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NATIONAL AMERICAN UNIVERSITY BLOOMINGTON CAMPUS BSN PROGRAM Nursing 3361: Holistic Nursing Care in Acute Illness I - Clinical

Fall 2013 Learning Plan 6 Clinical Day #6 Nursing Policies and Procedures Objective of the Course/Competency: 1. Examine the use of therapeutic communication skills in the development of therapeutic relationships with clients and families.
Knowledge and skills leading to mastery of this competency

a. Incorporate caring and healing techniques that promote a therapeutic nurse client relationship. b. Communicate effectively with the client and the client’s support network. c. Maintain self-awareness and a reflective nursing practice. d. Complete a health history. e. Demonstrate the ability to report orally the information necessary to facilitate the continued nursing care of a client. 2. Demonstrate professional behavior by maintaining appropriate dress and demeanor, maintaining client confidentiality, and assuming accountability for own actions.
Knowledge and skills leading to mastery of this competency

a. b. c.

Demonstrate accountability for personal and professional behaviors. Incorporate the professional standards of moral, ethical, and legal conduct. Demonstrate professionalism, including attention to appearance, demeanor, respect for self and others, and attention to professional boundaries with clients and families as well as among caregivers d. Protect client privacy and confidentiality of client records and other privileged communications. e. Ensure that ethical standards related to data security, regulatory requirements, confidentiality, and clients’ right to privacy. 3. Incorporate the art and science of nursing when performing psychomotor skills, managing common symptoms and client’s responses to interventions.
Knowledge and skills leading to mastery of this competency

a. b.

Examine the Patterns of Knowing. Provide compassionate, client-centered, evidence-based care that respects client and family preferences. c. Demonstrate the application of psychomotor skills for the efficient, safe, and compassionate delivery of client care. d. Implement evidence-based nursing interventions as appropriate for managing the acute care of clients across the lifespan. 1

e.

Implement holistic, client-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across the lifespan

. 4. Interpret health data from a culturally and age appropriate health assessment and focus on physiologic, developmental and behavioral patterns of client response to acute conditions and processes.
Knowledge and skills leading to mastery of this competency

a.

Complete a comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessment of health and illness parameters of acute care clients, using developmentally and culturally appropriate approaches. b. Assess health/illness beliefs, values, attitudes, and practices of individuals and their families. c. Discuss the critical thinking process of the professional nurse in health assessment. d. Identify a variety of measurements of growth and development across the age span. 5. Develop plans of care that are client and family centered using evidence to inform nursing actions.
Knowledge and skills leading to mastery of this competency

a. b.

Use behavioral change techniques to promote health and manage illness. Provide nursing care based on evidence that contributes to safe and high quality client outcomes. c. Facilitate client-centered transitions of care, including discharge planning and ensuring the caregiver’s knowledge of care requirements to promote safe care. d. Demonstrate the effective use the nursing process. e. Create an individualized, holistic and culturally appropriate nursing care plan and/or concept map. f. Practice client and family level nursing actions. 6. Communicate effectively the client’s status and outcomes to others on the health care team.
Knowledge and skills leading to mastery of this competency

a. Use information and communication technologies to share client information. b. Communicate effectively with all members of the healthcare team. c. Use inter- and intraprofessional communication and collaborative skills to deliver evidence-based, client-centered care. d. Contribute the unique nursing perspective to interprofessional teams to optimize client outcomes. e. Report orally the information necessary to facilitate the continued nursing care of a client by any others involved. f. Record information necessary to maintain a record of nursing actions, client reactions to the care, and resulting client outcomes. 7. Apply ANA code of ethics to the care of clients with acute conditions/processes.
Knowledge and skills leading to mastery of this competency

a. Use an ethical framework to evaluate the impact of social policies on health care. b. Act to prevent unsafe, illegal, or unethical care practices. c. Analyze an ethical dilemma, citing ethical principles and a systematic approach or resolving the ethical dilemma. 2

Overview: This clinical experience will build on the foundational concepts to provide holistic and culturally congruent nursing care for adult clients in a sub-acute and long-term care setting. This clinical will place emphasis on learning the nursing actions necessary to manage clients who present with acute signs and symptoms. Students’ practice will be guided by clinical practice guidelines and standard policy and procedures, while learning to provide direct nursing care such as performing delegated medical treatments (medication administration, IV therapy, wound care, oxygen therapy, sterile technique, and surgical care). Students will be required to collect and interpret a variety of data to provide client and family centered care. Learning Activities: • Observe actual nursing practice on the unit to note compliance with, or deviations from nursing procedures when implemented by an RN (refer to unit/agency specific nursing policy and procedure manual) Review: Review the assignment description – Attachment 1 Come to class prepared to discuss: o Standardized nursing policies and procedures, standards of care, and other evidence based nursing practice guidelines Post-class: Clinical Paperwork Learning Objectives 1. Discuss the Nursing Scope of Practice 2. Identify where to locate information about policies and procedures on the nursing unit in which you are assigned 3. Discuss a nursing procedure that was observed on the unit, and discuss the role of the RN 4. Discuss why RN’s may or may not follow agency written policies and procedures

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Nursing Policy or Procedure Exploration
This assignment is meant to familiarize you with standardized nursing policies, procedures, standards of care, and other evidence based nursing practice guidelines, and to encourage you to observe actual nursing practice on the units to note compliance with, or deviations from nursing procedures when implemented by an RN. The following aspects of the assignment can guide you in preparation for the clinical conference discussion. This assignment will be presented in post clinical discussion. 1. Choose a nursing policy or procedure that is commonly used on the nursing unit. Ex. Central line dressing change, hand washing, pain management, foley catheter insertion, medication administration 2. Find the current written nursing policy or procedure in place for your institution/unit and answer these questions: a. How easy/difficult was it to find the policy/procedure? b. Id the RN’s know where to find the written policy/procedure? c. Is the policy/procedure evidence-based? Review the current practice standards from professional organizations and/or oversight and accreditation groups (e.g. JCAHO, CDC) and/or the research literature. 3. Observe the RN’s on the unit performing the identified procedure and describe: a. What steps the RN took b. In what ways the RN deviated from the written policy/procedure c. What prompted the RN to make the deviations she/he did? d. As many details as you can recollect 4. Discuss why RN’s may or may not follow institution’s written policies and procedures. Reflect on the opportunities and challenges of evidence based practice and the implementation into actual bedside nursing practice. 5. Discuss what the proper response should be when you as an RN discover unsafe practice that deviated from standards, policies or procedures.

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