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Sultanate of Oman

Oman College of Health Sciences


Nursing Program

ADULT HEALTH NURSING - II

Course Syllabus
(NUR 217-Laboratory)

YEAR TWO - SEMESTER IV


Academic Year 2020- 2021

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MINISTRY OF HEALTH
Oman College of Health Sciences
Baccalaureate Nursing Program

Course Title: Adult Health Nursing II / Lab

Course Code and No. NUR 217

Credit Hours Allocated: 1

Actual Hours Allocated: 30 hours

Placement of the Course: Second Year – Semester 4

Co-requisite course: NUR 216 Adult Health Nursing II / Theory

Course Description:

This course is designed parallel to Adult Health Nursing II theory which will develop the
student’s psychomotor skills. The students are presented with theoretical content related to the Adult
Health Nursing skills integrating previously learned concepts from Anatomy & Physiology and
Introduction to Health Assessment. The students will be introduced to practice adult health nursing
skills with major emphasis on critical elements of the nursing procedures and the scientific rationale
for performing the procedure competently. The course intends to develop competency among students
by application of nursing knowledge and master adult health nursing skills safely and accurately
through graded supervised skills practice in a simulated laboratory setting.

Course Learning Outcomes:

Upon the completion of this course, the students will be able to:

1. CLO 1: Identify the procedures and rationale for specific adult health nursing skills using the
nursing process as the organizing framework.
2. CLO 2: Demonstrate adult health nursing skills accurately incorporating patient safety measures.
3. CLO 3: Integrate critical thinking and reasoning skills while performing the skills.
4. CLO 4: Implement a range of nursing procedures that fall within the scope of nursing practice and
in accordance with best practice standards.
5. CLO 5: Demonstrate competency in using different resources for own development and learning.
6. CLO 6: Practice nursing procedures in accordance with DNMA guidelines.
7. CLO 7: Utilize scientific knowledge in performing specific nursing procedures.
8. CLO 8: Integrate technology and information systems in performing nursing procedures.

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The course learning outcomes contribute to achievement of the following BSN program
competency statements (PCS):

Competency PCS CLOs Program Competency Statement Level of


Domain Number Achievement
Knowledge Base in 1.3 7 Utilizes knowledge base in the basic R
Nursing and other and health sciences including
Disciplines anatomy & physiology,
biochemistry, pathophysiology,
pharmacology, microbiology,
epidemiology, genetics, immunology
and nutrition.
Provision and
management of care
2.1 Assessment 2.1.1 3 Gathers accurate and relevant R
objective and subjective data through
systematic health and nursing
assessment.
2.1.2 2,3 Organizes analyses, interprets, and R
synthesizes, data from different
sources to derive a nursing diagnosis
and determine a care plan.
2.2 Planning 2.2.4 2,3 Applies critical thinking and clinical R
reasoning skills underpinned by
knowledge of nursing and other
disciplines to the care planning
process.
2.3 Implementation 2.3.1 2,4 Implements a range of procedures, I
treatments and interventions that fall
within scope of practice for the
registered nurse and in accordance
with nursing and best practice
standards.
2.4 Evaluation 2.4.1 4,5 Monitors and documents progress R
towards expected outcomes
accurately and completely
Interpersonal &
Inter-professional
relationship
3.1 Interpersonal 3.1.4 4 Communicates clear, consistent and I/R
accurate information verbally, or in
written and electronic forms, that
fall within professional responsibility
and maintains confidence in care.

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Legal and Ethical 4.1 6 Practices in accordance with R
Practice professional, relevant civil
legislation and regulations.
4.2 6 Practice in accordance with ONMC R
and local policies and procedural
guidelines.

Critical Thinking 5.3 2 Applies critical thinking skills and a R


Evidence Based systems approach to problem solving
Practice and nursing decision-making across a
range of professional and care
delivery contexts.
Information 6.1 8 Demonstrates competency in I
Management and determining how and where to find
application of evidence to ensure quality patient
patient care care
technology 6.4 8 Demonstrates competency in using I
electronic medical records (Al Shifa)
for planning, documentation of
nursing interventions, monitoring
progress and management of
information for decision support
Professional and 7.1 5 Undertakes regular review of own R
Personal Growth practice by engaging in reflection,
and Development critical examination and evaluation
and seeking peer review.
7.2 5 Assumes responsibility for lifelong R
learning, own professional
development and maintenance of
competence.

CLO - Course Learning Outcome I: Introduced R: Reinforce M: Mastered

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Assessment Plan

The course will be evaluated based on the following methods:

METHODS MARKS WEEK Remarks


ALLOCATED
Each institute should assess their
students a minimum of 7-8
Continuous Assessment 70% 8 & 11 procedures listed in the essential
skills.
The students are expected to
perform three (3) skills during the
OSCE Final Examination 30% 15 final exam.

Please Note:

 The Course coordinator together with his or her AHN team will create a procedure station where a
student will perform a specific skill listed below. A performance checklist will be used during the
supervised skill practice which is attached in the course syllabus.

 During the final laboratory exam, the student is subjected to a simulated learning environment using
the OSCE approach. The student is expected to perform a procedure based on the scenarios developed
by the AHN team in each of the college branches.

LIST OF ESSENTIAL SKILLS

MINOR SKILLS MAJOR SKILLS

 Gastrointestinal Intubation (NGT Removal)  Gastrointestinal Intubation (NGT Insertion)


 Colostomy / Ileostomy Appliance Care  Insertion & Care of Foley’s catheter
 Eye Patch Application (Male/Female)
 Positioning Patient after Stroke  Instilling Eye Medications: Eye Drops
 Assisting with Application of Skin Traction & Eye Ointment
 Assisting with Cast Application (Plaster of  Instilling Ear medications (Drops)
Paris & Fiberglass)  Bandaging Techniques
 Assisting with Cast Removal
 Application of Sling

Grading System: The course grade is calculated on percentage basis and each grade has a numerical
value in accordance with the following table:

Grade Grade Point % Grade Grade Point %

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A 4.00 100-90 C 2.00 68 - less than71
A- 3.75 90- less than 85 C- 1.75 65 - less than 68
B+ 3.25 85- less than81 D+ 1.50 60 - less than 65
B 3.00 81- less than78 D 1.00 50- less than 60
B- 2.75 - less than 7875 F 0 Less than 50
C+ 2.25 - less than 7571

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MINISTRY OF HEALTH
BACHELOR OF SCIENCE IN NURSING PROGRAM

GUIDELINES FOR GRADING STUDENT’S SKILLS PERFORMANCE


Academic Year 2020-2021

Continuous Assessment: (70%)


1. Skills Performance can be assessed through OSCE or on individual basis when the student is ready for
assessment on week 3.
2. Due date for completing assessments for all students for a set of skills should be determined by the
college branch and/or as per the course syllabus
3. All skills are important and of equal value.
4. Skills performance checklist/rating scales should be used to evaluate student’s performance. Critical
elements that should be performed at 100% accuracy should be identified.
5. Failing to perform any of the critical elements at 100%, the student fails the whole skill. Twenty five
percent (25%) of the maximum points allotted to the skill will be recorded, e.g. if 10 points is allocated
for each skill, 2.5 points will be recorded to the failed skill.
6. No resit is given for any failed skill in the continuous assessment
7. Feedback should be provided to the student indicating strengths and areas that he/she needs to improve.
a. A record of students with the failed skills should be completed and disseminated to the
concerned teacher(s).
b. Opportunities to practice the skill should be provided by the concerned teacher(s).
c. The student is responsible to improve performance before the final examination. The teachers
to keep anecdotes on students’ progress
8. The continuous assessment mark is an aggregate of student’s marks obtained in skills performance
assessment; the aggregate mark should be out 70 for procedures.

Final Examination (30%)


1. Final examination should be conducted before the examination week of theory so teachers of other
courses can help in the examination and additional space to set up stations will be available.
2. Students should be informed to study and get ready for all skills (major & minor).
3. A set of essential skills that will be assessed should be identified (2 major skills and 1 minor skill).
OSCE stations to be prepared for those skills. Some stations could be written stations, to assess
students’ comprehension of underlying principles and students critical thinking when carrying out
certain steps in a given procedure.
4. Failing to perform any of the critical elements at 100%in a skill station, the student fails the whole skill.
25% of the maximum points allotted to the skill will be recorded, e.g. if 10 points is allocated for each
skill, 2.5 points will be recorded to the failed skill.
5. The Final Examination mark is an aggregate of student’s marks obtained in all stations; the aggregate
mark should be out of 30.

Final Course Marks


1. Final Course mark is an aggregate of continuous assessment mark and final examination mark.
2. If the student scored less than 50% after aggregating the entire marks (Continuous assessment and the
final clinical exam marks) the student is considered failed the course.

Approved by: The Curriculum Evaluation Committee and by the Council of Nursing Institutes on April 6, 2015

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GENERAL GUIDELINES

LAB AND CLINICAL COURSES ASSESSMENT

General Notes for Task forces and Course Teachers:

1. Identify essential skills to be taught in the lab course congruent to both theory & clinical courses.

2. Map competencies of skills outlined to course learning outcomes and to the overall program competencies
and competency statements and to the types of assessments.

3. If a clinical course is running parallel skills reinforcement is done in the same semester and further in the
consecutive semesters.

4. Ensure that students focus on the holistic care of the patient and the available opportunities to perform
skills under guidance and supervision

5. Course pass mark is an aggregate of continuous and final with a pass grade of 50%

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General Guidelines for ASSESSMENT DESIGN OF LAB COURSES
Weightage of Approach
Marks
Continuous 1. Taskforce outlines a list of the essential skills to be performed.
Assessment 2. Taskforce to suggest references of skills rubrics or develop the skills rubric for
70% all skills delivered and assessed in the course
3. All skills outlined need to be assessed and each course should not bare more than
12 skills to be assessed and not less than 6 skills. These numbers of skills will
ensure ample time for practice and assessment and will help meet the course
credit requirement.
4. Identify any critical elements that require 100% compliance.
5. Each college branch uses scheduled assessment for skills allocating assessment
throughout the semester.
6. Conduct skills assessment after adequate time has been allocated for
demonstration and return demonstration.
7. Skill assessment focuses solely on demonstration of the skill from hands washing
to hands washing
8. If a student fails to perform a critical element then 25% of the mark allotted for
that skill is given to the student regardless of how well the student performs in
other elements of the skill however, the student should still be allowed to finish
the procedure and should be informed after the evaluation.
9. No OSCE's to be conducted in continuous assessment.

10. The checklist marking should be changed into (0 1 2 ) instead of 0 1 or Yes / No

1. A minimum of three (3) OSCE stations to be organized and developed by the


Final taskforce.
30% 2. Scenarios are formulated by the taskforce in collaboration with the course
teachers in each college branch. Skills for OSCE Stations Scenarios should be
provided two weeks before the implementation by the taskforce.
3. All students will go through all stations for fair and standardized exam situations
4. A scenario reflects a procedure or a group of procedures. Well-constructed
scenarios should be presented with enough time for each procedure.
5. Students are asked to prepare for the final by reviewing all the procedures taught
in the course.
6. Student who fails a critical element in any of the given skills will receive 25% of
the mark allotted to the final assessment. For skills demonstration, the same skills
rubric is used that has been adopted for the continuous assessment.
7. Failure in the OSCE does not reflect failure in the course unless the total course
aggregate is less than 50%.

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ADULT HEALTH NURSING II
LAB COURSE OUTLINE
Week No. of UNIT CHAPTER LAB SKILLS
Hours SESSION
I Introduction to the Lab Course
Digestive &
1-2 4 Gastrointestinal 44 1 Gastrointestinal Intubation
Function
47 2 Colostomy / Ileostomy Care

3 2 *IHA Assessment of Gastrointestinal System


(Supervised Lab Practice)
4 2 II 55 3 Insertion and care of Foley Catheter
Urinary & Renal
5 2 Function *IHA Assessment of Kidney & Urinary Function
(Supervised Lab Practice)
6 2 Continuous Assessment 1

7 2 IV *IHA Assessment of Integumentary Function


Integumentary (Supervised Lab Practice)
Function
8 2 63 4 Eye Patch and Instilling Eye Medications
Eye drops, Ointment
V Instilling Ear Medications: Ear drops
Sensorineural Function
9-10 4 *IHA Assessment of the Eye and Vision
*IHA Assessment of Patients with Hearing and
Balance Disorders
11 2 *IHA Assessment of Neurological function

12 2 Continuous Assessment 2
VI *IHA Assessment of Musculoskeletal Function
13 2 Neurologic Function
67 5 Positioning the Patient after Stroke

VII 40 6 Assisting with Cast Application and


14-15 4 Musculoskeletal removal of Cast
Function 7 Assisting with Application of Skin Traction
Bandaging Techniques (Sling, Splint,
Binders)
Final OSCE
Exam
Total:
30hrs

*IHA- Introduction to Health Assessment

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Week No. of Health Assessment Supervised Lab Practice
Hours
3 2 Assessment of Gastrointestinal System Please Note:
5 2 Assessment of Kidney & Urinary Function
The following assessments stated in the
Measuring Intake & Output course outline has been introduced and
7 2 Assessment of Integumentary Function assessed during their Introduction to Health
Assessment course in first year. Hence, there
9 2 Assessment of the Eye and Vision is a need to reinforce during the lab session
Assessment of Patients with Hearing and so the students will master the skills
Balance Disorders competently in succeeding years. Thus, the
faculty needs to review the assessment again
11 2 Assessment of Neurological function
during the lab sessions.
13 2 Assessment of Musculoskeletal Function
The checklist to be used for all of these
assessments will be from their Introduction
to Health Assessment course for consistency
and uniformity.

Additional Learning from Students Perspectives (10%):


Ten percent of the class time should be allotted towards the end of the semester (starting from week
14) to address additional students’ learning needs relevant to the course learning outcomes. Students’
needs can be elicited through one of these ways:

 Self-directed learning: Review skills checklist


 Demonstration and Return demonstration

Suggested Teaching/ Learning Strategies:

The students are encouraged to seek different resources to fulfill learning objectives with the guidance
and teacher’s facilitation. In addition, reflective writing and journal should be initiated at simulated
laboratory settings. Although this course syllabus provides procedures checklist, they are not exclusive
and the teachers should highlight to the students the most updated method (based on scientific
evidence) as well as the practice in the hospitals. Using study guide will encourage student active
participation in learning process. Moreover, students might be asked to read, answer question or search
evidence as preparation and participation for the laboratory session.

The followings are suggested teaching and learning strategies:


 Skills demonstration and re-demonstration
 Supervised laboratory practice
 Audiovisuals/ Multi Media
 Problem based learning
 Lecture / Discussion
 Self-guided learning
 Concept mapping

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 Group activity
 Study guide
 Role play

Student Learning Activities

Students are instructed to view the nursing skills available in the e-library of the Ministry of Health
(http://mohe-library.com) prior to attending the laboratory sessions. Prior viewing of the procedures will
enhance and strengthen their skills, knowledge and attitude regarding the content covered in the session.

Submission date of Assignment/ Case study/ Project/…..: (to be filled out by the course
teacher/coordinator at the college branch level)

Late Submission:
(Assignments/ Group projects are to be completed and handed in on time either electronically or hard
copy. In order to be fair to students who complete their assignment on time, work that is not submitted
on the specified date will be considered as late and will be penalized 10% off of the assigned grade
per day late. If a student is absent on the day of submission, the work assigned is still due via email
during the working hours of the specified submission date.).
Note: consistency of implementation across all courses and by various teachers should be maintained
Extension: (Extension is rarely granted and are only allowed in unforeseen circumstances (student’s
severe sickness, death of a family member, events that beyond student’s control e.g. natural events)

Academic integrity: (It is the student responsibility to be aware and informed about academic
integrity and unfair practices policy, it is available in the student handbook. Breaching the policy will
subject the student to penalties. Examples of unacceptable behaviors include cheating, plagiarism,
and academic fraud)

Continuous Quality Improvement (CQI) Plan:

This course is designed in line with the new BSN curriculum program. The course will be reexamined
in the light of the feedback that will be obtained from teachers and students at the end of first semester
of the academic year 2018-2019. It is recommended that teachers and students and curriculum planners
review the course every two years.

Learning Materials:

The student is responsible for seeking knowledge from different sources such as but not limited to:
recommended text book and references, multimedia resources, MoH e-library resources.
Students are required to take notes in the class to help them further study the concepts deeply.

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REQUIRED TEXTBOOK

 Smeltzer, S.C., Bare, B.G., Hinkle, J. L., & Cheever, K. H. (2018) Brunner and Suddarth’s
Textbook of Medical Surgical Nursing, 14TH ed. , Philadelphia, PA: J.B. Lippincott, Williams &
Wilkins, Co.

OTHER REFERENCES:

 Dewitt, Susan C. (2005) Fundamental Concepts and Skills for Nursing, 2nd ed., Elsevier Saunders,
Philadelphia, Pennsylvania 19106 ISBN 0-7216-0311-4

 Endacott, Ruth, Jevon, Phil & Cooper, Simon (2009) Clinical Nursing Skills Core and Advanced, Oxford
University Press ISBN 978-0-19-923783-8

 Lyn, Pamela &LeBon, Marilee (2008) Taylor’s Clinical Nursing Skills A Nursing Process Approach
Skills Checklist to Accompany, 2nd ed. Lippincott Williams & Wilkins, Wolters Kluwer, Philadelphia
ISBN 13:978-0-7817-6405-6

 Luckmann, Joan (1997) Saunders Manual of Nursing Care, WB Saunders Company, Philadelphia,
Pennsylvania ISBN 0-72165017-1

 Perry, Anne Griffin &Potter, Patricia A. (2010) Clinical Nursing Skills & Techniques, 7th ed. Mosby,
Elsevier, Inc. ISBN 978-0-323-05289-4

 Perry, Anne Griffin & Potter, Patricia A. (2011) Basic Nursing, 7th ed. Mosby, Elsevier, Inc. St. Louis
Missouri ISBN 978-0-323-05891-9

 Smith, Sandra F. & Duell, Donna J. (2000) Clinical Nursing Skills Basic to Advanced Skills, 5th ed.
Prentice Hall Health, Upper Saddle River, New Jersey ISBN 0-8385-1566-5

E-Resources
 http://moh-elibrary.gov.om/
 http://www.ncbi.nlm.nih.gov/pubmed/
 http://www.nursingtimes.net
 http://studentnurseconnection.com/links.htm/
 http://www.freebooks4doctors.com/
 http://www.freemedicaljournals.com/
 http://highwire.stanford.edu/
 www.nzsp.org.nz/MainMenu
 Journals/radiology eBooks online text_download.html
 http://www.ncbi.nlm.nih.gov/pmc/
 http://www.ncbi.nlm.nih.gov/pubmed
 http://ukpmc.ac.uk
 http://www.library.nhs.uk/default.aspx
 http://repository.nie.edu.sg/jspui/
 http://digitalstatelibnc.cdmhost.com/cdm4/index.php

Adult Health Nursing II Laboratory AY 2020-2021 Page 13


 http://chesterrep.openrepository.com/dcr/
 http://www.medscape.com/welcome/journals
 http://www.freemedicaljournals.com/
 http://www.mrw.interscience.wiley.com/cochrane/

Prepared by:

Course Task Force Members:


Academic Year 2020-2021

Supervised by:
Dr. Suad Al Junaibi- Chairperson, OCHS- Muscat
Mr. Norman P. Gutierrez- Co-chairperson, OCHS- Muscat
Ms. Saramma Binu Thomas, Member, OCHS- Muscat
Ms. Malathi Natarajan, Member, OCHS- Muscat
Ms. Laila Al Balushi, Member, OCHS- Muscat
Ms. Habiba Al Manji, Member, OCHS- Muscat

Ad-hoc Members:
Ms. Nadia Salim Al Shabibi, Royal Hospital
Ms. Fatma Al Jabri, Al Nahda Hospital
Ms. Samia Al Zadjali, Al Nahda Hospital

Reviewed by Internal Reviewers:

Mr. Khamis Al Aufi, OCHS- Al Batinah


Mr. Monty Ronquillo Zabala, OCHS- Dhahira

Date: June 2020

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ADULT HEALTH NURSING II
LABORATORY COURSE
CONTENT

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COURSE CONTENT
Unit Lab Time Learning Objectives Content Teaching- Assessment Reference
Session (Hours) Learning Methods
Activities

I 1 2hrs Indicate the purpose of Gastrointestinal Intubation Lecture discussion Assessment of http://moh-
Digestive & gastrointestinal intubation, skills with elibrary.go
Gastrointestinal gastrostomy tube feeding NGT Insertion Demonstration checklist v.om/en/Li
Function and parenteral nutrition. ppincott
Introduction
Practice session Use the Skills procedures
Classify the major types of Equipment checklist
nasogastric and nasoenteric Preparation of available in the
tubes Equipment Video (to be MOH e-library
viewed prior to the
Demonstrate the procedure Implementation lab session by the
skills of nasogastric Special teacher and
intubation. Considerations students)

Discuss nursing Patient Teaching


management of Nasogastric Complications
and nasoenteric intubation.
Documentation
Review the skills of
administering the
nasogastric/enteric tube NGT Removal
feedings Introduction
Equipment
List the complication of
enteral therapy. Implementation
Special
Considerations
Documentation

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Unit Lab Time Learning Objectives Content Teaching- Assessment Reference
Session (Hours) Learning Methods
Activities
I 2 2 hrs. Explain the purpose of a Colostomy & Ileostomy Lecture discussion Assessment of http://moh-
Digestive & colostomy or Ileostomy. Appliance Care skills with elibrary.go
Gastrointestin Demonstration checklist v.om/en/Li
Introduction
al Function Discuss the nursing ppincottpro
management of the patient Equipment Use the Skills cedures
requiring colostomy or Practice session checklist
Implementation Smeltzer,
Ileostomy: available in the
a. Maintaining Special MOH e-library S.C., Bare,
Optimal Nutrition Considerations B.G.,
b. Providing wound Hinkle, J.
care Patient Teaching L., &
c. Monitoring and Complications Cheever,
Managing K. H.
complications Documentation (2018)
Brunner
Follow the steps of and
changing a Suddarth’s
colostomy/Ileostomy Textbook
appliance. of Medical
Surgical
Commence self-practice of Nursing,
the procedure to gain 14 TH ed. ,
further skill. Philadelph
ia, PA:
J.B.
Lippincott,
Williams
& Wilkins,
Co.
Chapter 44
II 3 2hrs Identify the reasons / Insertion and Care of Lecture discussion Assessment of http://moh-
Urinary purpose for urinary Foleys Catheter (Female) skills with elibrary.go
& Renal catheterization. Demonstration checklist v.om/en/Li
Introduction
Function ppincott
Equipment procedures

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Demonstrate male and Practice session Use the Skills
Implementation
female urinary checklist
catheterization including Special available in the
selection of proper catheter Considerations MOH e-library
and emphasizing strict Patient Teaching
sterile technique.
Complications
Provide care for the Documentation
indwelling catheter
according to hospital Insertion and Care of
routine. Foleys Catheter (Male)
Introduction
Equipment
Implementation Video (to be
viewed prior to the
Special lab session by the
Considerations teacher and
Patient Teaching students)

Complications
Documentation

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UNIT OBJECTIVES
Unit Lab Time Learning Objectives Content Teaching-Learning Assessment Reference
Session (Hours) Activities Methods
V 4 2 State the indication of the Eye Patch Application Lecture discussion Assessment of http://moh-
Sensorineural prescribed eye medication skills with elibrary.gov.om/en/
Introduction Demonstration checklist Lippincott
Function Demonstrate the steps
Equipment procedures
applying eye patch,
instillation eye medication Implementation Use the Skills
Practice session checklist
like eye drops and ointment Special Considerations available in the
Document the various types Patient Teaching MOH e-library
of eye medication
Documentation

Instilling Eye Medications


Eye Drops Application
Introduction
Equipment
Preparation of
Equipment
Implementation
Special Considerations
Patient Teaching
Complications
Documentation

Eye Ointment Application


Introduction
Equipment
Preparation of
Equipment

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Implementation
Special Considerations
Patient Teaching
Complications
Documentation
Instilling Ear Medications

Ear drops Application

State the indication of the Introduction Lecture discussion Assessment of http://moh-


prescribed ear medications. Demonstration skills with elibrary.gov.om/en/
Equipment Practice session checklist Lippincott
Follow the steps of instilling Preparation of procedures
the ear medication safely. Equipment Use the Skills
checklist
Record and report the Implementation
available in the
response of the patient. Special Considerations MOH e-library
Complications
Documentation

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Unit Lab Time Learning Objectives Content Teaching- Assessment Reference
Session (Hours) Learning Methods
Activities
VI 5 2 Explain the different Positioning a Patient after Lecture discussion Assessment of Perry, Anne Griffin
Neurologic positioning to the patient. Stroke Demonstration skills with & Potter, Patricia
Function Practice session checklist A. (2011) Basic
State the indication for Nursing, 6th ed.
changing position of patient Mosby, Elsevier,
after a Stroke / CVA. Inc. St. Louis
Missouri ISBN
Describe how to Improve 978-0-323-05891-9
mobility and prevent joint pg. 335-338
deformities
Smeltzer, S.C.,
a) Preventing Shoulder Bare, B.G., Hinkle,
Adduction J. L., & Cheever,
K. H. (2018)
b) Positioning the Brunner and
Hand and Fingers Suddarth’s
Textbook of
c) Changing Positions Medical Surgical
Nursing, 14TH ed.
, Philadelphia, PA:
d) Establishing J.B. Lippincott,
Exercise Program Williams &
Wilkins, Co.
Practice the different Chapter 67
positioning of patient after a
Stroke / CVA safely.

Record and report the


response of the patient.

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UNIT OBJECTIVES
Unit Lab Time Learning Objectives Content Teaching- Assessment Reference
Session (Hours) Learning Methods
Activities
VII 6 2 State the purposes of cast. Cast Application (Plaster Lecture discussion Assessment of http://moh-
Musculoskeletal of Paris) skills with elibrary.gov.om/en/
Function Demonstration checklist Lippincottprocedur
Describe the types of cast.
es
Introduction
Discuss the nursing Practice session
Equipment
management of patients Smeltzer, S.C.,
with cast. Preparation of Use the Skills Bare, B.G., Hinkle,
Equipment checklist available J. L., & Cheever,
Demonstrate the procedure in the MOH e- K. H. (2018)
Implementation library
for applying a cast and its Brunner and
removal. Special Considerations Suddarth’s
Textbook of
Patient Teaching Medical Surgical
Complications Nursing , 14TH ed.
, Philadelphia, PA:
Documentation J.B. Lippincott,
Cast Application Williams &
(Fiberglass) Wilkins, Co.
Chapter 40
Introduction
Equipment http://moh-
Use the Skills
elibrary.gov.om/en/
Preparation of checklist available
Lippincott
in the MOH e-
Equipment procedures
library
Implementation
Special Considerations
Patient Teaching
Complications

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Documentation
Cast Removal

Introduction http://moh-
Use the Skills elibrary.gov.om/en/
Equipment checklist available Lippincott
Preparation of in the MOH e- procedures
Equipment library
Implementation
Special Considerations
Teaching
Complications
Documentation

Unit Lab Time Learning Objectives Content Teaching- Assessment Reference


Session (Hours) Learning Methods
Activities
VII 7 2 Describe the types of Assisting with Application Lecture discussion Assessment of http://moh-
Musculoskeletal traction. of Skin Traction skills with elibrary.gov.om/en/
Function Demonstration checklist Lippincott
Discuss the nursing Care of Patient in procedures
management of patients with Traction
traction. Practice session Use the Skills
checklist available
Introduction in the MOH e-
Demonstrate the procedure
Equipment library
of pin site care.
Preparation of
Demonstrate how to apply Equipment
skin traction. Implementation

Demonstrate bandaging Special Considerations


techniques. Patient Teaching http://moh-
Complications elibrary.gov.om/en/
Lippincott
Documentation procedures

Adult Health Nursing II Laboratory AY 2020-2021 Page 23


Perry, Anne Griffin
Skull Tongs (Pin site) & Potter, Patricia
Care A. (2011) Basic
Nursing, 6th ed.
Introduction Mosby, Elsevier,
Inc. St. Louis
Equipment
Missouri ISBN
Preparation of 978-0-323-05891-9
Equipment pg.
Implementation
Perry, Anne Griffin
Special Considerations & Potter, Patricia
Complications A. (2011) Basic
Nursing, 7th ed.
Documentation Mosby, Elsevier,
Inc. St. Louis
APPLYING SKIN Missouri pg. 409
TRACTION

APPLYING ELASTIC
BANDAGE Perry, Anne Griffin
& Potter, Patricia
 Spiral
A. (2011) Basic
 Figure of eight Nursing, 7th ed.
 Spiral – reverse Mosby, Elsevier,
 Circular Inc. St. Louis
Missouri pg. 411-
BINDERS 412
 Abdominal
Introduction http://moh-
elibrary.gov.om/en/
Equipment Lippincott
Preparation of procedures
Equipment
Implementation
Special Considerations

Adult Health Nursing II Laboratory AY 2020-2021 Page 24


Patient Teaching
Complications
Documentation

APPLICATION OF Perry, Anne Griffin


SLING & Potter, Patricia
Use the Skills A. (2011) Basic
checklist available Nursing, 7th ed.
in the MOH e- Mosby, Elsevier,
library Inc. St. Louis
Missouri pg. 411-
412

Adult Health Nursing II Laboratory AY 2020-2021 Page 25


AHN II LAB
PROCEDURE CHECKLISTS

Adult Health Nursing II Laboratory AY 2020-2021 Page 26


Appendix 1
PERFORMANCE CHECKLISTS
S# Lab Name of the Procedure Page
Session No.
1 1 Nasogastric Tube Insertion 28-29

Nasogastric Tube Removal 30

2 2 Colostomy and Ileostomy, Appliance Care 31

3 3 Indwelling Urinary Catheter (Foley) Insertion, Female 32-34

Indwelling Urinary Catheter (Foley) Insertion, Male 35-36

4 4 Eye Drop Administration 37-38

Eye Ointment Application 39-40

Eye Patch Application 41-42

Ear Drop Instillation 43-44

5 5 Positioning After Stroke 45-48

6 6 Elastic Compression Bandage Application 49-50

7 CLINICAL SKILLS LOG SHEET 51-52

Adult Health Nursing II Laboratory AY 2020-2021 Page 27


Name of the Student: Examiner:
Student No. Date:
Group:
Marks Scored: ___________ / 10 % Remarks (If any):

NASOGASTRIC TUBE INSERTION


PERFORMANCE CHECKLIST

S# Steps SCORE Comment/s


C PC NC
2 1 0
1* Verifies the physician’s order for NGT insertion.
2 Gather and prepares the equipment.
*3 Performs hand hygiene and dons non-sterile gloves. (PPE,
if exposure to bodily fluids anticipated).
*4 Confirms the patient's identity using at least two patient
identifiers. (Checks I/D and asks full name)
5 Provides privacy by closing the door to the patient’s room
and/or drawing the curtain surrounding the patient’s bed.
6 Explains the procedure to the patient, including what to
expect and sensations he/she may experience.
7 Emphasizes that swallowing will ease the tube's
advancement.
*8 Helps the patient into the high Fowler position,
(45 to 90degrees), unless contraindicated.
9 Stands at the patient's right side if you're right handed or at
his/her left side if you're left handed.
10 Drapes the towel or fluid impermeable pad over the patient's
chest.
*11 Determines the length of the tube to be inserted to reach the
stomach; holds the proximal end of the tube at the tip of the
patient's nose and extends it to the earlobe and then down
to the xiphoid process.
12 Marks this distance on the tubing with tape.
13 Determines which nostril will allow easier access; uses a
penlight and inspects for a deviated septum or other
abnormalities.
14 Assesses airflow in both nostrils and chooses the one with the
better airflow.
15 Assesses patient’s abdomen for distension, pain, and/or
rigidity. Auscultates for bowel sounds.
*16 Lubricates the first 3"inch (7.6 cm) of the tube with a
water-soluble lubricant.
17 Instructs the patient to hold his/her head straight and upright.
18 Grasps the tube with the end pointing downward, curve it if
necessary, and carefully inserts it into the more patent nostril.

Adult Health Nursing II Laboratory AY 2020-2021 Page 28


S# Steps SCORE Comment/s
C PC NC
2 1 0
19 Aims the tube downward and toward the ear, advancing the
tube slowly.
20 When the tube reaches the nasopharynx, tells the patient to
lower his/her head slightly. Then rotates the tube 180 degrees
toward the opposite nostril to redirect it.
21 Offers the patient a cup or glass of water with a straw, if
appropriate, and directs him/her to swallow as you slowly
advance the tube into the esophagus.
22 Uses a tongue blade and penlight to examine the patient's
mouth and throat for signs of a coiled section of tubing.
23 Watch for signs of respiratory distress.
24 Stops advancing the tube when the tape mark reaches the
patient's nostril.
*25 Determines tube location i.e. aspirates secretions and
inspects the visual characteristics.
26 Anticipates an X-ray to verify placement.
27 Secures the NG tube to the patient's nose using a commercial
securement device or tape.
28 Discards used supplies in the appropriate receptacle.
29 Removes and discards gloves and any other personal
protective equipment worn.
30 Performs hand hygiene.
*31 Documents the procedure (Date & time, procedure name,
which nostril, tube size, verification method, any
unexpected outcomes and signature).
(*) Critical elements
Calculation of Marks: No. of Correct Steps performed / Total No. of steps x 10%

Total No. of Items performed correctly


Marks scored = -------------------------------------------- = ------------------------ × 10 =
Total Score 62

Adult Health Nursing II Laboratory AY 2020-2021 Page 29


Name of the Student: Examiner:
Student No. Date:
Group:
Marks Scored: ___________ / 10 % Remarks (If any):
NASOGASTRIC TUBE REMOVAL
PERFORMANCE CHECKLIST
S# Steps SCORE Comment/s
C PC NC
2 1 0
*1 Verifies the physician’s order for NGT removal.
2 Gathers the equipment.
*3 Performs hand hygiene and dons non-sterile gloves. (PPE if
exposure to bodily fluids anticipated).
*4 Confirms the patient's identity using at least two patient identifiers.
(Checks I/D and asks full name)
5 Explains the procedure to the patient, informing him/her that it may
cause some nasal discomfort and sneezing or gagging.
6 Provides privacy by closing the door to the patient’s room and/or
drawing the curtain surrounding the patient’s bed.
*7 Helps the patient into semi Fowler position.
8 Drapes a towel or fluid impermeable pad across the patient's chest.
9 Checks the placement of the tube to ensure it before flushing.
10 Flush the tube with 30 mL of air or normal saline to clear it from
gastric drainage.
11 Removes the securing tape from the patient's nose.
12 Clamps the NG tube by folding it in your hand to prevent spillage of
gastric content.
*13 Asks the patient to hold his/her breath and withdraws the tube
gently and steadily; upon reaching the nasopharynx, withdraws it
quickly.
14 Covers and removes the tube immediately.
15 Assists with oral care.
16 Cleans any tape residue from the patient's nose.
17 Disposes of used equipment in an appropriate receptacle.
18 Removes and discards gloves and PPE , if worn.
19 Performs hand hygiene.
20 Cleans and disinfects stethoscope using a disinfectant pad.
21 Performs hand hygiene.
*22 Documents the procedure (date, time, procedure, unexpected
outcomes and signature.
(*) Critical elements
Calculation of Marks: No. of Correct Steps performed / Total No. of steps x 10%

Total No. of Items performed correctly


Marks scored = -------------------------------------------- = ------------------------ × 10 =
Total Score 44

Adult Health Nursing II Laboratory AY 2020-2021 Page 30


Name of the Student: Instructor:
Student No. Date:
Group:

COLOSTOMY AND ILEOSTOMY, APPLIANCE CARE


PERFORMANCE CHECKLIST
S# Steps SCORE Comments
C PC NC
2 1 0
1 Gathers the appropriate equipment.
*2 Performs hand hygiene and dons non-sterile gloves. (PPE if
exposure to bodily fluids anticipated).
3* Confirms the patient's identity using at least two patient
identifiers. (Checks I/D and asks full name)
4 Introduces self and explains the procedure to the patient.
5 Provides privacy by closing the door to the patient’s room
and/or drawing the curtain surrounding the patient’s bed.
*6 Determines the best pouching system and fit the skin
barrier and pouch for the individual patient
7 Observes the stoma for color and size – stoma should be pink
to bright red and shiny
8 Empties, remove and discards the old pouch, if applicable.
*9 Wipes the stoma and peristomal skin with a soft cloth or
Gauze.
10 Cleans, dry, and assesses the peristomal skin. Consult the
Practitioner or a wound, ostomy, continence nurse, as needed.
11 Places a skin barrier over the stoma, if needed.
12 For a one-piece pouch, centers the pouch opening over the
stoma, and secured it by pressing gently
13 For a pouching system with flanges, aligns the lip of the
pouch flange with the bottom edge of the skin barrier flange
and press until the pouch securely adheres to
the barrier flange.
14 Encourages the patient to remain still for 5 minutes.
15 Leaves a small amount of air in the pouch and applies a
closure clamp, if necessary.
16 Disposes of all used supplies in appropriate receptacles
17 Removes and discards gloves and PPE , if worn.
18 Performs hand hygiene
19 Documents the procedure.
(*) Critical elements
Calculation of Marks: No. of Correct Steps performed / Total No. of steps x 10%

Total No. of Items performed correctly


Marks scored = -------------------------------------------- = ------------------------ × 10 =
Total Score 38

Adult Health Nursing II Laboratory AY 2020-2021 Page 31


Name of the Student: Examiner:
Student No. Date:
Group:
Marks scored: Remarks (if any)

INDWELLING URINARY CATHETER (FOLEY) INSERTION, FEMALE


PERFORMANCE CHECKLIST

S# Steps SCORE
C PC NC Comments
2 1 0
*1 Verifies the practitioner's order.
2 Checks the patient's medical record for allergies including latex
and iodine.
3 Gathers the appropriate equipment.
4 Obtains the assistance of a coworker, as needed.
*5 Performs hand hygiene and dons non-sterile gloves. (PPE if
exposure to bodily fluids anticipated).
*6 Confirms the patient's identity using at least two patient
identifiers. (Checks I/D and asks full name)
*7 Provides privacy by closing the door to the patient’s room
and/or drawing the curtain surrounding the patient’s bed.
8 Introduces self and explains the procedure to the patient.
9 Raises the patient's bed to waist level.
*10 Positions the patient supine or in a lithotomy position with her
knees bent and legs abducted; Alternately, positions on her
side in a knee chest position if necessary. A rolled towel or an
inverted bedpan placed under the hips to tilt the pelvis upward
may help improve visualization.
11 Places a fluid impermeable pad on the bed between the patient's
legs and under her hips.
12 Opens the outer packaging of the prepackaged insertion kit and
place it between the patient's legs.
13 Wash the patient's perineal area with warm water and soap.
Rinse and dries thoroughly. Alternately, if the catheter insertion
kit contains soap containing wipes, used them to clean the
perineal area.
14 Removes and discards gloves.
*15 Performs hand hygiene.
*16 Using sterile technique, opens the insertion kit wrap.
*17 Put on sterile gloves.

Adult Health Nursing II Laboratory AY 2020-2021 Page 32


S# Steps SCORE
C PC NC Comments
2 1 0
*18 Places the sterile under pad drape beneath the patient; shields
gloves by cuffing the drape material over the gloved hands.
*19 Places a sterile fenestrated drape over the perineal area.
*20 Tears open the packet of antiseptic swabs or saturate
applicators or the sterile cotton balls with antiseptic solution.
Be careful not to spill the solution on the equipment.
21 Opens the container of water soluble lubricant and deposits the
lubricant into the insertion kit tray.
22 If not pre-connected, attaches the drainage bag to the other end of
the catheter.
23 Attaches the syringe filled with sterile water to the balloon. Don't
pretest the balloon unless dictated by the manufacturer.
24 Separates the labia majora and labia minora with the thumb,
middle, and index finger of your non-dominant hand.
25 With your dominant hand, uses an antiseptic swab or antiseptic
soaked. Applicator or pick up a sterile antiseptic soaked cotton
ball with the plastic forceps to clean the labia minora furthest
from you using a downward stroke and discard the swab or cotton
ball. Repeat for the labia minora closest to you. Use another swab
or antiseptic soaked cotton ball to clean the area between the labia
minora.
*26 Maintaining sterile technique, picks up the catheter with your
dominant hand and lubricate the catheter tip with water soluble
lubricant.
*27 Held the catheter 2" to 3" (5 cm to 7.6 cm) from the tip and
slowly insert the lubricated catheter tip into the urinary meatus.
28 Continues to hold the labia apart until the urine begins to flow,
and advances the catheter about 2" to 3" (5 cm to 7.6 cm) further.
*29 Inflates the balloon with the previously attached water filled
syringe. Gently pull the catheter until the inflated balloon is
snug against the bladder neck.
30 Secures the catheter to the patient's thigh using a securement
device.
31 Keeps the catheter and collecting tube free from kinking.
*32 Positions the drainage bag below the level of the patient's
bladder; Doesn’t allow the drainage bag to rest on the floor.
33 Disposes all used supplies in the appropriate receptacles.
34 Removes and discards gloves and other personal protective
equipment, if worn.
35 Returns the bed to the lowest level.
*36 Performs hand hygiene.
*37 Documents the procedure.
(*) Critical elements

Adult Health Nursing II Laboratory AY 2020-2021 Page 33


Calculation of Marks: No. of Correct Steps performed / Total No. of steps x 10%

Total No. of Items performed correctly


Marks scored = -------------------------------------------- = ------------------------ × 10 =
Total Score 74

Adult Health Nursing II Laboratory AY 2020-2021 Page 34


Name of the Student: Examiner:
Student No. Date:
Group:
Marks scored: Remarks (if any)

INDWELLING URINARY CATHETER (FOLEY) INSERTION, MALE


PERFORMANCE CHECKLIST

S# Steps Score
C PC NC Comments
2 1 0
*1 Verifies the practitioner's order.
2 Checks the patient's medical record for allergies, including latex
and iodine.
3 Gathers the appropriate equipment.
4 Obtains the assistance of a coworker, as needed.
*5 Performs hand hygiene and dons non-sterile gloves. (PPE if
exposure to bodily fluids anticipated).
*6 Confirms the patient's identity using at least two patient
identifiers. (Checks I/D and asks full name)
*7 Provides privacy by closing the door to the patient’s room and/or
drawing the curtain surrounding the patient’s bed.
8 Introduces self and explains the procedure to the patient.
9 Raises the patient's bed to waist level.
*10 Positions the patient supine with his legs extended and flat on
the bed.
11 Places a fluid impermeable pad on the bed between the patient's
legs and under his hips.
12 Opens the outer packaging of the prepackaged insertion kit and
place it between the patient's legs.
13 Washes the patient's periurethral area with warm water and soap.
Rinse and dries Alternately, if the catheter insertion kit contains
soap containing wipes, use them to clean the periurethral area.
14 Removes and discards gloves.
*15 Performs hand hygiene.
*16 Using sterile technique, opens the insertion kit wrap.
*17 Puts on sterile gloves.
*18 Places the sterile under pad drape beneath the patient; shield
your gloves by cuffing the drape material over your gloved
hands.
*19 Places a sterile fenestrated drape over the patient's lower
abdomen and upper thighs so that only the genital area remains
exposed.

Adult Health Nursing II Laboratory AY 2020-2021 Page 35


S# Steps Score
Comments
C PC NC
2 1 0
*20 Tears open the packet of antiseptic swabs or saturate sterile
applicators or cotton balls with antiseptic solution.
21 Opens the container of water soluble lubricant and deposit the
lubricant into the insertion kit tray.
22 If not pre-connected, attach the drainage bag to the other end of
the catheter.
23 Attaches the syringe filled with sterile water to the balloon
inflation port. Don't inflate balloon before insertion unless directed
by the manufacturer.
*24 Holds the penis with non-dominant hand, stretches to a 60 -to 90
degree. Retracts the foreskin of an uncircumcised penis and
gently positions the penis.
25 Properly cleans the glans with antiseptic swabs or antiseptic
soaked sterile applicators or cotton balls held in forceps.
*26 Inserts the catheter with dominant hand. Hold the catheter 2" to
3" (5 cm to 7.6 cm) from the tip.
*27 Asks the patient to cough as you're inserting the catheter and
instructs to breathe slowly and deeply.
28 Advances the catheter to the bifurcation and checks for urine flow.

*29 When the urine stops flowing, inflates the balloon by using the
water filled syringe. Gently pull the catheter until the inflated
balloon is snug against the bladder neck.
*30 Hangs the collection bag below bladder level.
31 Secures the catheter using a catheter securement device, or tapes
the catheter to the patient's abdomen or thigh.
32 Returns the bed to the lowest position.
33 Discards all used supplies in appropriate receptacles.
34 Removes and discards gloves and PPE, as used.
*35 Performs hand hygiene.
*36 Documents the procedure.
(*) Critical elements

Calculation of Marks: No. of Correct Steps performed / Total No. of steps x 10%

Total No. of Items performed correctly


Marks scored = -------------------------------------------- = ------------------------ × 10 =
Total Score 72

Adult Health Nursing II Laboratory AY 2020-2021 Page 36


Name of the Student: Examiner:
Student No. Date:
Group:
Marks Scored: ___________ / 10 % Remarks (If any):

EYE DROP ADMINISTRATION


PERFORMANCE CHECKLIST

S# Steps SCORE Comment/s


C PC NC
2 1 0
*1 Verifies the physician’s order for the prescribed
medication.
2 Checks the patient’s medical record for an allergy
or contraindication to the prescribed medication.
*3 Performs hand hygiene and dons non-sterile gloves. (PPE if
exposure to bodily fluids anticipated).
4 Gathers and prepares the appropriate equipment.
*5 Checks the expiration date. If the medication is expired,
return it to the pharmacy and obtain new medication.
6 Visually inspects the medication for discoloration and any
other signs of loss of integrity.
7 Warms the medication to room temperature by rolling the
bottle between your hands for about 30 seconds, if needed.
*8 Confirms the patient's identity using at least two patient
identifiers. (Checks I/D and asks full name)
9 Provides privacy by closing the door to the patient’s room
and/or drawing the curtain surrounding the patient’s bed.
10 Teaches about possible adverse reactions and discusses any
other concerns related to the medication if he/she is
receiving the medication for the first time.
*11 Verifies administering the medication at the proper time, in
the prescribed dose, and by the correct route.
12 Introduces self and explains the procedure to the patient.
13 Removes the patient's eye dressing, if present, by gently
pulling it down and away from the forehead.
14 Cleans around the eye with gauze pads moistened with warm
water or normal saline solution.
15 Removes and discards gloves.
*16 Performs hand hygiene.
17 Puts on new gloves as needed.
*18 Have the patient tilted the head back and toward the side of
the affected eye.

Adult Health Nursing II Laboratory AY 2020-2021 Page 37


S# Steps SCORE
C PC NC
2 1 0
19 Removes the bottle cap and place it on a clean, dry surface.
*20 Instructs the patient to look up and away and then instills
the drops in the conjunctival sac.
21 Instructs the patient to close her eyes gently.
22 Gently press your thumb on the inner canthus for 2 to 3
minutes.
23 Uses a sterile gauze.to remove excess solution leaking from
the eye.
24 Replaces the medication cap.
25 Applies a new eye dressing if necessary.
26 Replaces the equipment.
27 Removes and discard the PPE, if used.
28 Performs hand hygiene.
*29 Documents the procedure (date, time, name, dose and route
of medicine, any unexpected outcomes, signature)
(*) Critical elements

Calculation of Marks: No. of Correct Steps performed / Total No. of steps x 10%

Total No. of Items performed correctly


Marks scored = -------------------------------------------- = ------------------------ × 10 =
Total Score 58

Adult Health Nursing II Laboratory AY 2020-2021 Page 38


Name of the Student: Examiner:
Student No. Date:
Group:
Marks Scored: ___________ / 10 % Remarks (If any):

EYE OINTMENT APPLICATION


PERFORMANCE CHECKLIST
S# Steps SCORE Comment/s
C PC NC
2 1 0
*1. Verifies the physician’s order for the prescribed
medication.
2. Gathers and prepares the medication and equipment.
3. Compares the medication label to the practitioner's
order; Confirms the correct eye for treatment.
4. Checks the patient's medical record for an allergy or
other contraindication to the prescribed medication.
*5. *Checks the expiration date on the medication, and
obtain new medication if it's expired.
6. Visually inspects the medication for discoloration and
other signs of loss of integrity.
7. Warms the medication tube as needed.
8. Performs hand hygiene and dons non-sterile gloves.
(PPE if exposure to bodily fluids anticipated).
*9 Confirms the patient's identity using at least two patient
identifiers. (Checks I/D and asks full name)
10 Introduces self and explains the procedure to the patient.
11. Provides privacy by closing the door to the patient’s
room and/or drawing the curtain surrounding the
patient’s bed.
12. Teaches about possible adverse reactions and discusses
any other concerns related to the medication if he/she is
receiving the medication for the first time.
*13. Verifies before administering the medication at the
proper time, in the prescribed dose, and by the correct
route.
14. Have the patient sit or lie down in the supine position.
15. Removes the patient's eye dressing, if present, by gently
pulling it down and away from the forehead.
16. Cleans around the eye with sterile gauze pads moistened
with warm water or normal saline solution from inner
canthus to outer canthus.
17. Removes and discards gloves.

Adult Health Nursing II Laboratory AY 2020-2021 Page 39


S# Steps SCORE Comment/s
C PC NC
2 1 0
18. Performs hand hygiene.
19. Puts on new gloves.
*20. Instructs the patient to tilt his head back.
*21. Applies eye ointment to the edge of the conjunctival sac
from the inner canthus to the outer canthus onto the
lower lid without touching the tube tip to the client’s
eye or eyelid or your hands or fingers.
*22. Instructs the patient to close his eyes gently without
squeezing the lids shut and to roll his eyes behind the
closed lids.
*23. Waits for 10 minutes before applying a second ribbon
of medication.(if applicable)
24. Uses a clean tissue to remove any excess solution or
ointment leaking from the eye.
25. Applies a new eye dressing if necessary.
26. Reapplies the cap to the medication tube and return it to
the storage area.
27. Removes and discards gloves and PPE , if worn.
28. Performs hand hygiene.
*29. Documents the procedure (date, time, name, dose and
route of medicine, any unexpected outcomes, and
signature).
(*) Critical elements

Calculation of Marks: No. of Correct Steps performed / Total No. of steps x 10%

Total No. of Items performed correctly


Marks scored = -------------------------------------------- = ------------------------ × 10 =
Total Score 58

Adult Health Nursing II Laboratory AY 2020-2021 Page 40


Name of the Student: Examiner:
Student No. Date:
Group:
Marks Scored: ___________ / 10 % Remarks (If any):

EYE PATCH APPLICATION


PERFORMANCE CHECKLIST
S# Steps SCORE Comment/s
C PC NC
2 1 0
*1. Verifies the physician’s order.
2. Gathers the appropriate equipment.
*3. Performs hand hygiene and dons gloves (PPE as
Necessary).
*4. Confirms the patient's identity using at least two
patient identifiers. (Checks I/D and asks full name)
5. Provides privacy by closing the door to the patient’s
room and/or drawing the curtain surrounding the
patient’s bed.
6. Introduces self and explains the procedure to the
patient.
7 Positions the patient either supine or seated with the
head tilted slightly backward and the eye(s) to be
treated facing upwards.
8 Cleans the dressing area around the eye gently and
then dry it thoroughly.
9 Applies ophthalmic ointment or instill drops, if
prescribed, following safe medication administration
practices.
*10. Chooses a gauze pad or a commercial eye patch of
appropriate size and place it gently over the closed
eye. (Places the straight edge of the folded eye pad
over the top of the closed eyelid)
11 Places a plastic or metal shield on top of the gauze pad
if needed.
*12. Secures the gauze or patch with strips of tape,
extending from the mid forehead across the gauze or
patch and to below the earlobe. Avoid taping the
eyebrow if possible.
13 Applies a pressure patch, if ordered, by applying
additional gauze pads and tape it firmly.
14 Disposes used materials appropriately.
15 Removes and discards PPE, if worn.
16 Performs hand hygiene.
*17 Documents the procedure (date, time, name of
procedure, any unexpected outcomes, and signature).
(*) Critical elements

Adult Health Nursing II Laboratory AY 2020-2021 Page 41


Calculation of Marks: No. of Correct Steps performed / Total No. of steps x 10%

Total No. of Items performed correctly


Marks scored = -------------------------------------------- = ------------------------ × 10 =
Total 34

Adult Health Nursing II Laboratory AY 2020-2021 Page 42


Name of the Student: Examiner:
Student No. Date:
Group:
Marks Scored: ___________ / 10 % Remarks (If any):

EAR DROP INSTILLATION


PERFORMANCE CHECKLIST

S# Steps SCORE Comment/s


C PC NC
2 1 0
*1 Verifies the physician’s order for the prescribed
medication.
2 Gathers and prepares the medication and the equipment.
3 Selects the correct medication and compares the label
to the order in the patient's medical record.
4 Checks the patient's medical record for an allergy or other
contraindication to the prescribed medication.
*5 Checks the expiration date on the medication
6 Visually inspects the medication for particles,
discoloration, or other signs of loss of integrity.
*7 Performs hand hygiene and dons non-sterile gloves (PPE
as necessary).
*8 Confirms the patient's identity using at least two patient
identifiers. (Checks I/D and asks full name)
9 Provides privacy by closing the door to the patient’s room
and/or drawing the curtain surrounding the patient’s bed.
10 Teaches about potential adverse effects or other concerns
related to the medication if the patient is receiving the
medication for the first time.
*11 Verifies that the medication is being administered at the
proper time, in the prescribed dose, and by the correct
route.
*12 Confirms in which ear he/she must administer the
medication.
13 Explains the procedure to the patient.
*14 Have the patient sit or lie with his head turned to the
unaffected side.
15 Straighten and examines the ear canal, and then removes
any drainage using normal saline (NS) and gauze.
*16 Holding the ear canal straight, instills the ordered
number of eardrops in the correct ear.
Aims the drops toward the side of the ear canal, not at
the tympanic membrane.
17 Massages the tragus to promote distribution of the
medication into the Otis externa.
18 Instructs the patient to remain with his head to the side and
ear canal open for 3 to 5 minutes.

Adult Health Nursing II Laboratory AY 2020-2021 Page 43


S# Steps SCORE Comment/s
C PC NC
2 1 0
*19 Repeats the procedure in the other ear after 3 to 5
minutes, if ordered.
20 Monitors the patient for signs of local irritation, itching,
stinging, or burning or if you feel dizzy or nauseous or
experience vertigo or indication of allergic reaction to the
medication instilled
21 Removes and discards PPE, if worn.
22 Performs hand hygiene.
*23 Documents the procedure (Date and time, procedure,
name of medication, number of drops, site, and
signature).

(*) Critical elements

Calculation of Marks: No. of Correct Steps performed / Total No. of steps x 10%

Total No. of Items performed correctly


Marks scored = -------------------------------------------- = ------------------------ × 10 =
Total Score 46

Adult Health Nursing II Laboratory AY 2020-2021 Page 44


Name of the Student: Examiner:
Student No. Date:
Group:
Marks scored: Remarks (if any)

POSITIONING PATIENT AFTER STROKE

PERFORMANCE CHECKLIST

S# Steps SCORE
C PC NC Comments
2 1 0
*1 Performs hand hygiene and dons non-sterile gloves.
(PPE if exposure to bodily fluids anticipated).
2 Provides privacy by drawing curtain surrounding the
patient’s bed.
*3 Puts bed in flat position
A. Moving immobile client up in bed (one nurse):
4 Places client on back with head of bed flat; stand on
one side of bed.
5 Places pillow at head of bed.
6 Correctly moves client up in bed.
7 Keeps arms level with client’s hip.
8 Slides client’s hip diagonally toward head of bed.
9 Maintains proper body alignment.
10 Supports client’s head on worker’s arm nearest the
head of bed.
11 Places the other arm under client’s chest.
12 Slides client’s head, shoulders, and chest toward head
of bed.
13 Raises side rail next to client and repositioned self on
other side of bed.
14 Repeats procedure until client reached desired height in
bed.
15 Correctly centers client in middle of bed.
B. Assisting client to move up in bed (one or two nurses):
16 Places client on back with head of bed flat.
17 Places pillow at head of bed.
18 Faces head of bed.
19 Stands in proper position.
20 Asks client to flex knees.
21 Instructs client to flex neck.
22 Instructs client to push feet on bed surface to assist
movement.
23 Instructs client to push heels and elevate trunk.
24 Shifts weight while client elevated trunk
Adult Health Nursing II Laboratory AY 2020-2021 Page 45
S# Steps SCORE Comments
C PC NC
2 1 0

C. Moving immobile client up in bed using draw sheet (two nurses):

25 Places draw sheet under client.


26 Places client on back with bed flat.
27 Positions one nurse at each side of client.
28 Grasps draw sheet firmly near client.
29 Maintains proper body alignment while shifting weight
to move client and draw sheet to desired position.
D. Realigning client in proper body alignment.

30 Elevates head of bed 45-60 degrees.


31 Places small pillow under thighs.
32 Rests client’s head against mattress or placed small
pillow underneath client’s head.
33 Places pillows appropriately to support hands and arms
correctly.
34 Places pillow at lower back.
35 Places small pillow or roll under ankles.
36 Places footboard at bottom of client’s feet.
E. Positioning hemiplegic client in supported Fowler’s position:

37 Elevates head of bed 45-60 degrees.


38 Flexes knees and hips by using pillow.
39 Makes client sit up as straight as possible.
40 Positions client’s head with chin slightly forward.
41 Supports involved arm and hand.
42 Positions flaccid hand in normal resting position.
43 Positions affected hand with wrist in neutral or slightly
extended position.
44 Supports feet in dorsiflexed position
F. Positioning client in supine position:

45 Places client on back with bed flat.


46 Places small pillow under upper shoulders, neck, and
head.
47 Places trochanter rolls along hips and upper thighs.
48 Places small pillow or roll under ankle.
49 Places foot support to maintain feet in dorsiflexion.

Adult Health Nursing II Laboratory AY 2020-2021 Page 46


S# Steps SCORE Comments
C PC NC
2 1 0
50 Places pillows under pronated forearms. •
51 Places hand rolls to maintain hands in functional
position.
G. Positioning hemiplegic client in supine position:
52 Places head of bed flat.
53 Places folded towel or pillow under shoulder of
affected side.
54 Places affected arm properly.
55 Places affected hand properly.
56 Places folded towel under hip of involved side.
57 Flexes affected knee by 30 degrees.
58 Supports feet with soft pillows
H. Positioning client in prone position:
59 Places client on abdomen with bed flat.
60 Turns client’s head to one side supported by a small
pillow
61 Places a small pillow under client’s abdomen
62 Supports arms, flexed at shoulders on pillows
63 Places a pillow under lower legs to elevate toes off bed
I Positioning hemiplegic client in prone position:
64 Moves client toward unaffected side.
65 Rolls client onto side.
66 Places pillow on client’s abdomen.
67 Turns head toward involved side.
68 Positions involved arm properly.
69 Flexes knees and placed pillows correctly.
70 Maintains feet at right angles
J. Positioning client in lateral (side-lying) position:
71 Lowers head of bed to comfortable level.
72 Positions client on one side of bed.
73 Turns client onto one side.
74 Places a pillow under client’s head and neck.
75 Brings shoulder blade forward.
76 Positions arms in slightly flexed position.
77 Places a pillow behind client’s back.
78 Places a pillow under upper leg.

Adult Health Nursing II Laboratory AY 2020-2021 Page 47


S# Steps SCORE Comments
C PC NC
2 1 0
79 Places a sandbag parallel to plantar surface of foot.
K. Positioning client in Sim’s (semi prone) position:
80 Lowers head of bed completely.
81 Places client in supine position.
82 Positions client in lateral position partially lying on
abdomen.
83 Places pillow under client’s head.
84 Places pillow under flexed upper arm to support arm
level with shoulder.
85 Places pillow under flexed upper leg to support leg
level with hip
86 Places sandbags parallel to plantar surface of feet to
maintain feet in dorsiflexion.
87 Performs hand hygiene.
*88 Documents procedure in nurse’s notes including
condition of skin, joint movement, client’s ability to
assist with repositioning.
Source: Perry, Anne Griffin &Potter, Patricia A. (2010) Clinical Nursing Skills & Techniques, 7th ed.
Mosby, Elsevier, Inc. ISBN 978-0-323-05289-4

(*) Critical elements

Calculation of Marks: No. of Correct Steps performed / Total No. of steps x 10%

Total No. of Items performed correctly


Marks scored = -------------------------------------------- = ------------------------ × 10 =
Total Score 176

Adult Health Nursing II Laboratory AY 2020-2021 Page 48


Name of the Student: Examiner:
Student No. Date:
Group:
Marks Scored: ___________ / 10 % Remarks (If any):

ELASTIC COMPRESSION BANDAGE APPLICATION


PERFORMANCE CHECKLIST
S# Steps SCORE Comment/s
C PC N
C
2 1 0
*1. Verifies the practitioner’s order.
2. Reviews the patient’s medical record for contraindications.
3. Gathers the appropriate equipment.
*4. Performs hand hygiene and dons non-sterile gloves. (PPE if
exposure to bodily fluids anticipated).
*5. Confirms the patient's identity using at least two patient
identifiers. (Checks I/D and asks full name)
6. Provides privacy by closing the door to the patient’s room
and/or drawing the curtain surrounding the patient’s bed.
7. Introduces self and explains the procedure to the patient.
8. Positions the patient comfortably with the body part to be
wrapped in a normal functioning position.
9. Inspects the area to be wrapped for lesions or skin
breakdown, taking action appropriate to the findings.
10. Cleans and dry the skin surface on the area to be wrapped and
applies a skin barrier cream as indicated.
11. If applying a compression wrap, obtains the assistance of a
wound care nurse or other practitioner competent in the
application of compression wraps as needed.
12. Before applying an elastic compression bandage to an
extremity with significant dependent edema, elevates the
extremity for 15 to 30 minutes.
13. Places gauze pads or absorbent cotton as needed between
skin surfaces such as toes and fingers, or under breasts and
arms.
*14 Holds the elastic compression bandage with the roll facing
upward, unrolled it and wrap the body part ensuring equal
tension and pressure.
*15 When wrapping an extremity, begin wrapping at the most
distal part and work proximally. Anchoring the elastic
compression bandages initially by circling the body part
twice. If wrapping the foot, also wraps the heel; don’t wrap
the toes.

Adult Health Nursing II Laboratory AY 2020-2021 Page 49


S# Steps SCORE Comment/s
C PC NC
2 1 0
*16 Overlaps each layer of the elastic compression bandage by
one-half to two-thirds of the width of the strip.
17. As you wrap, asks the patient whether he feels tingling,
itching, numbness or pain; loosen the elastic compression
bandage if he/ she responds affirmatively.
18. Secures the end of the elastic compression bandage with tape
or self-closure.
19. Assesses the patient’s distal circulation immediately after the
elastic compression bandage has been secured and every 4
hours thereafter.
20. If the wrapped body part is an extremity, elevated it for 15 to
30 minutes after wrapping.
21. Removes the elastic compression bandage every 8 hours or
when it’s loose or wrinkled and replaces it at least once daily.
22. Removes and discards gloves and PPE, if worn.
23. Performs hand hygiene.
*24. Documents the procedure.
Total Marks
(*) Critical elements

Calculation of Marks: No. of Correct Steps performed / Total No. of steps x 10%

Total No. of Items performed correctly


Marks scored = -------------------------------------------- = ------------------------ × 10 =
Total score 48

Adult Health Nursing II Laboratory AY 2020-2021 Page 50


OMAN COLLEGE OF HEALTH SCIENCES
Adult Health Nursing II
LAB SKILLS LOG SHEET
Student Name Student ID: Group:

S# Name of the Procedure Re-demo 1 Comments/ Re-demo 2 Comments/ Re-demo 3 Comments/


Date Sign Date Sign Date Sign

1. Assessment of Gastrointestinal System


2. Gastrointestinal Intubation (NGT
Insertion)
3. Gastrointestinal Intubation (NGT
Removal)
4. Colostomy / Ileostomy Appliance Care
5. Assessment of Kidney & Urinary
Function
6. Insertion & Care of Foley’s catheter
(Male/Female)
7. Assessment of Integumentary Function
8. Assessment of the Eye and Vision

9. Eye Patch Application

10. Instilling Eye Medications: Eye Drops


& Eye Ointment
11. Assessment of Patients with Hearing
and Balance Disorders
12. Instilling Ear medications (Drops)
13. Assessment of Neurological function

14. Positioning Patient after Stroke

Adult Health Nursing II Laboratory AY 2020-2021 Page 51


S# Name of the Procedure Re-demo 1 Comments/ Re-demo 2 Comments/ Re-demo 3 Comments/
Date Sign Date Sign Date Sign

15. Assessment of Musculoskeletal


Function
16. Assisting with Application of Skin
Traction
17. Assisting with Cast Application
(Plaster of Paris & Fiberglass)
18. Assisting with Cast Removal

19. Application of Sling

20. Bandage application

Teacher’s Signature

Overall Remarks

Adult Health Nursing II Laboratory AY 2020-2021 Page 52

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