RLE 102

Clinical Focus First Semester, CY 2011-2012
KATHERINE C. BENGAN, RN MSN

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I. A. B. C. D. E. II. III.

BASIC COURSE INFORMATION:............................................................................................................ 3 COURSE NUMBER AND TITLE ..................................................................................................................... 3 DATE OF REVISION .................................................................................................................................... 3 SEMESTER CREDIT HOURS ....................................................................................................................... 3 PLACEMENT IN CURRICULUM ..................................................................................................................... 3 FACULTY .............................................................................................................................................. 3 RLE DESCRIPTION: .................................................................................................................................. 3 LEARNING OBJECTIVES: ................................................................................................................... 3

TEACHING STRATEGIES: ................................................................................................................................ 4 CLINICAL EXPERIENCE ................................................................................................................................... 4 PRE-CONFERENCE........................................................................................................................................... 4 POST-CONFERENCE ........................................................................................................................................ 4 PRE OR POST CONFERENCE GUIDELINES ................................................................................................ 4 STUDENT OBJECTIVES: ...................................................................................................................................... 4 THE STUDENT WILL: ........................................................................................................................................... 4 STUDENT GUIDE FOR DISCUSSION..................................................................................................................... 5 CLINICAL ORIENTATION ................................................................................................................................. 5 OPERATIVE NURSING ...................................................................................................................................... 7 ROLE AS A CIRCULATOR WITHIN THE DISCIPLINE OF NURSING: .............................................................. 7 ROLE AS A SCRUB NURSE WITHIN THE DISCIPLINE OF NURSING: ............................................................ 7 SKILLS EXPERIENCE ........................................................................................................................................ 8

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RLE 102 Clinical Focus First Semester, CY 2011-2012

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ST. ANTHONY COLLEGE OF ROXAS CITY COLLEGE OF NURSING

NCM 102 CLINICAL FOCUS

I.

Basic Course Information: A. Course number and Title: B. Date of Revision: C. Semester Credit Hours: RLE 102 June 2011 6 units clinical hours (306 hours) 255 hours ± Hospital setting 102 hours - Laboratory skills for OR First Semester ± Level 3 Katherine Conlu-Bengan, RN MSN Rubilyn Bulquerin, RN Maureen N. Patricio, RN Sheryl M. Ablao, RN Nadia Bisnar, RN

D. Placement in Curriculum: E. FACULTY:

II. RLE Description: This Related Learning Experience deals with the application of the concepts, principles and processes basic to the practice of nursing with emphasis on health promotion, health maintenance, preventive, risk reduction, curative and rehabilitative aspects of care for the mother, child and family, population group and community with problems of oxygenation, fluid and electrolyte balance, metabolism and endocrine system. It includes the utilization of the nursing process and the core competencies under the eleven (11) key areas of responsibility, research and management and leadership skills in the practice of nursing. III. Learning Objectives: At the end of the course, given relevant simulated situations involving health promotion, disease prevention, health maintenance, risk reduction, curative and rehabilitative aspects of care for the mother, child and family, population group and community, the student will be able to: 1. apply the nursing process in the care of individuals, families, population group in selected settings. 1.1 assesses client/s condition/health status through data derived from case scenarios (history, physical examination, interpretation of laboratory findings) 1.2 identifies actual and at risk nursing diagnosis 1.3 plans appropriate nursing interventions with client/s and family for identified nursing diagnosis 1.4 Implements plan of care with client/s and family 1.5 evaluates the progress of his/her/their client¶s condition and outcomes of care ensure a well organized and accurate documentation system 2. utilize bioethical concepts/ principles, core values and nursing standards in the care of clients 3. integrate the various competencies in the various key areas of responsibilities in the care of selected clients.

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RLE 102 Clinical Focus First Semester, CY 2011-2012

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Teaching Strategies: 1. Pre and Post Conferences. 2. Individual student/faculty interactions. 3. Written comprehensive holistic assessment and daily assessment. 4. Role modeling. 5. Clinical rounds. 6. Structured patient care. 7. Case Studies. 8. Hands on supervised clinical experiences. 9. Alternative instructor facilitated learning experience. 10. Group discussions. Clinical Experience Each student will be based in an acute care hospital caring for adult or geriatric clients. Students rotate amongst a team of Medical-Surgical and Operating Room faculty. Clinical assignments will be made at the beginning of each clinical day. The student will be responsible for delivering total care to two to three (2-3) clients on selected clinical units. The nursing process will be utilized to assist clients in achieving optimum health through goal attainment. Clients with diagnoses discussed in theory class will be assigned whenever possible to facilitate student application of newly acquired knowledge. Pre-Conference Prior to student rendering of direct patient care a clinical pre-conference will be held. The time and location of the pre-conference is at the discretion of the clinical instructor. The focus will be reviewed, goals for the day established and learning needs identified. The pre-conference is intended to be a brief, but important, review of the day¶s activities. Clinical instructors will assist the clinical group in identifying care priorities, learning opportunities and organizational needs. Nursing care plans for each client may also be randomly chosen for discussion. Post-Conference Post-conferences are intended to discuss nursing care challenges of interest for the benefits of all the students in the conference group and to share ideas for meeting these challenges. The location and time for clinical post-conferences will be scheduled by the clinical instructor.

The clinical instructor will facilitate the post-conference discussion. Each student is expected to participate in evaluating the day¶s goals and learning experiences. Activities relevant to the clinical focus will be discussed with emphasis on expected and actual outcomes of care, alternate interventions and staff nurse responsibilities in the overall management of care for the client.

PRE OR POST CONFERENCE GUIDELINES
During Pre- and Post- Conferences, the following Objectives and Guide for Discussion will be utilized: Student Objectives: The student will: 1. Identify the client. 2. State client needs. 3. Describe pertinent observations in a review of systems manner.
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4. Report situation and potential or real problems experienced. 5. Discuss nursing approach/solution to these. 6. List the drugs administered, and state the action, dose, desired effect, untoward effects and method of administration for each. 7. List treatments, and state the purpose of, and client¶s response to each. 8. IV solutions. 9. Labs/pertinent to patient. 10. Teaching. Student Guide for Discussion 1. Who is my client? (for example: age, marital status, psychosocial history, medical conditions and mental status). 2. State significant events of this hospitalization (admitting diagnosis, surgery, emotional crises, fracture). 3. What are your client¶s needs TODAY? (Describe client situation, your observations, potential or real problems and your approach). a. Basic daily needs b. Needs requiring special attention 4. What medications were administered, or is your client receiving? a. Why? b. What were the positive and negative effects? c. What safety measures were used? 5. What treatments were done? a. Why were these done? b. What special principles or safety measures were involved? 6. Did I meet my client¶s needs? Explain your answer. 7. What could I do to improve my nursing care of this client? 8. What were my feelings about taking care of this client? 9. Presentation of special topics.

CLINICAL ORIENTATION
Focus: Orientation to the Clinical setting. The student will: 1. Learn the physical layout of the clinical area.

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RLE 102 Clinical Focus First Semester, CY 2011-2012

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2. Review and be familiar with guidelines regarding universal precautions as related to the clinical setting; know where to find protective equipment, sharps disposal boxes and infection control manuals located on the unit. 3. Discuss the ethical, legal issues involved in the nursing care of the members of the Nursing Care Units. 4. Identify the chain of command as it relates to the clinical area. 5. Be familiar with usual routines for the unit: a. vital signs b. meal time c. visiting policies 6. Be introduced to the charting system for the clinical facility. 7. Be introduced to policies related to IV¶s and medication administration. 8. Discuss nursing responsibilities related to medication administration. 9. Review school policies as they relate to clinical attendance, e.g. absenteeism, tardiness, etc. 10. Be oriented to clinical assignments, time of clinical experience, location and time of pre and post conferences and other scheduled clinical experiences in this course. 11. Review the clinical evaluation tool. 12. Discuss the role of the nurse as provider of care, manager of care and member of the profession. 13. Discuss the issues of confidentiality related to the clinical setting. 14. Review the requirements for papers related to this course.

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RLE 102 Clinical Focus First Semester, CY 2011-2012

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OPERATIVE NURSING

CLINICAL FOCUS:

This exposure is designed to introduce the individual to Perioperative Surgical Nursing with a focus on Intraoperative Nursing. This course includes a study of the Patient s Perioperative Experience, Roles and Responsibilities of the Operating Room Nurse; Principles and Practice of Sterile Technique; Sterilization and Disinfection; Operating Room Hazards; and an Introduction to Surgical Technique.

Upon completion of the RLE, the student will be able to: ROLE AS A CIRCULATOR WITHIN THE DISCIPLINE OF NURSING: 1. Describe the basic role and responsibilities of the Registered Nurse during the preoperative, intraoperative, and postoperative phase of the patient s surgical experience. Identifies the role and responsibilities of the circulator as a member of the OR Team.

2. Identifies the basic principles of surgical Aseptic Technique and the methods of sterilization and disinfection.

3. Establishes a client outcome and plan of care that focuses on prevention of problems. Identifies potential surgical hazards and safety measures to prevent injury including patient and occupational related hazards.

4. Demonstrate ability to position and perform surgical skin preparation for the surgical patient in the practice lab and clinical settings.

5. Demonstrate ability to establish and maintain the sterile field as a nonsterile member of the team.

ROLE AS A SCRUB NURSE WITHIN THE DISCIPLINE OF NURSING: 1. Identifies the role and responsibilities of the surgical scrub as a member of the OR team. 2. Demonstrate ability to perform the surgical scrub, gown, and glove technique correctly.

3. Demonstrate ability to establish and maintain the sterile field as a sterile member of the team.

4. Identifies key basic surgical instruments necessary for all surgical procedures. 5. Identifies basic surgical technique principles regarding tissue handling, wound closure, and hemostasis.

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RLE 102 Clinical Focus First Semester, CY 2011-2012

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SKILLS EXPERIENCE 1. Demonstrate satisfactory proficiency in required skills as an Operating Room Nurse in the Operating Room.

2. Identifies safety hazards and interventions appropriate for patient and environmental safety such as counts, electrical, Infection Control measures, and Personal protection requirements. 3. Demonstrate patient assessment skills such as vital signs.

4. Demonstrates and applies the principles of surgical fundamentals such as aseptic technique, storage and handling of sterile supplies as the individual assigned the task.

5. Demonstrates case preparation skills to ensure an organized and efficient case setup especially in regards to tourniquets, and electrosurgical units.

6. Identifies appropriate action to take when confronted with an equipment-related malfunction or emergency.

7. Demonstrates patient care procedures correctly and safely such as skin preparation, positioning, and draping. After three (3) days of clinical exposure, the students will be able to:

ACTIVITIES 1. Attend the orientation and familiarize with the physical set-up, personnel and policies of the institution.

EXPECTED OUTCOME CORE COMPETENCY Adheres to organizational LEGAL RESPONSIBILITY policies and procedures utilized in the institution. Acts in accordance with the established norms of conduct of the institution / organization.

Utilizes resources to support MANAGEMENT OF RESOURCES patient care. AND ENVIRONMENT

2. Receives ward endorsement and patient assignment for the day

Performs comprehensive and SAFE AND QUALITY NURSING systematic nursing assessment. CARE

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RLE 102 Clinical Focus First Semester, CY 2011-2012

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ACTIVITIES 3. Identify and provide a sound decision making in the care of individuals. families/groups considering their beliefs and values. 4. State expected outcomes of nursing intervention. 5. Develop a comprehensive client care plan. 6. Implement nursing intervention that is safe and comfortable. 7. Act according to clients health condition and needs. 8. Perform nursing activities effectively and in a timely manner. 9. Assess the learning needs of the client. 10. Develop health education plan based on assessed and anticipated needs. 11. Monitor effectiveness of nursing interventions 12. Revise care plan when necessary. 13. Establish trust and confidence with assigned client. 14. Listen attentively to client s queries and requests. 15. Spend time with the client to facilitate conversation that allows client to express concerns.
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EXPECTED OUTCOME CORE COMPETENCY Formulates a plan of care in SAFE AND QUALITY NURSING collaboration with clients and CARE other members of the health team.

Implements planned nursing care SAFE AND QUALITY NURSING CARE to achieve identified outcomes.

HEALTH EDUCATION

Evaluates progress expected outcome.

toward

Establishes rapport with SAFE AND QUALITY NURSING patients, significant others and CARE members of the health team.

COMMUNICATION COLLABORATION TEAMWORK

and AND

RLE 102 Clinical Focus First Semester, CY 2011-2012

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ACTIVITIES EXPECTED OUTCOME CORE COMPETENCY 16. Utilize appropriate patient Documents care rendered to LEGAL RESPONSIBILITY care records and reports. patients. RECORDS MANAGEMENT 17. Accomplish accurate documentation in all matters concerning client care in accordance to the standards of nursing practice. 18. Render nursing care consistent with the patient s bill of rights: (i.e. confidentiality of information, privacy, etc.) Respects the rights of individual.

and

ETHICO-MORAL RESPONSIBILITY

19. Observe proper disposal of Maintains a safe environment. wastes. 20. Adhere to policies, procedures and protocols on prevention and control of infection. 21. Utilize findings in research in the provision of nursing care to individuals / groups / communities. 22. Make use of evidencebased nursing to ameliorate nursing practice. 23. Identify own learning needs, i.e., one s strengths, weaknesses/limitations. 24. Project a professional image of the nurse 25. Possess positive attitude towards change and criticism. 26. Detect variation in specific parameters, i.e, vital signs of the client from day to day.
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MANAGEMENT OF RESOURCES AND ENVIRONMENT

Applies research nursing practice.

findings

in RESEARCH

PERSONAL AND PROFESSIONAL DEVELOPMENT PERSONAL AND PROFESSIONAL DEVELOPMENT PERSONAL AND PROFESSIONAL DEVELOPMENT

QUALITY IMPROVEMENT

RLE 102 Clinical Focus First Semester, CY 2011-2012

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ACTIVITIES 27. Report significant changes in client s condition/environment to improve stay in the hospital.
Prepared by:

EXPECTED OUTCOME

CORE COMPETENCY QUALITY IMPROVEMENT

KATHERINE C. BENGAN, RN MSN Level III Coordinator

Noted by: SR. EDITHA A. BAGAYAUA, DC RN MSN DEAN ± COLLEGEOF NURSING

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RLE 102 Clinical Focus First Semester, CY 2011-2012