TERNOPIL STATE MEDICAL UNIVERSITY

 

 

TERNOPIL STATE MEDICAL UNIVERSITY

INSTITUTE OF NURSING

DEPARTMENT OF CLINICAL IMMUNOLOGY, ALLERGOLOGY

AND GENERAL PATIENT CARE

 

 

“CONFIRMED”

Vice-rector of tsmu

Prof. Ihor R. Mysula

M.D., Ph.D, d.m.

24.06.2010

 

SylLabus

 

NURSING CARE OF ADULTS IІI Practicum

 

for 2^nd year ADN students

Specialty 5.12010102 „Nursing”

 

Structural Academic Plan

 

 

 

Prepared by                                                               Iryna Iavorska, MD,BSN

                                                                               Volodymyr Horodetsky, MD, PhD

 

The program was discussed at Department meeting. Minute № 12 from June 10, 2009.

The Head of department                                                 Prof. I. Ya. Hospodarsky

 

The program was confirmed at Nursing School cycle methodological commission.

Minute №___7____ from __June 23, 2009__

 

The Head of commission                             As. Prof. S.O. Yastremska, Ph.D, BSN

 

Ternopil 2009

 

 

SYLLABUS:  SPRING 2010

 

Faculty: Volodymyr Gorodetsky, MD, PhD

            Iryna Iavorska, MD, BSN

Room No.:   Nursing 06

Office Telephone No.:  +380 352 430927

Office Hours Posted or Additional by appointment

E-mail: [email protected]

         

 

I.          Course Description

            Clinical applications of theoretical concepts for the nursing care of adults with acute and chronic health care needs, utilizing the nursing process for advanced clinical decision making. Coordination and management of care for a group of clients in acute care settings is emphasized utilizing basic management principles.

 

Prerequisites:    Nursing Care of Adults II, Nursing Care of Adults II Practicum

 

            Corequisites:     Nursing Care of Adults III

 

8.7 hrs lab per week (for 11 weeks) 

US Credit hours: 2

UA: Total hours 125

        Contact hours: 96

        Practical classes hours: 96

        Independent study hours: 23

        ECTS credits: 4

 

II.        Conceptual Framework

                        Health

                        Patient

                        Nursing

                        Nurse

                        Setting

 

III.       Course Goals and Objectives

 

            A.        Course Content:  This course is designed to allow clinical application of theoretical concepts essential to the nursing care of adults at various stages of adaptation on the health-illness continuum with respect to potential and actual complex humaeeds interferences. This course also allows for clinical application of basic nursing leadership and management skills.

            B.        Course Goals:  This course will enable the participant to perform and expand assessment skills, formulate and prioritize nursing diagnoses, implement nursing interventions and evaluate patient outcomes at an advanced level.

            C.        Course Objectives:  Upon completion of this course, the participant will be able to independently and/or with consultation of faculty:

 

                        a.         Basic Human Needs

            1.         Assist adult patients in resolving humaeed interferences.

            2.         Plan care consistent with goals, recognizing the interrelatedness of basic humaeeds.

                        b.         Nursing Process

            1.         Apply the nursing process as a framework for determining nursing care for adult patients experiencing interferences in humaeeds in both the acute and community based setting.

          2.           Collect, cluster, interpret and validate assessment data (to include diagnostic studies) as it specifically relates to individuals experiencing interferences in the human needs within the nursing process framework.           

3.         Formulate and prioritize actual and/or potential nursing diagnoses

4.         Construct measurable goals for adults experiencing interferences in humaeeds.

            5.         Plaursing care consistent with goals and organized by priority of needs.

            6.         Prioritize and perform nursing interventions (to include pharmacologic and nutritional interventions) appropriate to individuals experiencing interferences in humaeeds. Interventions will reflect adaptations appropriate to variant patient situations and established agency policies and procedures.

            7.         Evaluate goal attainment according to established outcome criteria to determine the effectiveness of nursing interventions and resolution of humaeeds interferences.

                        c.         Manager of Care

1.         Manage an organized plan of care for adults in collaboration with other members of the health team, considering safety, resources, and time management.

                        d.         Communication

            1.         Communicate therapeutically with patients and family members using effective communication skills during interactions.

            2.         Communicate effectively when documenting the delivery of health care.

                        e.         Caring

            1.         Apply knowledge of cultural diversity in planning and implementing nursing care.

            2.         Provide nursing care to patients with interferences in humaeeds in a manner that is empathetic, respectful of individual needs, and is unconditional iature.

            3.         Implement nursing interventions that facilitate physical and emotional independence of patients with interferences in humaeeds.

            4.         Implement nursing interventions that meet anticipatory needs of adults experiencing interferences in humaeeds.

            5.         Collaborate with individuals and family members experiencing interferences in humaeeds when developing a plan of care.

            6.         Function as a patient advocate for individuals experiencing interferences in humaeeds.

                        f.          Teaching/Learning

1.         Apply appropriate principles in meeting teaching/learning needs of adults across the health-illness continuum.

2.         Develop a teaching plan with consideration of developmental levels and resources for a client in the home setting.

                        g.         Skills

            1.         Perform previously learned skills independently and with faculty supervision according to established criteria and critical elements when providing patient care.

            2.         Integrate cognitive, psychomotor and effective dimensions in the performance of previously learned skills.

                        h.         Responsibility/Accountability

            1.         Demonstrate responsibility and accountability as a provider of care to adults experiencing interferences in humaeeds.

            2.         Discuss the findings of nursing research on specific nursing actions.

            3.         Provide patient care within an ethical and legal framework.

          4.           Discuss moral and ethical issues that impact individuals experiencing interferences in humaeeds and their family members both the acute and community based setting.

 

IV.       Methods of Instruction

           

Critical thinking exercises, group discussion in clinical pre and post conferences, observational experiences, nursing care of selected clients in acute care settings, computer assisted instructions and video programs.

 

V.        Course Requirements and Grade Calculations

 

            A.        Course Requirements

                        1.         See items 2-10 for specific assignments

a.         The schedule of course events is subject to change in the event of unforeseen circumstances. Notice will be given if the schedule will vary.

                        2.         Comprehensive drug calculation competency exam (75 % is required to successfully complete course; you will have three opportunities to complete this requirement). See course calendar for dates of required drug dosage calculation quizzes. The following calculations will be included on the exam:

                                   a.         oral medications

                                   b.         parenteral medications

                                               -premixed solutions

                                   c.         intravenous medications

                                               -calculation of flow rates

                                               -calculation of infusion times

                                               -adding drugs to IV fluids

                                               -calculating drug infusion rates (i.e. Heparin drip using a protocol)

                                   d.         Students will be expected to perform calculations based on body weight

                                   e.         All calculations must be shown on the quiz

                        3.         Skills competency evaluation for previously learned skills will be done on the second day of clinical. Each student will randomly select TWO of the following skills to perform to be evaluated/validated by the instructor during a summative 1:1 evaluation opportunity.

                                   a.         Nasogastric tube insertion and removal

                                   b.         Indwelling catheterization of the female urinary bladder

                                   c.         Tracheostomy suctioning and care

                                   d.         Changing the central intravenous line dressing

e.        Insulin injection and intramuscular injection

                                   f.          Intermittent IV medication via existing IV fluids

                                   g.         IV bolus medication via peripheral INT

                                   h.         Intermittent IV medication via unused port of a central intravenous catheter line

                                   i.          Irrigating the unused port of a central intravenous catheter

 

                                   NOTE:  Failure to demonstrate competency of skills will result in course failure.

                                                See Skills Evaluation Guidelines.

                        4.         One graded nursing care plan. Please submit the “Nursing Care Plan Grading Criteria” with the care plan.

                                   a.         Re-submissions ARE NOT allowed, however students have the option of asking the instructor to review the care plan PRIOR to submission for feedback.

                                   b.         Each care plan must consist of 3 nursing diagnosis excluding the use of “pain” and/or “knowledge deficit”. Students should use more than 3 nursing diagnoses if needed.

5.         One physical assessment forms with a grade of 90 or better is required. The physical assessment form will be graded using criteria of the “Nursing Assessment/Clinical Preparation Grading Criteria” form. The student must hand in a written assessment on each patient assignment until have been graded with a grade of 90 or above to obtain satisfactory. (p. 54) Students must make an appointment with the clinical instructor for assistance if unable to obtain a grade of 90 after two(2) assessments.

 

                        6.         Dialysis Paper – See Grading Criteria (p. 44)

7.         Endoscopy Paper – See Grading Criteria (p. 43)

                        8.         Clinical Exam

a.         Exam content will include questions related to skills (as outlined in syllabus), course objectives, delegation, and prioritization of patient care, math calculations, nursing leadership/management, observational experiences, and clinical foci.

                                   b.         Format of exam will be multiple choice, short answer and/or essay.

                        9.         Laboratory and Clinical Performance   

                                   a.         The participant is expected to demonstrate the following behaviors in laboratory and clinical experience:

1.   The day prior to each clinical experience, each student will go to the nursing unit and select a patient(s) for clinical the following day. The student will research the medical record for the patient’s history, diagnoses), labs, meds, and progress. The student should introduce themselves to each patient and visually assess the environment each day. The student is expected to communicate each assignment to the instructor as arranged.

2.   Be prepared for the laboratory or clinical experience by completing the Clinical Prep Tool and Medication Form for each assigned patient. Students are expected to hand in the Clinical Prep Tool during pre conference each day. (p. 48-50)

3.   Be on time for the laboratory or clinical experience

4.   Provide safe nursing care to patients during the clinical experience

5.   Contribute to post-conference discussions regarding (1) the findings of nursing research on specific nursing actions, (2) moral and ethical issues that impact individuals experiencing interferences in humaeeds and their family members both the acute and community based setting, and (3) related topics.

6.   Apply the basic principles of nursing leadership, management, delegation and prioritization of patient care.

7.   Pagers and cell phone use are not allowed during any clinical experience.

8.            Clinical and Laboratory Attendance

                                   a.         Attendance is required for all clinical and lab experiences. If a laboratory or clinical experience is missed, a clinical make-up day will be assigned if possible. A formal paper will be required for a second clinical absence.

 

            B.        Final Grade Calculation

                                   a.         Comprehensive drug calculation exam …..…….15 %

                                   b.         Skills competency evaluation ……………….….30 %

                                   c.         Average of all pop-quizzes …………………….…5 %

                                   d.         Dialysis Paper……………………………..……….5 %

                                   e.         Endoscopy Paper………………………….………..5 %

                                   f.          Nursing care plan……………………………….…15 %

                                   g.         Clinical exam………………………………..…….25 %

 

                    

C.        Grading Scale:

 

1-12 Points Grade (TSMU)	% of points	Amount of right answers (of 60)	Amount of right answers (of 100)	Letter Grade (US)	1-5 Mark (UA)
“12”	97-100	60-58	97-100	A+	5+ (Excellent)
“11”	93-96	57-55	93-96	A	5 (Excellent)
“10”	89-92	54-52	89-92	A–	5– (Excellent)
“9”	85-88	51-49	85-88	B+	4+ (Good)
“8”	81-84	48-46	81-84	B	4 (Good)
“7”	76-80	45-43	76-80	C+	4 – (Good)
“6”	72-75	42-40	72-75	C	3+ (Satisfactory)
“5”	68-71	39-37	68-71	D+	3 (Satisfactory)
“4”	64-67	36-34	64-67	D	3 – (Satisfactory)
“3”	60-63	33-31	60-63	F	2 (Failed)
“2”	59 & less	30 & less	59 & less	F	1 (Failed)

 

            D.        Student Responsibilities

1.      The instructional work of the course is designed for lab/clinical attendance and participation.

2.      Students are responsible for the content of all classes as outlined in the course syllabus, including announcements regarding policies and academic activities.

3.      Students are expected to complete assigned readings, computer assisted instruction, and videos prior to class. Class time will be used to discuss, clarify and supplement written materials. All content included in the reading assignments will not be repeated in class. The student is responsible for the assigned content regarding the clinical foci.

4.      Students are expected to be present for all scheduled tests. In the event that a student is unable to attend a scheduled test, the student must:

                                   a.         Notify the faculty member regarding absence PRIOR to the scheduled time for the test. In the event of an emergency on the day of the test, notify the faculty member as soon as possible.

                                   b.         Tests are to be made up during exam week.

                                   c.         Faculty reserves the right to change the test format when giving make-up test.  

5.         The student is expected to initiate a meeting with the instructor to determine how missed work/tests will be made up within 1 week of the absence.

6.         Clinical Practice (hospital or other health care agency)

                                   a.         Students are expected to adhere to *dress code, be punctual, and prepared for all scheduled clinical/laboratory experiences. Students who report to the clinical area late, unprepared and/or not in adherence to the dress code will be dismissed. This will count as a clinical absence.

                        b.         The faculty reserve the right to refuse clinical access at any time during the semester to a student who performs unsafe/unsatisfactory clinical practice.

                                   c.         Students are required to maintain current CPR & physical requirements to attend the clinical area.

                                  d.           Pre- and post-conferences are considered an essential component of the clinical experience and attendance is required. Students are evaluated on participation in these conferences.

e.       Violation of patients’ rights under HIPPA regulations constitutes cause for immediate clinical failure. Students MUST NEVER have any paperwork with a patient’s name on it.

           

VI.       Instructional Materials

            A.        Instruction Methods:  Demonstration/return demonstration of skills in laboratory and clinical settings, role modeling, care of selected patients in the clinical agency, role playing, conferences, discussion, independent learning modules, current nursing literature, computer programs and audio-visuals will be utilized to facilitate learning.

 

            B.        Required Textbooks:

                       

Ackley, B., & Ladwig, G. (2004). Nursing diagnosis handbook: A guide to                     planning care (6th ed.). St. Louis: Mosby.

Bates, B., Bickley, L. & Hoekelman, R. (2000). A pocket guide to physical examination and history taking (3^rd ed.). Philadelphia: Lippincott.

Hausman, K. & Ignatavicius, D. (2002). Clinical companion for medical-surgical nursing: Critical thinking for collaborative care (4^th ed.). Philadelphia: Saunders.

Ignatavicius, D. & Workman, L. (2002). Medical-surgical nursing: Critical

thinking for collaborative care (4^th ed.). Volume I & II. Philadelphia: Saunders.

Kennedy, E. (2002). Virtual clinical excursions for medical-surgical nursing: Critical thinking for collaborative care (4^th ed.). Philadelphia: Saunders.

Pagnana, K. D. & Pagnana, T. J. (2005). Mosby’s diagnostic and laboratory test reference (6^th ed.). St. Louis: Mosby Year Book.

Skidmore-Roth, L. (2005). Mosby’s drug guide for nurses. St. Louis:

Mosby.

Taylor, C., Lillis, C., & LeMone, P. (2001). Fundamentals of nursing: The

art and science of nursing care (4th ed.). Philadelphia: Lippincott.

Taylor, C., Lillis, C., & LeMoore, P. (2001). Study guide: Fundamentals of

nursing: The art and science of nursing care (4th ed.). Philadelphia: Lippincott.

Thomas, C. L. (Ed.). (2001). Taber’s cyclopedic medical dictionary (19th

ed.). Philadelphia: Davis.

United Way of the Piedmont. (2004). Directory of Services.

 

           

Refer to your previous textbooks used in Nutrition and Pharmacology, including clinical calculation book.

 

 

VI. Course Content: PRACTICAL CLASSES

 

#	Topic	Contact hours	Assignment	Date	Teacher
1.	Orientation to Nursing Unit Review equipment – HIPPA requirements.	7	Review syllabus, course requirements, and expectations. Care plans, policy changes, clinical rotation schedule	25.01	Dr. I.Iavorska
2.	Assessment of the Ear and Hearing	5	Chap. 48 (Ignatavicius, Workman) p. 1048-1060	27.01	Dr. Malovana
3.	Conditions affecting the external ear. Conditions affecting the middle ear.	5	Chap. 49 (Ignatavicius, Workman) p. 1061-1067	29.01	Dr. Malovana
4.	Conditions affecting the inner ear. Hearing loss.	5	Chap. 49 (Ignatavicius, Workman) p. 1067-1077	01.02	Dr. Malovana
5.	Assessment of the client with eyes and vision problems External eye disorders: eyelid disorders Traumatic disorders: hyphema, contusion, foreign bodies, laceration, penetrating injuries	5	Chap. 46 (Ignatavicius, Workman) p.1011-1023 Chap. 47 (Ignatavicius, Workman) p.1024-1031, 1043-1045	03.02	Dr. T Tabaluk
6.	Intraocular disorders: lens disorders: cataract, glaucoma Vitreous hemorrage, uveitis	5	Chap. 47 (Ignatavicius, Workman) p.1031-1039	04.02	Dr. T Tabaluk
7.	Retinal disorders: hypertensive retinopathy, diabetic retinopathy, macular degeneration Ocular melanoma Blindness	5	Chap. 47 (Ignatavicius, Workman) p.1039-1043, 1044-1047.	15.02	Dr. T Tabaluk
8.	Assessment of the Gastro-Intestinal System. Interventions for Clients with Oral Cavity Problems.	5	Chap. 53(Ignatavicius, Workman) p. 1159-1177 Chap. 54(Ignatavicius, Workman) p. 1178-1191	01.03	Dr. I.Iavorska
9.	Interventions for Clients with Esophageal, Stomach Disorders	7	Chap. 55-56 (Ignatavicius, Workman) p. 1192-1239.	15.03	Dr. I.Iavorska
10.	Interventions for Clients with Intestinal Disorders	5	Chap. 57, 58 (Ignatavicius, Workman) p. 1240-1298	22.03	Dr. I.Iavorska
11.	Interventions for Clients with Liver Disorders Clients with Malnutrition and Obesity	5	Chap. 59 (Ignatavicius, Workman) p. 1299-1326 Chap. 61 (Ignatavicius, Workman) p. 1356-1381	24.03	Dr. I.Iavorska
12.	Interventions for Clients with Problems of the Gallbladder and Pancreas	7	Chap. 60 (Ignatavicius, Workman) p. 1327-1355	29.03	Dr. I.Iavorska
13.	Assessment of the Renal/Urinary System.	5	Chap. 69 (Ignatavicius, Workman) p. 1589-1613	15.03	Dr. I.Iavorska
14.	Interventions for clients with renal problems: infectious disorders Interventions for clients with urinary problems: UTI	5	Chap. 71 (Ignatavicius, Workman) p. 1646-1654 Chap. 70 (Ignatavicius, Workman) p. 1614-1641	19.04	Dr. I.Iavorska
15.	Interventions for clients with renal problems: congenital, obstructive, degenerative disorders, kidney tumors	7	Chap. 71 (Ignatavicius, Workman) p. 1642-1646, 1654-1663.	22.04	Dr. I.Iavorska
16.	Interventions for clients with Acute and Chronic Renal Failure	3	Chap. 72 (Ignatavicius, Workman) p. 1664-1700	26.04	Dr. I.Iavorska
17.	Management of Clients with Problems of the Nervous System	5	Chap. 41-43 (Ignatavicius, Workman) p. 871-952	29.04	Dr. L.Vovchuk-Milevska
18.	Management of Clients with Problems of the Nervous System	5	Chap. 44-45 (Ignatavicius, Workman) p. 952-1010	11.05	Dr. L.Vovchuk-Milevska