course Coordinator 410-822-5400 ext. 2716 Mrs. Jodi Stein, MSN, RN, Co-Course Coordinator 410-822-5400 ext. 2702 Mrs. Laura Higgs, MSN, BSN, RNBC 410-822-5400 ext. 2701 Mrs. Heather Westerfield, MSN, CMSRN, 410-822-5400 ext. 2703 Clinical Simulation Coordinator Offices in the Faculty Suite of the Center for Nursing Allied Health at Memorial Hospital in Easton Main Office phone numbers 410-770-3511, 410-827-5917, extension 5917 Total credits: 9 Credits 4 class hours/week (4 credits) 2 lab hours/week (1 Credit) 12 clinical hours/week (4 Credits) Course Description: Roles of the nurse within the healthcare delivery system are explored with emphasis in the Role of the Provider of Care, Manager of Care and a Member within the Discipline of Nursing in relation to meeting the health care needs of individuals with alterations in patterns of health. Building on prior nursing courses, theoretical knowledge from the humanities, physical, biological and behavioral sciences and nursing research are incorporated. The development of the students critical thinking, caring, communication, management skills, and professional behaviors are further enhanced. This course provides a variety of clinical settings that support implementation of the nursing process. The Clinical Simulation Lab will be used for the development of intermediate psychomotor skills. Course Objectives: 1. Apply theoretical knowledge from the humanities, physical, biological, and behavioral sciences and nursing research within the nursing process when meeting the health care needs of individuals and families with alterations in patterns of health. 2. Utilize critical thinking when implementing the nursing process to care for individuals and families with alterations in patterns of health. 3. Perform therapeutic communication techniques to interact effectively with individuals and families with alterations in patterns of health. 4. Demonstrate principles of caring behaviors to plan nursing care to meet the needs of individuals and families with alterations in patterns of health. 5. Utilize principles of management when providing care to individuals and families with alterations in patterns of health. 1
6. Apply professional, legal and ethical standards into care of individuals and families with alterations in patterns of health. Course placement: Level I, Spring Semester, 15 weeks Pre or Co-requisites: NUR 102, NUR 111, PSY 250 Topical Course Outline Provider of care: Theoretical Knowledge and Critical Thinking: Nursing management of the client with alterations of gas transport Nursing management of the client with alterations in glucose metabolism Nursing management of the client with alterations of reproductive function Nursing management of the client and family with normal pregnancy, birth and newborn Nursing management of the perioperative client Nursing management of the client with alterations in sensory/neurologic function Nursing concepts of loss/grief/dying and mgmt. of clients experiencing abuse or violence Nursing management of the client with alterations in coordination and mobility Nursing management of the client with abnormal cell growth Nursing management of the client with alterations in urinary/renal function Nursing management of the client with alterations of the gastrointestinal function Communication: Education for health promotion, maintenance and restoration Encouraging family involvement in teaching Medication education Play therapy Communicating effectively with members of health care team Effective communication with client Maternal-infant bonding Communication with clients with impairments Introduction to communication concerning grief and dying Caring: Promoting self-care Health maintenance for altered functioning Non-pharmacological pain/comfort interventions Caring behaviors in loss, grief and dying Caring behaviors in acute, long-term care and community settings Cultural diversity Psychosocial aspects of abuse Manager of care: Management Nursing care delivery systems in a variety of settings Exploring roles of the healthcare team and other disciplines Referring to community resources 2
Incorporating time management principles Collaboration with other disciplines Delegation of client care Member within the Discipline of Nursing: Professional Behaviors Legal and ethical considerations in a variety of settings Evaluates role of nurse in a variety of settings Delivery of safe care Risk reduction in nursing care Cost effective delivery of care Course Outline: Unit 1 Unit 2 Unit 3 Unit 4 Unit 5 Unit 6 Unit 7 Unit 8 Unit 9 Nursing Management of Clients with Alterations in Gas Transport Nursing Management of Clients with Alterations in Glucose Metabolism Nursing Management of Clients with Alterations in Reproductive Function Nursing Management of the Client and Family with Normal Pregnancy, Childbirth and Newborn Nursing Management of the Perioperative Client Nursing Management of Clients with Alterations in Sensory/Neurologic Function Nursing Concepts of Clients Experiencing Loss/Dying/Grief and Mgmt. of Clients Experiencing Violence or Abuse Nursing Management of Clients with Alterations Coordination and Mobility Nursing Management of Clients with Abnormal Cell Growth Unit 10 Nursing Management of Clients with Alterations in Urinary and Renal Function Unit 11 Nursing Management of Clients with Alterations in Gastrointestinal Function Method of Instruction: Lecture, demonstration, critical thinking exercises, simulations, discussion, assigned readings, technological enhanced aids, pre- and post- clinical conferences, observational experiences, On-line Activities, case studies, quizzes, concept maps, clinical simulation, guest speakers, group activities, computer research, and clinical experiences. 3
Required Texts: Lewis, Dirksen, Heitkemper, Bucher, and Camera (2011). Medical-Surgical Nursing: Assessment and Management of Clinical Problems. 4th edition. St. Louis, MO: Elsevier. Perry, Hockenberry, Lowdermilk, Wilson (2010). Maternal Child Nursing Care. 4 th edition. Maryland Heights, MO: Mosby. Edmunds, M.W. (2010). Introduction to Clinical Pharmacology. 7 th Edition. St. Louis, Mo: Mosby HESI (2010). Complete RN Online Case Studies 2010. Nursing Central Application (2012). Davis Drug Guide; Taber s 21 st Edition; Davis s Lab and Diagnostic Tests; Diseases & Disorders; MEDLINE Journals; RNotes; and Nurse s Pocket Guide. Unbound Medicine (n.d.) Method of Evaluation: Combined unit exams, final exam, competency/skill check off tests, clinical evaluation tools, student self-evaluation, nursing care plans, clinical simulation activities, clinical activities, case studies, and projects. All assignments must be completed to pass the course. Professionalism: Demonstrate courtesy and cooperation by turning off cellphones during class (see Nursing Student Handbook pg. 22), arriving prior to the beginning of a class session, and avoiding leaving the classroom during a class session. 1. Grade calculation (point system): The combined point value of all components is 1000 points. All components are course requirements and must be completed in order to pass the course. a. The components of NUR 120 and their point distribution are as follows: Exams 648 points Class Points 62 points Projects 10 points Final Exam 280 points TOTAL 1000 points b. NUR 120 Dimensions of Nursing has 6 unit exams. Each exam has been weighted according to the number of theory hours it encompasses. The point value for each exam is as follows: Exam 1 Unit 1 120.56 points Exam 2 Units 2 & 3 105.49 points Exam 3 - Units 4 105.49 points Exam 4 - Units 5 & 6 105.49 points Exam 5 Units 7 & 8 105.49 points Exam 6 Units 9 & 10 105.48 points Total 648 points c. Multiple choice and alternative type questions are included on the exams. The 4
exams will encompass required activities, i.e., textbook readings, clinical simulation activities and classroom activities. d. One theory hour is allotted for each unit exam. Two theory hours are allotted for the final exam. All nursing students must complete unit/final exams within those specified time frames. Special exam accommodations will be provided for those students with an accommodation plan in place through the Chesapeake College Coordinator for Students with Disabilities. e. Grades for the exam will be posted no later than the next class day. After exam return, all exams and answer sheets will be collected. Copying of exam questions is not permitted. A student may submit a scholarly discussion of exam questions, in writing, within one week of the exam return. Class time will not be used for individual exam review. A comprehensive exam review session is available after each exam (refer to NUR 120 course schedule for these sessions). Students unsuccessful in achieving a 75% or better on any unit exam are required to attend comprehensive exam review sessions to receive future grades. After attending a comprehensive review session, students may contact their advisor, within one week of exam return, for an appointment to discuss specifics. f. Refer to the Nursing Student Handbook for the policy on make-up exams. g. Final Exam- The final exam includes unit 11 and is a comprehensive evaluation of all course content. Multiple choice and alternative type questions will be used and the final exam is worth 280 points. 2. Clinical Simulation Lab a. To pass clinical simulation, a satisfactory completion of all assigned learning activities is required. Attendance is mandatory. b. The grade is based on the student s simulation participation and satisfactory completion of assigned learning activities. The student may earn a maximum of 36 points in this category. c. Unsatisfactory completion of a skill will prevent the student from performing that skill in the clinical area which will result in an unsatisfactory grade on the clinical evaluation tool until that skill has been completed in a satisfactory manner. d. Identified skills must be completed with satisfactory competence by specified dates to pass the simulation component of the course. 5
3. Project 4. Class Points/Activities a. The course project consists of a written research paper on an assigned disease process to include the disease, prevention of complications and analysis of resources. 10 points b. 75% of total points of the project is required to pass the project. a. Points are based on the student s completion of assigned HESI case studies associated with each unit. HESI case study completion is due prior to the start of class for that unit. The student may earn a maximum of 28 points during the semester. The student s class participation and completion of assigned learning activities is expected behavior. (See nursing student handbook for guidelines). 5. Clinical b. Students are expected to visit the on-line course website at least weekly for postings related to the course. a. Evaluation of clinical: Satisfactory (S) clinical behaviors are meeting clinical objectives Needs Improvement (NI) clinical behavior needs to be improved Unsatisfactory (U) unfavorable clinical behaviors, not meeting clinical objectives, showing no/little improvement in meeting clinical objectives or any unsafe clinical behavior (see nursing student handbook). Unsatisfactory in one of more objectives on the rotational or midterm evaluation will result in placement of the student on clinical probation and require a meeting with the course coordinator. Each situation will be evaluated on and individual basis to determine if the student has met the clinical criteria. b. To pass clinical: 1. All clinical objectives must be met consistently and in a satisfactory manner to pass the course. 2. Complete all weekly clinical activities and related documentation which includes the clinical tool, disease process sheets, perinatal assessment, and one satisfactory nursing care plan during the assigned rotation. 6
c. Policy in the clinical areas: 1. Clinical experiences are planned throughout the course for the application of theory. These experiences will be in a variety of settings. General clinical days and hours have been designated on the class schedule. The description of the specific activities, times and objectives will be provided by the clinical instructor. 2. Dress Code Policy See Nursing student handbook. 3. Attendance Policy See Nursing student handbook. 4. Students are not to administer medications without their instructor s knowledge. This may result in immediate dismissal from the program. 5. Students may not administer medications until they have attained 100% on the Medication Administration Competency Test (MAC math and pharmacology) within three attempts. Student will earn an Unsatisfactory in Theoretical Knowledge each clinical day until the MAC is passed. d. Preparation for clinical: Complete assigned readings related to clinical activities. Preparation includes understanding of concepts and nursing skills associated with clinical experience assignment. If a student is not adequately prepared, they may be asked to leave the clinical site. This will be considered an unsatisfactory clinical day. The instructor will inform the student of activities necessary to complete prior to the next clinical day. All required written activities are due with the clinical tool for the week. e. Written Assignments: One comprehensive nursing care plan is to be completed during the course that reflects the care given to an assigned client during an assigned clinical rotation. The written NCP should demonstrate the use of the nursing process, reflecting content from NUR 120, in the correct format, including the assessment of the client in the five dimensions, prioritized nursing diagnoses (at least, but not limited to 3), expected outcomes, nursing interventions (at least, but not limited to 5) with rationales for each nursing intervention and an evaluation of each nursing intervention with data to support the evaluation. Medications must be integrated into the nursing interventions to include administration, nursing considerations and teaching. A medication sheet is required for each medication administered to the client. Specific diagnostic test and labs (with results) should be included in assessments and nursing interventions. Nursing diagnoses should be actual, risk for and potential complications and encompass all dimensions of the client. See grading criteria rubric. The nursing care plan must be completed during the assigned rotation. If the care plan is unsatisfactory after the assigned rotation, the student will be given an opportunity on the next rotation and will be placed on clinical probation. If the care plan is unsuccessful after the second rotation, the student will meet with the course coordinators to 7
discuss ability to continue in the nursing program. Discussion about a nursing care plan may occur with the instructor on the clinical unit, but no just look at my NCP for review will occur. Students will have one week to return the NCP with revisions if they are needed for it to be accepted as Satisfactory. Students are allowed only one revision. If the nursing care plan is not satisfactory after the one revision, the student will need to start over with a new client. The NCP must be submitted the week care is provided for the client. All clinical assignments to include clinical tools, NCP, Disease Process Sheets, Perinatal Assessment and any other assignments requested by the instructor are due for section 501 day clinical, by Thursday mornings at 0900, section 501 evening clinical by Thursday 2000; Section 502 day clinical, by Saturday at 0900, Section 502 evening clinical are due by Saturday 2000. f. Clinical Evaluation Tool: The purpose of the clinical evaluation tool is to develop self-awareness of the roles of the Provider of care, Manager of Care and Member of the profession using student s self-evaluation and instructor s evaluation to document demonstration of consistency in meeting clinical objectives. Students are expected to document an example, for each clinical objective, of the student s clinical action that demonstrated meeting each clinical objective. There must be at least one behavior documented for each clinical objective (6) over the full 2- day clinical experience. All written clinical assignments, including the weekly clinical evaluation tool, must be submitted to the clinical instructor, as noted above via course mail/drop box, with all other clinical assignments (disease process sheet, care plans, medication sheets for care plan, and perinatal assessment. Students are expected to respond to comments and questions written by the instructor. Graded written assignments are to be printed, signed by the student and placed in the clinical folder. Clinical folders are to be handed in each week to the clinical instructor at the beginning of pre-conference. Instructors will sign, review student comments and plans for development and return to the student. (See Nursing student handbook) G. Medication Sheets - Medication Sheets- Using the CC/MGW format, are an effective way to learn medications. The most common medication list will be distributed prior to the start of the course. The common medications will be included in the pharmacology portion of the MAC test. It is the student s responsibility to know the medication that is being administered to a client. Lack of knowledge about a medication is a safety violation and may lead to dismissal from the clinical learning experience. Students may use the Nursing Central App. prior to presenting medications to their instructor for administration. If a student is unaware of a common medication, they may receive an unsatisfactory in professional behaviors and be dismissed from the clinical learning experience. 8
H. Disease Process Sheet- For each client (include client information): Definition of the current disease/problem, the etiology (cause) of the disease, pathophysiology at the cellular level of the disease and how it is affecting the client s health and the nursing plan of care. List the common symptoms and diagnostic tests related to disease, potential complications of the disease and how they will affect the plan of care. This is due at preconference. After caring for the client, highlight the symptoms the client experienced, describe briefly the results of any diagnostic tests the client had and resubmit the disease process sheet with the clinical tool. Please remember to site references. Any disease process sheet without references will be considered to be plagiarism and will be subject to the Chesapeake College Student Code of Conduct. I. Perinatal assessment Students will demonstrate and submit a written maternal and newborn physical assessment. Information from client, client interaction with family, and charts are needed for the assessment of the mother and baby. Individualize the client care. Identify nursing diagnoses on the client and list the interventions completed. The perinatal assessment may be used as the five dimensional assessment if this is an assigned rotation for a nursing care plan. The written work is due with the clinical tool after the clinical experience. J. Medication Administration Competency (MAC) Exam - Calculations of medication dosages are an important fundamental part of nursing. Math is incorporated in every nursing course. It is the student s responsibility to keep current with math skills using resources available. If a student is having difficulty recommended books are available in the book store and tutoring services are available. A Medication Administration Competency (MAC) exam is given on the 1 st clinical day of the semester. Students must pass the MAC with 100% to pass the course. Three attempts will be allowed. The MAC test will be comprised of 20 dosage calculations and 10 pharmacology questions related to the common medication lists. 6. Attendance: See Nursing Student Handbook. 7. Grading Scale: A = 920-1000 points B = 830-919 points C = 750-829 points D = 670-749 points F = below 670 points 9
8. Requirement for Successful Completion of the Course: Students must have achieved a minimum of 750 points or 2.0 C from exams, class points and final exam. Students must achieve a Satisfactory in clinical simulation (demonstration of satisfactory competency of all required skills); a Satisfactory in clinical (consistency and satisfactory in clinical objectives); and 100% on the MAC exam. Academic Instruction Emergency Management Plan In the event that Chesapeake College needs to close for an extended period of time due to a flu pandemic, severe weather event, or other emergency situation, consideration will be given to the timing and duration of the closure as follows: 1. Closure during the semester for up to one week there will be an opportunity to make up work missed without significant alteration to the semester calendar. 2. Closure extending beyond one week (or in situations where classes are cancelled on the same days/evenings over multiple weeks) the College may extend the length of the semester. Depending on the timing of the closure, scheduled breaks, end of semester dates, and/or the processing of final grades might be impacted. Students can acquire information about closures on the College website or by calling 410-822- 5400 or 410-228-4360. Chesapeake College courses held at off campus sites will follow the protocol of the host facility. Students enrolled in NUR 120, Dimensions of Nursing, have acknowledged by signature that he/she has received a copy of the current Nursing Student Handbook and has reviewed and understands each of the department policies and procedures outlined within the document. Each student enrolled in NUR 120, Dimensions of Nursing, will comply and adhere to all department policies and procedures as written in the Handbook. 10