KENT STATE UNIVERSITY ASSOCIATE DEGREE IN NURSING PROGRAM NRST 20208 NURSING AGENCY Ill SPRING SEMESTER 2015 This course outline may not be reproduced without permission of the Kent State University College of Nursing. NOTICE OF MY COPYRIGHT AND INTELLECTUAL PROPERTY RIGHTS. Any intellectual property displayed or distributed to students during this course {including but not limited to powerpoints, notes, quizzes, examinations) by the professor/lecturer/instructor remains the intellectual property of the professor/lecturer/instructor. This means that the student may not distribute, publish or provide such intellectual property to any other person or entity for any reason, commercial or otherwise, without the express written permission of the professor/lecturer/instructor.‘TABLE OF CONTENTS TIME ALLOTMENT COURSE DESCRIPTION ....ccssrsnsnnsenennnesense 4 STUDENT LEARNING OUTCOMES FOLLOWED BY COURSE OBJECTIVES vassessnanatn METHODS OF INSTRUCTION. METHODS OF EVALUATION. _ eee 2B BASIS FOR DETERMINATION OF FINAL GRADE..... 4 SYLLABUS STATEMENT ou ADA STATEMENT aa 4 WEBSITE DISCLAIMER, 4 MODULE 1 OBJECTIVES . 5 MODULE 4 CONTENT ae een 56 MODULE 2 OBJECTIVES «0.2.0. 78 MODULE 2 CONTENT 810 MODULE 3 OBJECTIVES ....... . . 414-42 MODULE 3 CONTENT... AB MODULE 4 OBJECTIVES ... AT MODULE 4 CONTENT se 18-20 CLINICAL EVALUATION TOOL... 21-26 ESSENTIAL FUNCTIONS FOR NURSING... FACULTY AND STUDENT EVALUATION TOOL OF CLINICAL AGENCIES. essere 28-29 CARE PLAN... 30-35NRST 20208 NURSING AGENCY Ii TIME ALLOTMENT: Credit per semester: 4 Class credit hours: 25 Clinical/Laboratory credit 15 Clinical: 660 clock hours Laboratory: 7.5 clock hours, COURSE DESCRIPTION: Nursing care of individuals with complex therapeutic self-care demands. Emphasis is placed on the nurse as provider and manager of patient care. Prerequisites: minimum C grade (2.00) in NRST 20206; NRST 20207; NURS 20950; with a minimum cumulative GPA of 2.00 and nursing technology (NRST) major. STUDENT LEARNING OUTCOMES FOLLOWED BY COURSE OBJECTIVES: ‘The student will be able to: 4, Use the nursing process to meet self-care demands of individuals in structured settings. a. Use the nursing process to provide and manage individualized care for individuals with complex, therapeutic self-care demands. b. Utilize clinical judgment, using evidence-based practice, to integrate increasingly complex knowledge, skills, and technologies as they relate to the client. 2. Demonstrate therapeutic communication skills in interactions with patients, families, and health team members. a. Use verbal and written communication skills with patients, families, significant others, and heaith team members independently. 3. Perform safely the nursing skills and techniques identified in all nursing courses. a. Perform nursing skills safely for patients with complex, therapeutic self-care demands. 4. Function within the legal and ethical guidelines of the nursing role as a provider of care, manager of care, and member of the profession. a. Practice within the ethical-legal framework of nursing as a provider of care, manager of patient care, and member of the profession. METHODS OF INSTRUCTION. Methods of instruction may include: fecture-ciscussion, demonstration, audio-visual aids, such as teaching fims, flmstrips, videotapes, and transparencies, conferences, writen reports, oral reports, panel discussions, role-playing, reference readings, nursing care plans, use of resource persons, utilization of the problem solving nursing process in the classroom and laboratory, case studies, worksheets, simulated laboratory practice and videotaping/debriefing, and computer-assisted instruction.‘The Associate Degree in Nursing Program supports the NLN competencies of human flourishing, nursing judgment, professional identity, and spirt of inquiry, which are threaded throughout the curriculum, METHODS OF EVALUATION: Students are responsible for reviewing and adhering to “Rules and Regulations for Students Enrolled in ADN Program” and "Policies for the Nursing Program” as delineated in the Nursing Student Handbook, Theory: Theory is eveluated by the following methods: quizzes, module exams, mid-term exam, final exam, and other methods as determined by faculty. A student missing a quiz or exam will be ‘expected to complete @ make-up exam as specified by the instructor. If this procedure is not followed, a grade of zero will be recorded. All quizzes and exams may include material encountered in the weekly reading assignments, in the required textbooks and syllabus, as well as lecture notes, information received from guest speakers, and designated audio- vistal/computer resources and educational materials. Students are advised to attend each class meeting so that they are assured of receiving proper and correct information. It is understood that any student who fails to attend class meetings accepts responsibilty for learning that material. Clinical aboratory: Ciinica/Laboratory experience is evaluated as satisfactory or unsatisfactory based upon one or more of the following: 4. Student performance during patient care based upon the Patient Care Evaluation Too! behaviors. 2. Student written reports, assignments, and projects. 3. Student skill tests of newly learned nursing skills. 4. Student ability to meet the critical requirements of previously leamed nursing skis. Medication Math Evaluation ‘The medication math competency evaluation is an assessment of previously learned medication calculations and associated concepts and is given in the second semester of the program and thereafter to validate the student's ability to safely administer medications in the clinical setting Although this medication math evaluation will be given in an on-campus classroom setting itis a simulation of the clinical experience. The medication math evaluation will consist of ten (10) math questions. The student will be allotted 20 minutes to complete the evaluation. The student must earn a score of 100% on the evaluation to be permitted to administer medications, Each failure to eam a score of 100% will result in the assignment of a clinical U. Therefore, in general, a failing grade (U) will be received for any act of omission or commission which may cause or potentially cause harm to the patient. Specifically for: Criteria for Unsatisfactory Grade 1, Failure to complete nursing skills or lab referrals by the date specified. 2. Failure of a critical requirement on a nursing skill test, following a second attempt. Each subsequent unsuccessful attempt will result in an additional clinical U.Only one U per clinical experiance can be assigned; each Skill Test is considered a clinical experience. Three (3) clinical U's constitutes an F for the course, Clinical progress reports will be completed weekly by the instructor and student using the Clinical Evaluation Tool. The instructor will have a student summative evaluation at mid semester and at the end of the semester; student conferences will be scheduled at these times. The final evaluation of the student's performance in the clinical area will be designated as “satisfactory” or “unsatisfactory”. Students are advised to avail themselves of an instructor- student conference at any time the student sees reason for question, believes himseltfherself to be a victim of unjust circumstance, or in any way feels that the need for consultation exists. Weekly office hours are posted on the doors of the instructors’ offices. Other times are available by appointment. if the student and instructor cannot for any reason settle or solve the question, a meeting with the Nursing Program Director will be scheduled. By following this procedure, student problems should not arise after the course is over; they will be discussed and solved while the problem in question is occurring. Absences must be reported to the instructor prior to the clinical laboratory experience or an "U" is received for that day's participation. A student missing a clinical laboratory experience is responsible for contacting the instructor within 48, hours and will be required to make up that day as specified by the instructor. Students are required to meet the class hours identified on this CORE syllabus and are responsible for any material during an absence. Students are required to attend all clinical, observational, and laboratory time to satisfactorily meet the course objective. Any missed clinical, observational, and laboratory time is required to be made with activities as defined by the instructor in order to pass the course. A student who does not make up the experience as specified will fil the course. BASIS FOR DETERMINATION OF FINAL GRADE: The nursing course is comprised of a theoretical, clinical, and laboratory component for which one letter grade is recorded. In order for the nursing student fo successfully complete this course in the nursing sequence, he or she must: 8. Achieve a grade of °C" or better in theory. Theory knowledge is evaluated by written ‘examinations, quizzes, and other methods as determined by faculty. Refer to campus ‘supplement for determination of final grade. The numerical equivalent will not be rounded. For example, 74.99 would remain 74.99. Numerical Equivalent Letters 100 - 92 91-83 82-75 74-66 65-0 noom>| Exams and quizzes will be reviewed as specified by the faculty. Within one week after the session, exams and quizzes are no longer available for review.b. Achieve a designation of "satisfactory" for his ot her performance in the clinical laboratory. Ifthe student receives a designation of “unsatisfactory” for his or her performance in the clinical area, the student will receive a letter grade of "F for the nursing course, c. When the student's clinical performance is “satisfactory”, the student's nursing course grade will be assigned trom the earned theory grade, SYLLABUS STATEMENT: This course outline is provided for use as @ guideline between students and faculty. This ‘outline may be subject to changes which are necessitated by circumstances arising during the semester. Any changes will be communicated to all students. Standardized Achievement Test(s) may be used at the faculty members discretion. Students are required to take the test(s) and will be charged a fee. (See Studant Handbook.) ADA STATEMENT: Students Accessibility Services students with disabilities be thelr equal access to course eabllity and require accommoda’ at the beginning of the semester to make aseroom adjustments. Please note, you must firet ity Ser (sas) university polio) provided reasonai content. If you have a doc please contact the instruc arrangements for necessary verify your el coordinator on Revised May 2014 WEBSITE DISCLAIMER: ‘The websites included in this syllabus are provided only as a reference and/or resource and do not imply, directly or indirectly, Kent State University's endorsement, sponsorship or approval of these websites. Kent State University does not assume responsibilty and/or liability for the accuracy or reliabilty of the information contained in the websites.MODULE 1: MANAGEMENT OF GROUPS OF PATIENTS WITH SELF-CARE DEFICIT A. Objectives While participating in and upon completion of the course, the student should be able to’ : Use the nursing process to provide and manage individual care for groups of individuals with complex, therapeutic self-care demands a. Identify importance of a systematic and comprehensive decision making process. b. Identify and incorporate techniques that can be used for effective time management. ©. Identify issues and problems of delegation of responsibilty. d, Identify three styles of management and their advantages and disadvantages, . Discuss the role of follower. {Discuss and implement components related to patient care and evidence based practice 2. Use verbal and written communication skills with patients, families, significant others, and health team members independently. a. Identify lines of authority and hierarchy of authority b. Identify uses of job descriptions, policies, and procedures, c. Define types of power. d. Identify two methods of delegation of responsibilty. 3. Practice within the ethical-legal framework of nursing as a provider of care, manager of patient care, and member of the profession a. Explain the role of institutional policy in legal decision making, b. Identify situations in which liability is shared by employees or supervisors, c. Discuss ethical decision making. 8. Content 1. Review a. Communicating b. Reporting 2. Provider of care a. Time management b. Decision making 1. Ethical Codes 2. Basic Ethical Concepts 3. Ethical Theories 4. Factors influencing ethical decision making ©. Coordinating care/ Home Health d. Advocacy3. Manager of care a. b. «. Leadership and management theories Delegation/accountability (1) Nursing competency a. Accreditation expections b. Critical requirements for practice-proficiency in delegation c, Maintaining competency d. Continuous quality improvements, peer review, and nursing standards Delivery systems for nursing care (1) Agencies and organizations providing health care a. Acute care hospitals b. Long term care facies c. Community health care agencies Risk management (1) Liability and Standards of Gare ‘a. Personal liability and the “prudent nurse” concept b. Employer c. Liability insurance (2) Prevention of suits-know your colleagues (3) _ Define continuous quality improvement (4) Describe the process of continuous quality improvement (5) Demonstrate the ability to implement care based on National Patient Safety GoalsMODULE 2: NURSING AGENCY FOR COMPLEX O; DEMAND A. Objectives While participating in and upon completion of Module Ii, the student should be able to: 1. Use the nursing process to provide and manage individualized care for individuals with complex O. demands. Assesses, Diagnoses, Plans, implements and Evaluates based upon: Health history. Physical assessment. Principles from the behavioral, biologic and nursing sciences. Self-care requisites/assets/defioits (1) ‘Health deviation (2) Universal (3) Developmental e. Socio-cultural and religious factors that influence the patient's response to iliness, 1. Priority nursing diagnoses. 9. Technical skills and individual patient needs. (1) Abnormal EKG (ventricular arrhythmias) (2) Ventricular defibrillation (3) AcLine care (4) Ventilator care (5) Endotracheal care (6) IV. titration h. Dietary needs which are influenced by individual, physiologic, religious and cultural factors. i, Diagnostic and laboratory studies needed for patients with complex O, demand. (1) Cardiac output (2) Swan-Ganz (3) _Hottigh related to fluid volume Pharmacologic actions, desired effacts, side effects, and nursing implications of agents used for patients with complex O, demand (1) Fibrinolytics (2) Antiarehythmics (3) Plasma expanders (4) LV. Inotropics (5) _.V. Vasopressors (6) LV. Vasodilators k. Rehabilitation and teaching needs of patients with complex O demand, |. Ethical iegal factors which impact patients with complex O2 demand. (1) Quality of life/patient desires. (2) Confidentiality (3) Documentation (4) Standing orders aegpm. Prototype health deviations/hazards of complex cardiac alterations, new and complex M.l., arrest, lethal dysrhythmias, cardiomyopathy, respiratory failure, shook, and DIC. Use verbal and written communication skills with patients, families, significant others, and health team members independently in the care and management of patients with complex O2 demands by: a, Communicating in precise and accurate terms, the patient's responses to nursing and medical intervention. b. interacting with other health team members in a collegial manner. c._Using appropriate lines of communication to accomplish role responsibilities as provider and manager of care. 4. Documenting cate of patients with complex O, demand according to legal standards. e. Using communication techniques and factual information to assist the patient, family and significant other to cope with and resolve problems. {Writing and directing a plan of care addressing current nursing needs for patients with complex O, demand. Perform nursing skilis safely for patients with complex Oz demand, (See skills listed in #1 above.) a. Administer and monitor the prescribed medical and nursing regimen of care. b. Demonstrate passing performance in newly leamed skills. Practice within the legal ethical framework of nursing as a provider and manager of nursing care for patients with complex G2 demand by: a. Adhering to the policies as stated in the Student Handbook. b. Providing care with NO act of omission or commission that causes or could potentially cause harm to the patient. ‘Adhering to the ethic of confidentiality Accepting responsibilty for own actions and actions of delegates. ‘Accepting responsibilty for own learning. Demonstrating soundness of moral character. Differentiating the roles of the associate degree nurse from those of other health team members. Demonstrating various methads of maintaining currency in the discipline of nursing. Using delegation and time management skills Demonstrate ability to implement care related to National Patient Safety Goals = @reaoB. Content 1. Review a A&P b. ABC's c. Breath sounds d. Heart sounds 2. Pathophysiology of patients with problems of ventitation/perfusion a. Cellular effects of O» deprivation (1) Acute respiratory failure (2) Acute vascular occlusion b. Effects on specific tissues (symptoms) (1) Skin (2) Myocardium (3) Brain (4) Lung (5) Kidneys c. Medical prototype (1) ARDS (2) Acute respiratory failure (3) Acute Myocardial infarction and Complications of MI (4) Pulmonary edema (8) Pulmonary Emboli (6) Cardio-pulmonary arrest (7) Lethal dysthythmias (8) Shook/DIC 3. Nursing Management a, Assessment (1) Chart review (@) Medical management (0) Diagnostic evaluation i. VIQ Scan ii, Chest X-Ray ii. Hemodynamic monitoring iv. Angiograms v.__ EKG's (abnormal) {c) History and physical (2) interview (2) Risk factors (b) Lifestyle {c) Knowledge (3) Physical exam (nursing) (2) Inspection (b) Palpation {c)Peroussion (a) Auscutationb, a. Diagnosis Based on Assessment - NANDA (1) Aiteration in tissue perfusions (2) Airway clearance, ineffective (3) Gas exchange, impaired (4) Breathing patterns, ineffective (5) Powerlessness (6) Anxiety Plan (1) Nursing related to medical management (a) Ventilators (2) Patient outcome (a) Improved ventilation (b) Improve gas exchange (c) Improved breathing patterns (8) _Disouss and implement components of the nursing process related to patient care and evidence based practice. Implementation i. Pharmacology aa, ACLS drugs bb. Vasopressors LV. Administration cc. Fibrinolytics dd. Antiarrhythmias ee. Vasodilators I.V. ff. LV, Inotropic agents ji, Skits aa. Titrating |.V-'s bb. Care of patient on ventilators cc. Endo-trachealitrach care dd. ACLS protocol Nutrition Ethicalliegat aa. Quality of life bb. Standing orders cc. DNR orders {e) Rehabiprevention/heatth education i. Cardiopulmonary rehablitation (Communication i. Tracheostomy fe. Evaluation 10MODULE 3: NURSING AGENCY FOR COMPLEX WATER AND ELIMINATION DEMAND. A. Objectives While participating in and upon completion of Module Ili, the student should be able to: 4. Use the nursing process to provide and manage individualized care for individuals with complex water and elimination demands. Assesses, Diagnoses, Plans, implements and Evaluates based upon: a. Health history. b. Physical assessment. c. Principles from the behavioral, biologic and nursing sciences. d._ Selt-care requisites/assets/deficts (1) Health deviation (2) Universal (3) Developmental e. Socio-cultural and religious factors that influence the patient's response to illness, Priority nursing diagnoses. g. Technical skills and patient needs. (4) Hourly outputs: (2) Dialysis (3) Peracentesis (4) Peritonealjugular shunt (5) Tamponade balloon h. Dietary needs which are influenced by individual, physiologic, religious and cultural factors. i. Diagnostic and laboratory studies needed for patients with ‘complex water and elimination demand. (1) Kidney function studies (2) Creatinine/BUN (3) Electrolytes (with application) (4) Peracentesis (5) Liver function studies (6) HBV j. Pharmacologic actions, desired effects, side effects, and nursing implications of agents used for patients with complex water and elimination demand, (1) lon exchange resins (2) Mineral regulation (3) Lactulose (4) Vitamin supplement k. _ Rehabilitation and teaching needs of patients with complex water and elimination demand, (1) Organ transplant |. Ethical legal factors which impact patients with complex water and elimination demand. (1) _ Issues of organ transplantation "m. Prototype health deviations/hazards which resutt in complex water and elimination demand: (1) Renal failure (2) Liver failure (Ascites, Cirthosis, Hepa (3) Multi system failure (4) Burn Use verbal and written communication skils with patients, families, significant others, and health team members independently in the care and management of patients with complex water and elimination demand by: a, Communicating in precise and accurate terms, the patient's responses to nursing and medical intervention, b. Interacting with other health team members in a collegial manner. ©. Using appropriate lines of communication to accomplish role responsibilities as provider and manager of care. 4. Documenting care of patients with complex water and elimination demand according to legal standards. e. Using communication techniques and factual information to assist the patient, family and significant other to cope with and resolve problems. {Writing and directing a plan of care addressing current nursing needs for patients with complex water and elimination demand, Perform nursing skills safely for patients with complex water and elimination demands. (See skills listed in #1.) a. Administer and monitor the prescribed medical and nursing regimen of care. b. Demonstrate passing performance in newly learned skills. Practice within the legal ethical framework of nursing as @ provider and manager of patient care for individuals with complex water and elimination demand by: a. Adhering to the policies as stated in the Student Handbook. b. Providing care with NO act of omission or commission that causes or could potentially cause harm to the patient. ‘Adhering to the ethic of confidentiality Accepting responsibilty for own actions and actions of delegates. Accepting responsibility for own learning, Demonstrating soundness of moral character. Differentiating the roles of the associate degree nurse from those of other health team members. Demonstrating various methods of maintaining currency in the discipline of nursing, i, Use time management and delegation skils. Demonstrate ability to implement care related to National Patient Safety Goals. Cancer) = @read 12B. Content (Part !) 1. Review a. A&P hepatic function 2. Pathophysiology a. Disorders (1) Altered hepatic function (2) Altered fiuid shifts b. Medical prototype (1) Liver failure (distinguish cirrhosis, hepatitis, Ca.) (2) Multi-system failure 3. Nursing Management a, Assessment (1) Chart review (a) Medical management i. Peritoneal jugular shunt ii, Tamponade balloon (b) Diagnostic evaluation i. Liver function studies ii, HBV iil, Paracentesis iv, Electrolytes {c) History and physical (2) Interview (a) Risk factors (b) Lifestyle (0) Knowledge (d) Social habits (3) Physical exam (nursing) (a) Inspection {b) Palpation {c) Percussion ()Auscutation b. Diagnosis Based on Assessment - NANDA (1) Fluid volume excess (2) Fluid volume deficit (3) Impaired skin integrity (4) Altered thought processes 4. Plan a. Nursing related to medical management (1) Bleeding (2) Ascites (3) Hepatic Coma b. Pationt outcome (4) Prevent bleeding episodes (2) Prevent hepatic coma (3) Improve fluid balance 135. Implementation a. Pharmacology (1) Vitamin supplements (2) Lactulose b. Skills (1) Paracentesis (2) Leven shunt (3) Temponade balloon cc. Nutrition (1) Low sodium diet (2) Fluid restriction (3) _ Protein restriction 4d. Ethicaviegal (1) Quality of life e, Rehab/prevention/health education (1) Compliance (2) Transplant @) AA Communication (1) Teaching (2) NCP's 6. Evaluation Improve Quality of life Prevent hepatic encephalopathy Improve fluid volume Compliance with regimen Maintain skin integrity eaoce 8. Content (Part ll) 1. Review a. A&P of renal function and altered fluid shifts 2, Pathophysiology a. Altered renal function b. Medical prototype Renal failure Burn’ 143. Nursing Management a. Assessment (1) Chart review (@) Medical management i. Sepsis ii, Dialysis (b) Diagnostic evaluation i. Kidney function studies ii, Creatinine/BUN il, Electrolytes with application iv. Cultures. wound, sputum, blood, urine v. Albumin level vi. WBC and Hgb and Het related to fluid volume (©) _ History and physical (2) Interview (a) Risk factors (b) Lifestyle (0) Knowledge (2) Previous infections. (e) Social habits () Environmental hazards (3) Physical exam (nursing) (a) Inspection (b)Palpation (0) Percussion (6) Auscutation b. Diagnosis Based on Assessment - NANDA (1) Altered fluid balance (2) Altered thought process (3) Altered nutrition (4) Grieving (5) Disturbances in setf concepts ©. Plan (1) Nursing related to medical management (2) Uremia (b) Hypertension (©) Arrhythmias (a) Pain control (e) Paralytc ileus {) GIBleeding {g) Hypoxia {h) Edema 15e. (2) Patient outcome (a) Control hypertension (6) Reduce arrhythmias (©) Improve cardiac function (d) Prevent uremia (e) Prevention of pain (f) Improve fiuid volume (3) Discuss and implement components of the nursing process related to patient care and evidence based practice Implementation (1) Pharmacology (a) lon exchange resins (b) Mineral regulation (0) Antibiotics (0) Application to Module Ill i. Plasma expanders il, Dopamine ii, IV fluids (2) Skills (2) Hourly output (b) Dialysis (©) IV titration (3) Nutrition (a) Fluid regulation (b) Sodium regulation (©) __ Protein regulation (4) Ethicallegal (2) Quality of fife (b)_ Organ transplant (5) Rehab/prevention/health education (2) Transplant (6) Communication (a) Teaching Evaluation 16MODULE 4: NURSING AGENCY FOR COMPLEX REST ACTIVITY DEMANDS A. Objectives While participating in and upon completion of Module IV, the student should be able to: 1. Use the nursing process to provide and manage individualized care for individuals with ‘complex rest/activity demands. Assesses, Diagnoses, Plans, Implements and Evaluates based upon Health history. Physical assessment. Principles from the behavioral, biologic and nursing sciences. Self-care requisites/assets/deficits (1) Health deviation (2) Universal {3) Developmental e. Socio-cultural and religious factors that influence the patient's response to iliness. 1. Priority nursing diagnoses. 9. Technical skills and individual noeds. (1) Trauma assessment (2) Triage |. Diatary needs which are influenced by individual, physiologic, religious and cultural factors. i. Diagnostic and laboratory studies needed for patients with complex restactivity aese demand. (1) ICP Monitoring (2) EEG (3) Cat scans (4) Rr (8) Lumbar Puncture (6) Wester BlovELISA (7) Hormone Levels i. Pharmacologic actions, desired effects, side effects, and nursing implications of agents used for patients with complex rest/activity demand, (1) Anticonvulsants (2) Thyroid agents (3) Osmotic diuretics (4) Current AIDS medications k. Rehabilitation and teaching needs of patients with complex rest/activity demand, (1) Self-care deficit |. Ethical legal factors which impact patients with complex rest/activity demand, (1) Triage (2) Brain Death m, Prototype health deviations/hazards of complex neurologic, endocrine, vision and immune dysfunction 72. Use verbal and written communication skills with patients, families, significant others, and health team members independently in the care and management of patients with complex rest/activity demands by: ‘a. Communicating in precise and accurate terms, the patient's responses to nursing and medical intervention. b. Interacting with other health team members in @ collegial manner. ©. Using appropriate lines of communication to accomplish role responsibilities as provider and manager of care. d. Documenting care of patients with complex rest/activity demand according to legal standards, . Using communication techniques and factual information to assist the patient, family and significant other to cope with and resolve problems. 4. Writing and directing a plan of care addressing current nursing needs for patients with complex restiactivity demand 3. Perform nursing skills safely for patients with complex rest/activity demand, (See skills listed in #1 above.) ‘a, Administer and monitor the prescribed medical and nursing regimen of care. b. Demonstrate passing performance in newly learned skills. 4, Practice within the legal ethical framework of nursing as a provider and manager of nursing care for patients with complex rest/activity demand by: a. Adhering to the policies as stated in the Student Handbook. b. Providing care with NO act of omission or commission that causes or could potentially cause harm to the patient. ©. Adhering to the ethic of confidentiality d. Accepting responsibility for own actions and actions of delegates. fe. Accepting responsibility for own learning, {Demonstrating soundness of moral character. 9. Differentiating the roles of the associate degree nurse from those of other health team members. h. Demonstrating various methods of maintaining currency in the discipline of nursing, Use time management and delegation skils. Demonstrate ability to implement care related to National Patient Safety Goals. B. Content 4. Review a. A&P of nervous system b. A&Pof endocrine system cc. Compromised immune system 2, Pathophysiology a. Disorders (1) Altered nerve conduction (2) Altered cerebral perfusion & increased intracranial pressure (3) Altered sensoryimotor function (4) Sleep deprivation 18b. Medical prototype (1) Trauma {a) Spinal Cord Injury {b) Head Injury (2) Neuro {a) CVA (b) Types of seizures (c) Parkinson's {d) Neurologic Infections i. Meningitis i. Encephalitis (e) Autoimmune Nervous System Disorders i. Multiple Sclerosis ii, Myasthenia Gravis Guillain-Barre Syndrome (3) HIVIAIDS (4) Endocrine Pathology (a) Thyroid (b) Parathyroid (c) Adrenal (d) Pituitary 3, Nursing Management a. Assessment (1) Chart review (a) Medical management i. Carotid endarterectomy il, Pallidotomy/Thalamotomy ili, Cryotherapy, photocoagulation and diathermy (b) Diagnostic evaluation i. ICP Monitoring i, EEG ili, CAT Scan iv. MRI v. Lumbar Puncture vi. Wester BIot/ELISA vii. Hormone Levels (©) History and physical (2) Interview (a) Risk factors (b) Lifestyle (c) Knowledge (3} Physical exam (nursing) (a) Inspection (©) Palpation () Percussion (@) Auscultation 19b. Diagnosis Based on Assessment - NANDA (1) Activity intolerance (2) Sensory - perceptual deprivation (3) Self-care deficit (4) High risk aspiration c. Plan (1) Nursing related to medical management (2) Patient outcome (3) _ Discuss and implement components of the nursing process related to patient care and evidence based practice 4. Implementation (1) Pharmacology (a) Anticonvulsants (b) Thyroid agents () Osmotic diuretics (d) Current AIDS medications {e) Current medications used in treatment of Multiple Sclerosis, Myasthena Gravis and Parkinson's (2) Skills (a) Trauma assessment (b) Triage (3) Nutrition (4) Ethicaliegat (a) Triage {b) Brain death (5) Rehab/prevention/health education (6) Communication barriers e. Evaluation Original: 1994 Revised: Nov. 1996 Revised: Jan. 15, 1997 Revised: March 20, 1997 Revised: May 17, 2000 Revised: August 23, 2001 Reviewed: May 13, 2003, Revised: May 17, 2005 Revised: May 17, 2006 Revised: May 15, 2007: May 2008, May 2013, May 2014 20KENT STATE UNIVERSITY ASSOCIATE DEGREE IN NURSING PROGRAM COURSE: —NRST 20208 STUDENT Nursing Agency Ii CLINICAL SITE CLINICAL EVALUATION TOOL Student success in the nursing program is dependent upon the building of knowledge and skills from one nursing course to the next. Because of this developmental process the clinical experience provides both learning time and evaluation time. When newly learned skills are first performed, a lesser competency is, expected. As previously learned skills are repeated, higher competency is expected and must be demonstrated by passing performance evaluation. The following definitions for performance scale designations are applied to the criteria on the following pages. Performance Scale Definitions. Action $s Safe, accurate, organized performance. Satisfactory Independent in previously learned skills. Competency level INCREASES over time. Needs occasional supportive cues or physical direction. Ni Performance below acceptable standard Needs Improvement | Criteria for passing not met on one occasion. Required frequent verbal or physical cues. ‘Anecdotal note to student, Lab referral (when appropriate). Ciinical E. if no improvement. u Unsafe performance. Criteria for passing | Anecdotal note to student. Lab Unsatistactory unmet. Unabie to safely demonstrate referral (when appropriate). behavior, skills and/or procedure. Requires | Clinical F. continuous verbal or physical cues. Midtorm Date Faculty Clinical Grade Student Exit Date Faculty Clinical Grade Student The following evaluation will be completed by the clinical faculty member following each clinical week. Students will be appraised of their performance as indicated by the ACTION column above, through verbal interaction during clinicals and by midterm and end of semester conferences. At midterm and end of semester, both the facully member and the student will complete the Clinical Evaluation tool. For NRST 20208, Nursing Agency Ill, three (3) clinical U's will constitute a course failure. The student will NOT be permitted to attend classroom or clinical activities if clinical or course failure occurs. Other designations that may be used: N: No experience NO: Not observed by professor NA: Not applicable 2While participating in and upon completion of NRST 20208, the student should be able to’ 1. _ Use the nursing process to provide and manage individualized care for individuals with complex therapeutic self-care demands. Week: Citi Ts 6 7 | ur] s BEHAVIORS: 1. Develop and alter priorities of the plan Of care to respond to changing self-care demands. a. enor Assess: Identify self-care requisites/assets/deficits health deviation universal -developmental Diagnosis Pian implement Evaluate 2. Implement individualized teaching plan. 3. Make referrals and plan discharge based on assessment of patient needs, 4. Identify delegable aspects of complex nursing care. 5. Establish priorities of care for a group of patients. 6. Discuss and implement the Components of the nursing process related to patient care and evidence based practice. DATE/INSTRUCTOR 22 9 | 10 | F COMMENTS:Use verbal and written commu and health team members independently. ation skills with p: nts, families, significant others, Week: neHleee | 3] 4]sf[6f]7 [urls |e 10 | F | BEHAVIORS: DATE/INSTRUCTOR COMMENTS: 1 Communicate in precise and accurate terms, the patient=s responses to nursing and medical interventions. Interact with other health team members in a collegial manner. Use appropriate lines ‘of communication to accomplish role responsibilities: Provider Manager Document care according to legal standards, Use communication techniques that assist the patient, family, and significant other to cope with and resolve problems. Complete written assignments. 23Perform nursing skills safely for patients with complex therapeut self-care demands. Week: “Tey tetete (7 [fe] [fF] BEHAVIORS: DATE/INSTRUCTOR COMMENTS: 1. Administer and monitor the prescribed medical and nursing regimen of care. Administer ‘medications with minimal instructor input, via numerous routes, to groups of pationts, Demonstrate ‘competence in previously learned skills Demonstrate passing performance in newiy learned skills. Recognize own limitations. Demonstrate ability to implement National Patient Safety Goals, a. Identify patients correctly. b. improve staff communication ¢. use medications safely. . Prevent infection e. Identify patient safety risks. £. Prevent mistakes in surgery. 24IV. Practice within the ethical-legal framework of nursing as provider of care, manager of patient care, and member of the profession. Week: 1 2 3 4 5 6 7 | MT to | F BEHAVIORS: DATE/NSTRUCTOR COMMENTS: 1. Adhere to the policies as stated in the Student Handbook 2. Provide care with NO act of omission or commission that causes or could potentially cause harm to the patient, 3. Adhere to the ethic of confidentiality 4, Accept responsibility for own actions and actions of delegates. 5. Accept responsibilty for own learning. 6. Displays professionalism in al verbal and non-verbal interpersonal relationships. 7. Recognize how requesting and receiving feedback can promote teamwork. 8. Provide feedback to delegates. 9. Discuss the types of evaluation of the delegate and key points to consider When evaluating the delegate with each ‘ype. 10. Evaluate the delegation process as outlined by the Ohio Board of Nursing 25Further Comments: Student initia! Date: Instructor initial: Date: Midterm Summary: Final Summary: Original: Jan, 1994 Revised: Nov 14, 1996 Revised: Sept 3, 1998 Revised: Aug. 23, 2001 Reviewed: May 13, 2003 Revised: May 17, 2005, May 13, 2013, Reviewed: May 15, 2007; May 2008 26KENT STATE UNIVERSITY Associate Degree in Nursing Program ESSENTIAL FUNCTIONS FOR NURSING The Essential Functions for students admitted to the Associate Degree in Nursing Program address the physical and mental demands that students encounter in the academic, laboratory, and clinical portions of the program. These standards have been identified by the National Council of State Boards of Nursing as essential core activities/attributes for registered nurses. Listed below are the standards each applicant must meet. Read each statement carefully. ESSENTIAL FUNCTIONS: Yes | ‘No 7 Must have the verbal and writing skills sufficient fo respond promptly in ‘communications with patients, co-workers, and physicians, This includes using grammar and vocabulary appropriate! 7%. Must have sufficient close and distant visual acuily and color perception fo observe the condition of the patient. Must have sufficient heating fo respond and react to auditory instructionsirequests/monitor equipment and perform auditory auscultation. 4, Must be able to stand and walk for 80% of clinical time. 5. Musthave physical strength and mobility to assist, ft, and maneuver patents without injury to patient, self, or other health care workers and respond to medical emergencies such as performing CPR. . Must have fine motor skills and dexterity to manipulate equipment such as used with medications and sterile technique. 7, Must have intellectual skils, ertical thinking abiities, and arithmetic competence." @. Must have the emotional stabiily to perceive and deal appropriately with environmental threats/stressors and continue to function safely and effectively during high stress periods 3. Must be able to protect oneself and others from hazards in the health care environment, including needles and other sharp instruments. ‘These Essential Functions are not intended as a compiete listing of behaviors required for cursing, but are a sampling of the types of abilties needed by the nursing student to meet program objectives and requirements. The Associate Degree in Nursing Program reserves the right to amend this list based on identification of additional criteria for nursing students. “if any “no" response is recorded above, the following must accur: ‘+ Supportive documentation in the clinical evaluation tool must be provided. + Ameeting with the student, clinical feculty and director must be held, “Student must be able to complete ten (10) medication math questions in twenty (20) minutes with 100% accuracy to demonstrate arithmetic competence. STUDENTS ACCESSIBILITY SERVICES Policy, if you have a documented disability, you may request accommodations to obtain equal access and to promote your learning in the classroom. Accommodations in clinical settings will be made after discussion between the Student Accessibility Services Coordinator, the ADN Program Director and the student. STUDENT DATE Adopted: DFAG 1/51/01 FACULTY DATE Revised 2108, 543 27KENT STATE UNIVERSITY Associate Degree in Nursing Program FACULTY AND STUDENT EVALUATION TOOL OF CLINICAL AGENCIES The following criteria were formulated to assist you in evaluating the clinical facility. These criteria are based upon the course/program objectives and Orem=s Self-Care Theory. Please read carefully and answer appropriately. Comments may also be written on the back ofthis form. Alf=Excellent B/2=Good Ci3=Fair —_Did=Poor Name of Faciity: _ Unit NRST Course #. Clinical Day/Time: SemesteriYear: THIS CLINICAL FACILITY PROVIDED ME THE OPPORTUNITY | EXCELLENT | Goop | FAIR | POOR 0: At B/2 cs Dia 4. Utlize the nursing process to care for individuals with a variety of physical and/or psychosocial self-care demands. 2. Safely perform all nursing skils pertinent to the Self-Care Requisites as identified in the course syllabus. 3. Utlize therapeutic communication techniques to faciitate and enhance sel-care, 4, Perform an assessment in order to recognize ormal/abnormal findings and individual variations. 5. Develop and implement a plan of care for individuals experiencing a variety of physical andlor psychosocial self- care demands. 6. Recognize and discuss legal-ethical implications in relation to ‘nursing care. 7. Collaborate and communicate with the nursing and auxiliary staff in order to meet the patients self-care requisites including patient education and health promotion, 8,_Adhere to the ethic of confidentiality 9. Accept responsibilty and accountability for own actions. 10._Leamn through staff support. 1. Usilize appropriate resources in order to meet patient solf- care needs. 12. Access facility resources (parking, food service areas, | conference rooms), 13._Experience a variety of patient care opportunities. 14. Meet the objectives of this course. 15,_Overall, the clinical facility rating is: 18. Other experiences & location: 28Comments: RovisediVoted Upon by DFAC Aug 28, 1006 RevisediVotes Upon by DFAC May 19, 1908 Reviewed: May 13, 2003 Reviewed: May 18, 2005 Reviewed: May 16, 2007; May 2008 29oe Nolov "USLNI avioos ranUMos. aaiatiaeecad ee eet aauoarao | aauoarens ADTWWYON SISONOVIG ONISUNN SOILSIHSLOVAVHS ONINISAG yosn {sa19NsTIV NOILWLNSIO SNOISITAY/TWYNLINI/OINOS | L erected faces ee __:INBWNOMIANS WOH 'SMuvis ATMS ESHEE fE ‘sISONOVIG ToIdaN 'STVUINU'WG :aiva LWoy Noluwonaa 40 13A31 :NouWdN990____:waqNaO. '30V__'STWILINI“Id 2MOLONELSNI dNOWD. szuvo 4 Siva Nagnis SHIBIg BOD NVId 3avo uresBo1g Bu|siny ul aas69q aye}ossy ALISHAAINN S3LV1LS LNSH4 id SuVvZvH stsoubejg Buisinn SOLLSII3LOVAVHO ONINIEIG wosnze asaya JALIALLOV. NONI waLym 1003 sysouBeg Buysiny ‘SOLLSIISLOVEVHO ONINIIIG wosnee (veoy6snsjfeoypow) wuounwon, (veoj6unsqeoipow) wounees, WOneIneC WaieaH sea WOREIAOG UNEOH WSs aig :S3LISINOIY SUVO-JT3S NOLLVIASG HLTW3H SALISINDAY SHVO-s1aS TWINAWOTSAIGve ~ NOLLWAVAS ~ SIVNOILVa SNOLLNSANAINI SSWODLNO SISONOVIC ‘ONISUAN:PATHOPHYSIOLOGY ‘Types of Nursing System inet Party Compensatory Supporive Eaucatve ‘SELF-EVALUATION: SKILLS PERFORMED: REFERENCES: INSTRUCTOR EVALUATION: CARE PLAN: S. NI Original: Jan. 1994 Revised: May, 2001 Reviewed: May 13, 2003 Revised: Dec. 2004 Reviewed: May 17, 2005 Reviewed: May 15, 2007; May 2013 35