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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum

WEST COAST UNIVERSITY DEPARTMENT OF NURSING COURSE TITLE: MEDICAL SURGICAL NURSING: PROMOTING WELLNESS IN OLDER ADULTS - PRACTICUM NURS 211L NURS 200 NURS 201

COURSE NUMBER: COURSE PREREQUISTES: COURSE COREQUISITES: INSTRUCTOR NAME:

DATE: CREDIT HOURS: COURSE LENGTH: 3 units 9 weeks

INSTITUTIONAL MISSION: West Coast University is a private, proprietary, nonsectarian, coeducational institution. The mission of the University is to ensure provision of an innovative and relevant learning environment; and to support the personal and professional development of adult learners in acquiring lifelong critical thinking and analytical skills. 01/2010 Page 1

WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum NURSING PROGRAM MISSION: The Nursing Program's mission is to assist each student in the recognition of his/her individual abilities to progress and build competence in a chosen nursing educational goal. The specific mission of the Bachelor of Science in Nursing (BSN) track is to prepare students to develop nursing competencies while building upon a liberal arts education that expands their world view of the global community. COURSE DESCRIPTION: Clinical practicum for the nursing care of older adult clients with complex acute and chronic health problems in the acute care setting. Experience with care of the older adult in the community is also included. This medical-surgical practicum course provides an opportunity for students to strengthen their assessment, critical thinking and leadership skills, while focusing on the interdisciplinary management of culturally diverse clients moving from acute illness and to wellness. Learning will be enhanced through application of Gordon's functional patterns and therapeutics/interventions in a variety of acute care settings. Acute Care Setting: The acute care experience will create opportunities for students to provide and coordinate culturally appropriate care to clients with complex acute and chronic health problems as they transition through the health care system. Students will utilize critical thinking to learn advanced skills, therapeutics, new technology, and to develop communication and delegation skills necessary to supervise unlicensed personnel. Through utilization of critical pathways and development of interdisciplinary care plans, students will learn to manage clients through integrated hospital systems that reflect point of care health services for clients along the health continuum. Community-Based Setting: Students may have additional hands-on experience as they rotate through senior day centers and other facilities that are community based clinical practice operations that represent partnerships among the culturally diverse communities they serve. COURSE OBJECTIVES: On conclusion of the course, in order to provide nursing care to promote health in diverse populations, the student will be able to: 1. Analyze the system issues related to the client's experiences in accessing and navigating the current health care systems for adults with acute and complex health problems. 2. Integrate national and federal guidelines and standards, such as Agency for the Healthcare Research and Quality (AHRQ) and Nursing Practice Standards (NPS) into client care management. 3. Demonstrate sensitivity for developmental state, socioeconomic status, diverse cultural values, and spiritual beliefs of all clients in the delivery of health care. 01/2010 Page 2

WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum

4. Conduct comprehensive nursing assessments, diagnosis, implementation and evaluation of adult and geriatric clients experiencing acute and chronic transitions in health status. 5. Collaborate with peers and/or interdisciplinary team to analyze outcome criteria, utilizing appropriate standards of care, critical pathways, AHRQ guidelines, or other quality indicators to measure clients' response to care delivery. 6. Demonstrate safe clinical skills in providing competent nursing care 7. Demonstrate professional behavior and communication skills (including therapeutic assertiveness, and conflict resolution), while interacting with faculty, peers, assigned client, families and other members of the health care environment. 8. Explain the pathophysiology and rationale for therapeutic interventions (including pharmacologic and nutritional) for clients experiencing acute and chronic transitions in health states 9. Utilize evidence-based research as a basis for application of nursing therapeutics to care delivery. 10. Assess, plan, implement, and evaluate appropriate client/family education to promote selfcare and transition for discharge to the home and community settings. 11. Demonstrate the appropriate use of pain measurement instruments, and identify appropriate pain relief interventions for selected groups of patients across the life-span. 12. Utilize the nursing process and Gordon's Functional Health Patterns in the care of the older adult client in the acute care and community settings. 13. Evaluate personal clinical performance throughout the semester, as evidenced by completion of the 211L Evaluation Tool, at mid-term and end of semester. Student is encouraged to keep weekly anecdotal records to document evidence of exceptional achievement of course objectives, as reflected in clinical evaluation tool. REQUIRED TEXT: Bucholtz, S. & Henke, G. (2008). Henke's med-math: Dosage calculation, preparation and administration (6th ed.). Philadelphia: Lippincott Williams & Wilkins. Carpenito, L. J. (2007). Nursing diagnosis: Applications to clinical practice (12th ed.). Philadelphia: Lippincott Williams & Wilkins. Fischbach, F. (2008). A manual of laboratory & diagnostic tests (8th ed.). Philadelphia: Lippincott Williams & Wilkins.

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum Lewis, S. L., Heitkemper, M. M., Dirksen, S. R., O'Brien, P. G., & Bucher, L. (2007). Medicalsurgical nursing: Assessment and management of clinical problems (7th ed.). St. Louis, MO: Mosby Elsevier. Stanley, M., Blaire, K. A. & Beare, P. G. (2005). Gerontological nursing: Promoting successful aging with older adults (3rd ed.). Philadelphia: F. A. Davis. SUPPLEMENTAL READINGS: Journals: Allibone, L. (2006). Assessment and management of patients with pleural effusions. Nursing Standard, 20(22), 55-64. Bielby, A. (2006). Understanding foot ulceration in patients with diabetes. Nursing Standard, 20(32), 57-67. Bruccoliere, T. (2000). How to make patient teaching stick. RN, 62(2), 34-38. Brooks, J. (2001). Postoperative nosocomial pneumonia: Nurse-sensitive interventions. AACN Clinical Issues: Advanced Practice in Acute and Critical Care, 12(2), 305-323. Glindel, M. E. & Grindel, C. G. (2006). Nursing care of the person having bariatric surgery. Medsurg Nursing, 15(3), 129-145. Mentes, J. (2006). Oral hydration in older adults. American Journal of Nursing, 106(6), 40-49. Webb, K. E. (2006). Use of insulin pumps for diabetes management. Medsurg Nursing, 15(2), 61-94. Evidence Based Practice: Coopey, M., Nix, M. P., & Clancey, C. M. (2006). Translating research into evidence-based nursing practice and evaluating effectiveness. Journal of Nursing Care Quality, 21(3), 195-202. Dale, A. E. (2006). Determining guiding principles for evidence-based practice. Nursing Standard, 20(25), 41-46. Heikkinen, K., Salantera, S., Kettu, M., & Taittonen, M. (2005). Prostatectomy patients' postoperative pain assessment in the recovery room. Journal of Advanced Nursing, 52(6), 592-600. Markwell, S. K. (2005). Long-term restraint reduction: One hospital's experience with restraint alternatives. Journal of Nursing Care Quality, 20(3), 253-260.

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum McCarter-Bayer, A., Bayer, F., & Hall, K. (2005). Preventing falls in acute care: An innovative approach. Journal of Gerontological Nursing, 31(3), 25-33. Online Resources: The Joanna Briggs Institute for Evidence Based Nursing & Midwifery (2002). Best practice information sheets. Retrieved August 17, 2002 from http://joannabriggs.edu.au/bpmenu.html Sigma Theta Tau International (2002) Sigma Theta Tau International Honor Society of Nursing. Retrieved August 17, 2002 from http://www.nursingsociety.org/ Georgia State University Department of Anthropology and Geography (2000). Nutrition education for new Americans project. Retrieved August 20, 2002 from http://monarch.gsu.edu/nutrition TEACHING STRATEGIES: Coordinating and providing older adult client care in a variety of health care settings is the primary method used for learning. This experience includes nursing assessments, management of nursing therapeutics, and development of interdisciplinary client care plans. Additionally, analysis of selected case studies and weekly post-conferences will be utilized for informal discussions on selected client care topics, clinical technology, and presentation of nutrition topics. EVALUATION METHODS / GRADING: Clinical Performance (final clinical evaluation) Med Math Exam Community Experience Report Care Plans Teaching Project (due week 10) Post-Conference Participation ATTENDANCE: The WCU Clinical Rotations and Practicum Policy is in effect for all classes. In addition: Clinical time includes all pre and post conferences and any scheduled observations; students are not to leave clinical rotations during these times/experiences. Leaving early or without explicit permission of the clinical instructor will elicit an absence for the clinical day and may be considered abandonment of the patient (a very serious infraction). All absences can potentially affect a student's ability to successfully complete the course objectives and consequently their ability to pass. In the event of an absence, a make-up day will not be allowed. Attendance at clinical is required? In extreme circumstances such as death, hospitalization, a physician's letter or death 01/2010 Page 5 76% 5% 5% 6% 4% 4%

WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum certificate will be required as proof. To maintain satisfactory attendance in a clinical course, only 20% of the total clinical class hours can be missed. The 20% is calculated based on the number of minutes/hours in the clinical day that were missed for that class and minutes/hours counted for tardiness. If absences due to illness or other matters are ongoing, and the student is therefore unable to complete the clinical objectives, the student will be advised to withdraw from the course. Withdrawal from the clinical course also requires withdrawal from the corresponding theory course by BRN regulations. Note: Students are responsible to notify the selected agency and the clinical faculty if unable to attend clinical or arrive on time. Calls must be made at least one hour prior to beginning of designated shift. Calls must be made directly to the clinical unit and the clinical faculty, and the message left with someone in authority at the clinical site as well as with the clinical faculty. ACADEMIC INTEGRITY: In its commitment to academic honesty and accurate assessment of student work, West Coast University uses a plagiarism-detection web-service to help prevent plagiarism. Consequently, instructors reserve the right to submit student assignments to the website to check for similarities between student submissions and the internet, various research databases, and the web-site's database of previous student submissions. Students may be required to electronically submit their work to the instructor or to the website, and by taking WCU courses, students agree that all assignments are subject to plagiarism detection processes and Academic Honesty policies. Assignments submitted to the website by the student or instructor will become part of the service's database and will be used for plagiarism prevention and detection. Student papers, however, will remain the intellectual property of the authors COURSE COMPLETION REQUIREMENTS: Based on California Board of Registered Nursing requirements each clinical nursing practicum class must be taken simultaneously with each theory class of that subject. Clinical practicum classes are important in order to learn how to apply nursing theory learned to the actual practice of nursing. The student's ability to apply that knowledge is evaluated by using the clinical evaluation tool designed to meet the conceptual needs of the curriculum and the syllabus for that class. The tool is graded by the clinical instructor on a day-by-day basis. Faculty will provide feedback, if not daily, than at least three times during the term of the class at about week 5, 7 and 10. In addition, each time a nursing skill is learned it must be performed in the skills lab under supervision first and when performed for the first time on a patient it must be observed by the instructor who will determine if the student has performed it safely. If the performance is satisfactory, the instructor will initial in the section of the skills booklet. This booklet is to be carried by the student each day she/he is at clinical or in skills lab to insure all skills are signed 01/2010 Page 6

WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum off prior to moving on to another class. Students should keep a copy of this booklet in a safe place. The information in this booklet is part of the grading for the class and without this booklet, there is no verification that a skill has been successfully completed. Therefore, it is crucial the student keep this booklet safe throughout the entire nursing program, as it is a record of skills achieved and a required reference by the Board of Registered Nursing that skills were obtained first in the skills lab and later in the clinical practicum. Quizzes: Unscheduled quizzes will be given periodically throughout the term. The quizzes will cover previous content and/or content covered during a particular class session in theory as it applies to clinical. Students are required to be present when an examination is given. If unexpectedly absent for an emergency (i.e. death in the immediate family), contact the professor as soon as possible to arrange a make-up examination. Students who do not take the exam on the scheduled date and do not contact the instructor within 48 hours will receive a 0%. Lack of preparation at the scheduled exam time is not an acceptable excuse for not taking an examination or quiz. The final grade is cumulative and includes clinical performance, medication tests, pre or post conference presentations, concept mapping of nursing care, nursing care plans, and quizzes. All students must pass with a 76% and evaluated by the clinical instructor to be a safe practitioner, to be eligible to move forward in the nursing curriculum. Case Studies will be assigned throughout the course either from the EVOLVE website or from the instructor. *Participation includes attendance, participation in discussions, and engagement in the learning activities during the clinical practicum as well as pre and post conferences. ** The medication math test will be given in each of the clinical classes throughout the nursing program. In each class, it is required that the students pass the medication math test for that practicum BEFORE they can pass medications. The passing grade is 85%. If the student does not pass the test on the first attempt, they may take it again two more times. The first grade achieved is the one counted toward the final grade. If the student does not pass this medication examination, they are considered unsafe and therefore fail the clinical class and must drop it and the corresponding theory class. Because the body of nursing knowledge builds from one class to the next and the practicum is based on knowing the corresponding theory, the student must successfully pass this class before they can move on to the next nursing class. The Board of Registered Nursing requires that the practicum be taken at the same time as the corresponding theory class, i.e. during the same term, as the theory course is given. If the student fails any course, they are given one opportunity to retake it and if they fail the second time, they are dropped from the program. Students must achieve a passing grade of C (76%) or above, submit all required exercises and projects, complete all required quizzes and examinations, and meet the standards of safe practice and the school attendance policy.

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum Student Papers: Unless designated as a Group Project by the instructor, all student papers and assignments must be completed by the individual student and represent the student's own original work. Group projects are designated as such so that all other assignments are individual assignments and are to be completed by the student and NOT as a group assignment or submitted as a group assignment. Any submitted papers that are not the student's original work will be considered plagiarism, in violation of the Academic Honor Code. For clarification of plagiarism, please refer to the RN Student Handbook, WCU Catalog, Dean or instructor. Each student is responsible for his or her own learning which includes all aspects of the work required for a class. In order to maintain security, student assignments must be submitted directly to the instructor via the method(s) approved by the instructor. Do not fax papers to the school. Do not e-mail papers to instructors without written permission from the instructor.

Grading Scale as Follows: Grade A B C D F TC W IN CR Points 4 3 2 1 0 N/A N/A N/A N/A Nursing Numerical Score 91-100 84-90 76-83 (minimum passing grade) 64-75 less than 63 Transfer Credit Withdrawal Incomplete Credit (75 or higher)

*Minimum passing grade for all nursing classes is a 76%. MAKE UP WORK POLICY: In the event of an absence, a make-up day will not be allowed. Students may not be absent for clinical for any reason, with the exception of extreme circumstances. These include a student hospitalization or a death in the immediate family. A physician's letter or death certificate will be required in these circumstances. Three absences from clinical will warrant a failure in NURS 211L. CLASSROOM / CLINICAL POLICIES: Students are required to speak, act, and dress professionally and with integrity, respect and decorum at all times in classroom and clinical settings. Appropriate language is an expectation.

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum Behavior that persistently or grossly interferes with clinical activities is considered disruptive behavior and may be subject to disciplinary action. Such behavior inhibits other student's abilities to learn and instructor's ability to teach. A student responsible for disruptive behavior may be required to leave the clinical area, pending discussion and resolution of the problem, and may be reported to the Office of the Director or Academic Dean for further action. ACADEMIC DISHONESTY: Written assignments and all other documentation:

The University considers plagiarism and falsification of documents, including documents submitted to the University for other than academic work, a serious matter that may result in a failure in the class or dismissal from the program. All student work is to be submitted to faculty and represent the student's original work. All students are required to follow the American Psychological Association (APA) writing guidelines. All sources used as references must be identified

Plagiarism-detection website: In its commitment to academic honesty and accurate assessment of student work, West Coast University uses a plagiarism-detection web service to help prevent plagiarism. Consequently, instructors reserve the right to submit student assignments to the website to check for similarities between student submissions and the internet, various research databases, and the website's database of previous student submissions. Students may be required to electronically submit their work to the instructor or to the website, and by taking WCU courses, students agree that all assignments are subject to plagiarism detection processes and Academic Honesty policies. Assignments submitted to the website by the student or instructor will become part of the service's database and will be used for plagiarism prevention and detection. Student papers, however, will remain the intellectual property of the authors. Students who violate university standards of academic integrity are subject to disciplinary sanctions, including failure in the course and suspension from the university. Since dishonesty in any form harms the individual, other students and the university, policies on academic integrity will be strictly enforced. Familiarize yourself with the academic integrity guidelines found in the current WCU catalog and/or Nursing Student Handbook. Examinations There is a school testing policy which includes such things as no phones or other electronic devises with you while taking exams, no food or drink, no baseball or other type of hats can be worn, no papers, backpacks or other type of material can be taken into the exam space. There is no talking or sharing of information regarding the test questions during the test. Please review the policy for the complete list of testing requirements and the Academic Honor Code. Once the exam results are available, the students can only schedule a review of their exam with their instructor. The student will be provided with a test copy (not applicable to HESI exams), answer sheet, and a copy of his or her Scranton, which must all be returned unchanged upon completion of review. No written or oral notes can be taken when a student reviews his or her exam. The school encourages students to review their test results as soon as the exam is completed. HESI (or ATI) exam results are available for review on line through the Elsevier (or 01/2010 Page 9

WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum ATI) website usually within 24 hours of completing the exam. Students are encouraged to use this information to tailor their remediation in areas of weakness as identified by subjects missed on the HESI or ATI exam. The HESI and ATI testing policy require that you may not share any of the testing information with anyone at any time. Please read it carefully as this is a legal document you are signing and will be legally held accountable to uphold, when taking these examinations. See Testing policy and Academic Honor Code in WCU catalog and/or Nursing Student Handbook. DISRUPTIVE BEHAVIOR: Behavior that persistently or grossly interferes with classroom activities is considered disruptive behavior and may be subject to disciplinary action. Such behavior inhibits other students' ability to learn and instructors' ability to teach. A student responsible for disruptive behavior may be required to leave class pending discussion and resolution of the problem and may be reported to the Office of the Dean/Director or Academic Dean. ACADEMIC ACCOMMODATIONS: Any student requesting academic accommodations based on a verified disability is required to provide documentation to, and to register with, the Director of Student Services at least six weeks prior to his/her first class start, or as soon as is reasonable based on the date of enrollment. This documentation will be reviewed and appropriate reasonable accommodations will be determined. A letter of verification will be provided to the student explaining the reasonable accommodation granted. Please be sure the letter is delivered to your instructors at the beginning of each class so that they may appropriately assist you.

Syllabus is subject to change throughout the course

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum AACN Essentials for Baccalaureate Education for Professional Nursing Practice The purpose of this section of the syllabus is to guide the student in understanding how the AACN 9 Essentials are incorporated into their education and to provide guidance to them in developing their individual portfolios. The Essentials that are met by this course include the following: Essential I, Liberal Education for Baccalaureate Generalist Nursing Practice · Outcome 5, Apply knowledge of social and cultural factors to the care of diverse populations · Outcome 8, Demonstrate tolerance for the ambiguity and unpredictability of the world and its effect on the healthcare system. o Through use of case studies and post conference clinical discussions that assists students to critically analyze the influence of social and cultural factors on nursing care decisions and actions for patient. o Describe factors causing significant changes in the healthcare delivery system and their impact on healthcare and the nursing profession. Essential III, Scholarship for Evidenced-based Practice · Outcome 5. Participate in the process of retrieval, appraisal, and synthesis of evidence in collaboration with other members of the healthcare team to improve patient outcomes. · Outcome 6. Integrate evidence, clinical judgment, interprofessional perspectives, and patient preferences in planning, implementing, and evaluating outcomes of care. · Outcome 7. Collaborate in the collection, documentation, and dissemination of evidence. o Presentation of studies exploring the efficacy of pharmacological and nonpharmacological treatment modalities (i.e. Therapeutic Touch, Guided Imagery, etc.) used to manage illnesses that impact the aging adult in the acute clinical setting. o Students are introduced to a variety of evidenced-based protocols and methods used in clinical practice Essential IV, Information Management and Application of Patient Care Technology · Outcome 1, Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice. · Outcome 5, Use standardized terminology in a care environment that reflects nursing's unique contribution to patient outcomes. o All papers be typed in word processing program, APA format, and that PowerPoint presentations are required for the end of the term group presentation. o Advanced technology (i.e. IV pumps, EKG monitors, Pyxis, etc.) and other measurement instruments to assist in delivering therapeutic care in the clinical setting will also be utilized. o Proficiency with electronic documentation will be implemented according to the agency policy.

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum Essential V, Healthcare Policy, Finance, and Regulatory Environments · Outcome 8, Discuss the implications of healthcare policy on issues of access, equity, affordability, and social justice in healthcare delivery. · Outcome 9, Use an ethical framework to evaluate the impact of social policies on health care, especially for vulnerable populations. o Is met by discussing the cultural implications related to access to healthcare, cultural bias, and insensitivity. o Discussion will also focus on the nurse's role as a patient advocate in the clinical setting and reporting agencies if suspected elder mistreatment or neglect. Essential VI, Interprofessional Communication and Collaboration for Improving Patient Health Outcome · Outcome 5, Demonstrate appropriate teambuilding and collaborative strategies when working with interprofessional teams. o is met by requiring students to work collaboratively amongst a diverse student population and present a health related topic that demonstrates their ability to incorporate Evidence Based Practices, new concepts and integrate old concepts with current professional nursing practices within the clinical setting. o Students will collaborate with peers and/or interdisciplinary team to analyze outcome criteria, utilizing appropriate standards of care, critical pathways, AHRQ guidelines, or other quality indicators to measure clients' response to care delivery. Essential VII, Clinical Prevention & Population Health · Outcome 3, Assess health/illness beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations. · Outcome 10, Collaborate with others to develop an intervention plan that takes into account determinants of health, available resources, and the range of activities that contribute to health and the prevention of illness, injury, disability, and premature death. o is met by describing the significance of heath education and preventive care in decreasing the incidence of diseases such as diabetes, Colon rectal cancer, and related complications. Essential VIII, Professionalism and Professional Values · Outcome 3, Promote the image of nursing by modeling the values and articulating the knowledge, skills, and attitudes of the nursing profession. · Outcome 8, Communicate to the healthcare team one's personal bias on difficult healthcare decisions that impact one's ability to provide care. · Outcome 9. Recognize the impact of attitudes, values, and expectations on the care of the very young, frail older adults, and other vulnerable populations. o is met by allowing students to witness and discuss the expanded professional nurse's role in a variety of clinical settings (i.e. ED, OR, ICU, etc.) and advance practice (i.e. NP, CNS, etc.). o Providing nursing care and education that is tailored and culturally sensitive among diverse aging populations is also discussed.

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum Essential IX: Baccalaureate Generalist Nursing Practice · Outcome 3, Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. · Outcome 8, Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan. o is met by incorporating a holistic approach utilizing Gordon's Conceptual Framework to deliver patient focused care, within the clinical setting, that is evidenced based practice and reflects the integrated knowledge of pharmacology, pathophysiology, and medical/nursing management of health related illnesses that affect the aging adult. o The utilization of evidence-based research will be the basis for application of nursing therapeutics to care delivery.

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum

Teaching Project Guidelines

TEACHING PROJECT

DUE BY _____________

PURPOSE: The purpose of the client/family teaching project is to develop and implement a teaching plan for a geriatric patient utilizing teaching learning principles. OBJECTIVES: By the conclusion of the presentation, the students will be able to: 1. State the various indications for a specified diet 2. Explain the scientific rationale for a prescribed diet 3. Describe food/fluid restrictions appropriate for diet or food/fluids encouraged to meet nutritional needs? 4. Describe how to present a short nutritional teaching plan to a client & family with cultural differences. 5. Apply current research related to the nutrition topic. REQUIREMENTS: 1. Utilize client teaching/nutrition project evaluation tool for essential criteria. 2. The paper should be between 3-5 pages (not including title page and references). 3. The paper must be typed and conform to APA format (5th edition). 4. A minimum of two references are required. 5. Written paper is due during the 7th week on the assigned clinical day

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum

Nutritional Presentation Guidelines

NUTRITIONAL ORAL PRESENTATION DUE BY

The student will be assigned one therapeutic diet from the following list. Each student will give an oral presentation of 15-20 minutes on the assigned therapeutic diet during a designated postconference. THERAPEUTIC DIETS: 1. Diabetic diet 2. Fat restricted and cholesterol restricted 3. Enteral nutrition 4. Sodium restricted 5. Total parental nutrition 6. Modified fiber and bland diets 7. Full and clear liquid diets 8. Nutrition in wasting diseases 9. Modified calcium and potassium diets 10. Dysphagia diets 11. Protein restricted diet 12. Anticoagulant diet Follow the teaching/nutrition project evaluation tool oral presentation criteria. Creative presentations are encouraged. A concise outline in handout is required.

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum

Teaching/Nutrition Proect Grading Criteria

Project due: ______________________________________ NAME:_______________________ID#__________________ASSIGNED NO:________ Evaluation Criteria Assessment of patient's learning needs/abilities/readiness. Include characteristics of the patient & environment that may hinder or enhance learning. Match patient current condition & environment to relevant teaching topic. Identify transitional stage of patient. Identification of 1-2 learning &/or discharge goals for patient & family. Include the desired patient outcomes that should be demonstrated at or prior to patient discharge from acute care setting. Outcomes should reflect transitions in health promotion, restoration, and/or palliation. Discussion of the interventions that should be implemented to attain stated learning &/or discharge goals. State interventions with rationales. Include multidisciplinary consults as appropriate. Integrate information regarding patient's support system & if there are needs for community resources. Evaluation and discussion of patient's possible responses to the interventions, goal achievement, and transitions progress. Brief summary of what the student learned while working on the teaching project. APA format, writing style, and references (organization & clarity, sentence structure, grammar, punctuation, spelling, reference style). Content 3-5 pages. Oral Presentation criteria: (2) Introduction/Purpose of presentation (8) Knowledge of Topic (3) Relevance to patient needs/Cultural considerations (3) Nursing Implications (3) Application of Research (3) Clarity and Organization/Outline (6) Communication skills (self confidence, eye contact, voice projection, use of time) (2) Class Participation Paper submitted on scheduled due date & time. Yes ______No _______ Date & Time submitted: TOTAL ________________ 100 Possible Points 10 Points Earned

10

20

10 10 10

30

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum

Community Experience

Students will spend 15 hours in community activities. Students should select at least two activities such as a senior activity center, a community center, a faith-based organization, or an assisted living center. Students will submit a 1 page, double-spaced reaction paper describing their experience. One experience must be completed by mid-term and the other by the 8th week of the term. The papers should follow APA format. Objectives The student will: 1. Evaluate the community setting from the perspective of a Registered Nurse. 2. Analyze the progression through the health care system, from inpatient to outpatient or outpatient to inpatient, through observations in community outpatient facilities. 3. Complete Community Experience Documentation and hand-in to instructor. Student Responsibilities 1. Demonstrate professional behavior and communication skills while interacting with facility staff, clients, and other members of the outpatient health care environment. 2. Determine requirements of the agency regarding immunizations, CPR, etc. Request copies from school office as needed, prior to visiting the site. 3. Carry WCU identification card and wear student name tag at all times during clinical activities. 4. Wear appropriate clothing. (No jeans or leggings allowed. It is preferred that the clinical uniform be worn. The blue uniform top with black pants is also acceptable. A lab coat may be needed in the actual clinics. If so, use a WCU lab coat. Refer to dress code in student handbook for further information.) 5. Be punctual. (If you are ill on a community experience day, contact the agency in the early morning.) 6. Avoid secluded areas such as; basements, stairwells, and elevators. 7. Do NOT transport/transfer clients for any reason. This includes turning clients or "pulling up" clients in bed. 8. Do NOT perform any patient care. This includes assessment, vital signs, procedures, or medication administration. 9. Report any situation provoking anxiety or infringing on the safety of the student to the instructor without delay.

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum

Community Experience Documentation

Name of student __________________________________________________________ Name of facility __________________________________________________________ Address _________________________________________________________________ Phone number ____(_____ )__________________________________________________ # of hours performed ________________________

Contact person (print name) __________________________________________________ Title_____________________________________________________________________ Contact phone number (if different from facility number) __________________________

I verify that the above named student has performed _______ hours of community experience observation at this facility.

Contact person signature _____________________________________________________

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum

Community Experience Report

Paper is to be typewritten, double spaced, and written using American Psychological Association (APA) manual guidelines. Content must include the following: Name of the organization:

Purpose of the organization:

Population served (type of patient and disease(s) served):

Geographical/environmental issues (describe the facility, physical layout, accessibility, transportation issues if any):

Professional services available in this setting:

Social issues in the lives of the population:

How does the organization communicate internally and with the larger community?

What programs or facilities would you add to better serve this population?

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West Coast University ­Nursing Program NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults Practicum Clinical Evaluation Tool Based on Gordon's Functional Health Plan Model

STUDENT: ID#: CLINICAL SITE: Score Obtained Percentage of Grade X .75 P/F X .05 X. 10 X. 05 X. 05 TOTAL 5th Week Evaluation Completed By: Student's Signature: Comments: 100 Points Obtained FINAL GRADE:

EVALUATION CRITERIA CLINICAL EVALUATION TOOL MED MATH EXAM COMMUNITY EXPERIENCE REPORT PREP GUIDES/CARE PLANS NUTRITIONAL PRESENTATION TEACHING PROJECT

7th Week Evaluation Completed By: Student's Signature: Comments:

Final Evaluation Done By: Student's Signature: Comments:

1

NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults Practicum Clinical Evaluation Tool

TH TH

BEHAVIORAL OBJECTIVES

5

Week

7

Week

STRENGTHS

AREAS FOR IMPROVEMENT

FINAL GRADE RATING SCALE (CIRCLE ONE)

1. Nursing process of assessment, diagnosis, plan, intervention and evaluation of nursing care A Demonstrate skill in using the nursing process according to Gordon's 11 patterns of human functioning for the patient/client, family and community. Uses these 11 patterns in the assessment, diagnosis, plan, implementation and evaluation of care. 1. 2. 3. 4. 5. 6. 7. 8. 9. health perception and health management patterns nutritional and Metabolism patterns elimination patterns activity and exercise pattern cognitive and perception patterns sleep and rest patterns self perception and self concept roles and relationship patterns sexuality and reproduction patterns 1 1 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 3 3 4 4 4 4 4 4 4 4 4 4 4 5 5 5 5 5 5 5 5 5 5 5

10. coping and stress tolerance patterns 11. values and beliefs patterns

B. Demonstrates skills in using the nursing process as a framework for development of a nursing plan of care 1. 2. 3. 4. 5. Uses Correct assessment skills Develops a plan of care based on assessment data Implements plans as appropriate to client situation Evaluates goal achievement and nursing interventions Based on evaluation of plans, alters them as needed to address client needs 1 1 1 1 1 2 2 2 2 2 3 3 3 3 3 4 4 4 4 4 5 5 5 5 5

2. Uses research methods to obtain data for determining the best nursing care available A. B. C. D. Uses various sources to obtain nursing clinical data Incorporates evidenced based information in the plan of nursing care Presents data that can be utilized in designing nursing care plans Uses APA format in presenting written sources of clinical data 1 1 1 1 2 2 2 2 3 3 3 3 4 4 4 4 5 5 5 5

3. Provides therapeutic nursing care in a variety of settings A. B. C. D. Provides nursing care to individuals Provides nursing care to families Provides nursing care to aggregates or communities Provides care but also evaluates and revises plan of care for a more therapeutic environment 1 1 1 1 2 2 2 2 3 3 3 3 4 4 4 4 5 5 5 5

2

NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults Practicum Clinical Evaluation Tool

BEHAVORIAL OBJECTIVES 4. Identifies areas of instruction needed by the client that will aid in development of health promotion and health maintenance of self-care activities A. B. Is able to assess and provide for the educational needs of the client Collaborates with the family to design, provide and evaluate an educational plan for the client and family Designs educational sessions appropriate to the learning abilities of the client and family Demonstrates the effectiveness of knowledge acquisition of the client, family or community 1 1 2 2 3 3 4 4 5 5 5 Week

th

7 Week

th

Strengths

Areas for Improvement

Final Grad Rating Scale (Circle One)

C.

1

2

3

4

5

D.

1

2

3

4

5

5. Uses effective written, verbal and nonverbal therapeutic communication skills. A. Verbal- is able to use proper therapeutic communication skills with individual, family, aggregates and community Nonverbal- is able to use proper therapeutic non verbal communication skills when caring for patients and their families Written- is able to use proper written communication skills in English in nursing notes, reports, patient instructions and presentations Speaks and writes in a professional manner 1 2 3 4 5

B.

1

2

3

4

5

C.

1

2

3

4

5

D.

1

2

3

4

5

6. Role Development as leaders, manager and patient advocate A. B. C. Demonstrates an accountability to agency and college protocols Demonstrates an accountability for client/ family well being Demonstrates and understanding of being accountable for ones own professional and self development Shows proper leadership styles depending on the nursing care or professional situation 1 1 1 2 2 2 3 3 3 4 4 4 5 5 5

D.

1

2

3

4

5

Others behaviors and comments

TOTAL RATING SCALE:

FINAL GRADE CALCULATIONS: 1-Rating for objective: 1A (11-55) _____ + B (5-25) _____ = 2-Rating for objective: 2 (4-20) = 3-Rating for objective: 3 (4-20) = 4-Rating for objective: 4 (4-20) = 5-Rating for objective: 5 (4-20) = 6- Rating for objective: 6 (4-20) = 20-180 TOTAL

Second Year Level I X 0.45 X 0.11 X 0.11 X 0.11 X 0.11 X 0.11 100%

Third Year Level II X 0. 30 X 0. 20 X 0. 15 X 0. 15 X 0. 10 X 0. 10 100%

Fourth Year Level III

X 0. 15 X 0..20 X 0. 15 X 0. 20 X 0. 10 X 0. 20 100%

Note: Any rating below "3" in the final evaluation constitutes a failure in this course.

3

NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults Practicum Clinical Evaluation Tool

Grades Letter Grade A B C* D F Percentage of Class Points 91 - 100% 84 - 90 % 76 - 83 % 68 - 75 % 67 or Less

*Minimum passing grade for all nursing classes is a 76%.

4

NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults Practicum Clinical Evaluation Tool

INSTRUCTIONS FOR USE EVALUATION METHOD: 1. 2. 3. 4. Use the key to rate each of the behavioral objectives on the tool. Enter the numerical rating that most accurately describes your perception of the student's performance. Clarify your ratings, both positive and negative, with examples of student performance in the comments section. Share your ratings in an evaluation conference with the student at the end of the clinical rotation.

RATING SCALE KEY Rating 5 4 3 Behavior Consistently demonstrates knowledge and behaviors in a manner which reflects a superior level of competence. Performance is independent, accurate and complete. (Creativity, initiative, systematic, resourceful, knowledge in depth) Consistently demonstrates knowledge and behaviors in a manner which reflects an above average level of competence. Performance requires minimal assistance from instructor. (Efficient, organized, goal director) Consistently demonstrates knowledge and behaviors in a manner which reflects an average level of competence. Performance requires moderate assistance from instructor; it is acceptable but needs strengthening. (Basic knowledge, but without breadth and depth beyond assigned content) Inconsistently demonstrates knowledge which reflects below average level of competence. Performance requires step by step assistance from instructor or staff nurse. (Inaccurate, incomplete, unable to reflect basic knowledge) Consistently demonstrates knowledge of behavior which reflects dangerous level of incompetence. Tasks are not completed and performance is unsafe. Cannot identify areas of need and does not benefit from special guidance. (Does not have basic knowledge, below level of safety, unaware). Course objectives which define course content. Judgment, safety, prediction, anticipation Regular, routine pattern of behavior observable over a period of time. Erratic unpredictable patterns of behavior.

2 1

Definition of terms in scale: Knowledge/ Behaviors: Competence: Consistency: Inconsistency:

5

NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults Practicum Clinical Evaluation Tool

1. DEMONSTRATES PROFESSIONAL RESPONSIBILITY AND ACCOUNTABILITY IN CARING FOR CLIENTS IN VARIOUS HEALTH CARE SETTINGS. Demonstrate skill in using the nursing process according to Gordon's 11 patterns of human functioning for the patient/client, family and community. Uses these 11 patterns in the assessment, diagnosis, plan, implementation and evaluation of care. 1A.THE STUDENT WILL BE ACCOUNTABLE TO AGENCY AND COLLEGE PROTOCOLS: Examples of the behavior include, but are not limited to:

STRENGTH

IMPROVE

Week 5 7 10 5

Week 7 10

1. Demonstrates professional dress at all times according to school policies as written in student handbook. 2. Arrives to clinical unit on time or contacts appropriate personnel before scheduled time when unable to meet time commitments. 3. Arrives to clinical conference on time or contacts instructor before scheduled time when unable to meet this commitment. This includes scheduled seminars. 4. Complies with attendance in clinical setting according to school policies as written in the student handbook and provided in course syllabus. 5. Follows agency policies and procedures and accepted standards of care. 6. Hands in clinical assignments on time in compliance with school policies as written in student handbook and provided in course syllabus. 7. Demonstrates the use of Gordon's 11 patterns of human functioning in developing the assessment, diagnosis, intervention plan and evaluation of care for the client and family. 8. Is prepared for clinical as evidenced by preparation of all clinical forms, knowledge of medications, and prioritizing of nursing care needs. 9. Other: 1B. THE STUDENT WILL BE ACCOUNTABLE FOR ENSURING CLIENT/FAMILY WELL BEING WITH ATTENTION TO SAFETY, ETHICAL, LEGAL AND ORGANIZATIONAL STANDARDS OF CARE: Examples of the behavior include, but are not limited to: 1. Provides care regardless of patient consideration: social, economic, ethnic, cultural health status.

2. Recognizes hazards to client safety and takes appropriate action to maintain a safe environment. a. b. c. Puts side rails up and bed down and call bell within reach when client is in bed. Restrains client safely when indicated with appropriate documentation per Hospital Policy. Able to complete a fall risk assessment and implement fall risk protocol per hospital policy.

3. Maintains confidentiality of client information. a. b. c. d. Shares client information only with appropriate health team members, instructor, and in group clinical post conferences. Uses only client initials on any papers/discussions containing client information. Provides for privacy of clients and families. Adheres to HIPAA guidelines ­ Completed HIPAA training with documentation.

4. Identifies advocacy roles and situations that require ethical decisions. a. Participates as advocate for the patient in situations of informed consent.

5. Other Comments:

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NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults Practicum Clinical Evaluation Tool

1C. THE STUDENT WILL BE ACCOUNTABLE FOR SELF DEVELOPMENT TOWARDS PROFESSIONAL ROLE BEHAVIORS: Examples of the behavior include, but are not limited to: 5 1. Seeks and participates in creative and innovative learning experiences to enhance own learning.

STRENGTH Week 7 10

IMPROVE Week 5 7 10

2. Demonstrates self-initiative by identifying own learning needs and communicating personal expectations to instructor. 3. Elicits feed back from instructor/agency mentor to enhance own learning. 4. Implements changes in practice based upon instructor's/agency mentor's feedback. 5. Participates in constructive evaluation of self, faculty, and clinical site. 6. Recognizes how own values and values of others influence care of the client. 7. Accepts values of others that differ from student's own value system. 8. Accepts responsibility for own nursing actions. 9. Other Comments:

2.

USES RESEARCH METHODS, SUCH AS EVIDENCED BASED PRACTICE, TO OBTAIN DATA FOR DETERMINING THE BEST NURSING CARE AVAILABLE. Examples of the behavior include, but are not limited to:

STRENGTH Week 5 7 10

IMPROVE Week 5 7 10

1. 2. 3. 4.

Uses various sources to obtain nursing clinical data Incorporates evidenced based information in the plan of nursing care Presents data that can be utilized in designing nursing care plans Uses APA format in presenting written sources of clinical data. Cites sources as appropriate.

5. Other Comments:

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NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults Practicum Clinical Evaluation Tool

3. DEMONSTRATES SKILL IN USE OF THE NURSING PROCESS AS A FRAMEWORK FOR DEVELOPMENT OF A NURSING PLAN OF CARE STRENGTH Week 5 1. 2. 3. Collects and analyzes subjective and objective assessment data, pertinent to each individual client and appropriately document assessment findings. Utilizes appropriate interviewing techniques for obtaining historical information from client. Perform a complete Admission Assessment on a client. Utilizes a systematic approach to collect biological, psychosocial, cultural, spiritual, and developmental data to use as a basis for assessment. Able to document in Clinical Record appropriately and thoroughly. Utilizes appropriate physical assessment techniques to assess integumentary, musculoskeletal, neurological, cardiovascular, respiratory, GI, renal, and HEENT systems with proper and complete documentation. Distinguishes between normal and abnormal findings in both subjective and objective data as appropriate for the Older Adult Client. Distinguishes normal physiological changes of the Older Adult client. Assesses the ability of both client and family to engage in self-care, as client experiences transitions in current health status to the continuum of care. Performs a focused assessment individualized to the client's medical diagnoses, changing condition, and nursing care needs and documents in client's medical record. Assesses and documents client's nutritional, environmental, pharmacotherapeutic and health screening needs. Communicates pertinent data, consults to staff nurse or physician, when indicated. 7 10 5 IMPROVE Week 7 10

3A. DEMONSTRATES CORRECT ASSESSMENT SKILLS: Examples of the behavior include, but are not limited to:

4.

5. 6. 7. 8. 9.

10. Assesses use of mechanical devices used in relation to client's needs and physician's orders. Able to demonstrate appropriate use of devices in the Medical Surgical Setting such as IV pumps, Pneumatic Sequential Compression Devices, Continuous Passive Motion machines, PCA pumps, Vital Signs Equipment, Bladder Scanner, Dopplers, Heating Devices, 02 supplies, suction equipment among others. 11. 12. 13. Analyzes and interprets laboratory reports and various other forms of medical information and assesses client's response to diagnosis and therapy provided. Analyzes Radiologic reports such as Chest X-Rays, MRI's CT scans and other Diagnostic tests in relation to client's disease processes. Other

3B. DEVELOPS A PLAN OF CARE BASED ON ASSESSMENT DATA: Examples of the behavior include, but are not limited to: 5 1. 2. 3. 4. 5. 6. Develops complete and appropriate nursing diagnoses adapted to individual client needs. Determines a prioritized nursing list of nursing diagnoses for each client, based on subjective and objective data. Develops a client care plan utilizing prioritized nursing diagnoses adapted to individual client needs. Identifies realistic, client focused, and measurable (time oriented) goals. Involves both client and family whenever possible, in the development of short and long term goals. Plans nursing interventions appropriate to meet client's goals. a. b. 7. 8. States scientific rationale for nursing interventions. Utilizes research findings to provide a basis for development of nursing interventions. Week 7 10 5 Week 7 10

Integrates appropriate data from critical pathways into individualized care plan. Other 8

NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults Practicum Clinical Evaluation Tool

3C. IMPLEMENTS PLANS AS APPROPRIATE TO CLIENT SITUATION: Examples of the behavior include, but are not limited to: 5 1. Demonstrates competence in selected psychomotor skills. A. Administers oral, parenteral, and topical medications safely by: a. b. c. Stating classification, action, reason for use, and adverse effects for each medication before administering. Calculating drug dosages and flow rates accurately. Determining the 5 rights and accurately checking client identification. Use 2 patient identifiers in accordance to individual hospital policy per JCAHO National Patient Safety Goal 2008. Identifying factors related to client age, diagnosis, and current status that may change in response to administered medication. Identifying and implementing assessment parameters to monitor client's response to medications. Charting client response to medications within 30 minutes of med administration to evaluate patient's response. STRENGTH Week 7 10 5 IMPROVE Week 7 10

d. e f. B.

Administers parenteral fluid therapy safely by: a. Monitoring IV infusions via peripheral and central venous access. Able to differentiate Central Venous Catheters, Implanted Ports and PICC lines ­ its care and management. Identifying and implementing precautions in the administration of blood products. Able to define the safety process and double checks of Blood Administration. Recognizing complications associated with I.V. administration and reporting to appropriate staff. States scientific rationale for individual client fluid replacement.

b.

c. d. 2. 3. 4.

Uses clinical indicators to determine opportunities of administering prescribed drugs and treatments (e.g. pulse rate, blood sugar level, pain rating, emotional stress) Articulates and applies relevant research to nursing care with appropriate reference. Implements nursing interventions required for selected diagnostic and therapeutic procedures. a. b. c. Investigates unfamiliar medications, diagnostic and therapeutic procedures. Performs all client care in accordance with established policies and procedures and standards of care in a timely manner. Prepares client for all nursing interventions by explaining procedure and allaying anxiety.

5. 6. 7.

Implements use of universal precautions, and technique as appropriate to the client situation. Draws on resources in community with appropriate referrals as necessary. Other:

9

NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults Practicum Clinical Evaluation Tool

3D. EVALUATES GOAL ACHIEVEMENT AND NURSING INTERVENTIONS: Examples of the behavior include, but are not limited to: 5 l. 2. 3. 4. Evaluates client's response to nursing interventions. Evaluates client goal achievement in an on going manner as a basis for adapting nursing care. Updates client care plan based on evaluation as appropriate to clinical setting and at least once a shift. Identifies variances in critical pathways. STRENGTH Week 7 10 5 IMPROVE Week 7 10

5. Other: Comments:

4A. IDENTIFIES AREAS OF INSTRUCTION NEEDED BY THE CLIENT THAT WILL AID HEALTH PROMOTION AND HEALTH MAINTENANCE OF SELF-CARE ACTIVITIES Examples of the behavior include, but are not limited to:

STRENGTH Week 5 7 10

IMPROVE Week 5 7 10

1.

Demonstrates skill in providing culturally appropriate health promotion and health maintenance education to clients and families in diverse populations, when appropriate. Develops and implements selected teaching plans that are appropriate to the client's situation related to value systems and psychosociocultural and educational background, age and health status. Involves client and/or family in identification of learning needs during transitions in health status. Uses learner strategies appropriate to age, educational level, and cultural background. Teaches correct principles, procedures, and techniques of health promotion and health maintenance according to clients needs. Informs client and family about health care status when appropriate. Teaches client and family stress reduction techniques (e.g. guided imagery, relaxation breathing and diversion). Uses resources appropriately during the planning and implementation of the teaching plan. Evaluates client and/or family response to learning of provided education.

2.

3. 4. 5. 6. 7. 8. 9.

10. Documents teaching intervention and client's response to education. 11. Other: COMMENTS:

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NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults Practicum Clinical Evaluation Tool

5. USES EFFECTIVE WRITTEN, VERBAL AND NON VERBAL COMMUNICATION SKILLS: STRENGTH Week 5 1. Records pertinent subjective and objective information accurately, promptly, legibly, and concisely in a format that is grammatically correct and conforms to agency policy. Utilizes correct medical/nursing terminology. Demonstrates application of the nursing process in written charting. Demonstrates application of the nursing process, according to hospital plan of care for individual nursing units. Demonstrates ability to retrieve and make appropriate entries if indicated, into automated data systems Other 7 10 5 IMPROVE Week 7 10

5A. DEMONSTRATES WRITTEN COMMUNICATION SKILLS: Examples of the behavior include, but are not limited to:

2. 3. 4. 5. 6.

5B. DEMONSTRATES VERBAL COMMUNICATION SKILLS: Examples of the behavior include, but are not limited to: 1. Develops an effective relationship with individual clients as evidenced by: a. b. c. d. e. f. g. 2. 3. 4. 5. Communicates facts, ideas, and feelings clearly. Listens receptively, focuses on client's feelings during interactions. Conveys an attitude of acceptance and empathy. Remains aware of how personal body language can effect each client. Displays a non judgmental attitude during the nurse client interaction. Uses appropriate non verbal communication techniques (gestures, facial expressions) Communicates to client on the level of the learner using appropriate terminology. Gives explanation and verbal reassurance when needed.

Provides support for clients and support/family members of clients. Demonstrates assertive skill in management of professional duties. Presents report on client in an organized, concise, and accurate manner. Other

5C. DEMONSTRATES NON VERBAL COMMUNICATION SKILLS: Examples of the behavior include, but are not limited to: 1. 2. 3. 4. Signals professional role by dress, body language and other nonverbal cues. Uses touch appropriately in application of nursing interventions. Uses appropriate verbal communication techniques that is appropriate with the Older Adult Client. Other

COMMENTS:

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NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults Practicum Clinical Evaluation Tool

6. DEMONSTRATES BEGINNING MANAGEMENT AND LEADERSHIP SKILLS: Examples of the behavior include, but are not limited to: 5 1. 2. 3. Organizes work priorities to conserve energies of client and self and completes assignment efficiently and in a timely manner. Assists in admission, discharge and transfer of clients according to hospital policy and procedure. Stays with assigned clients or knows where and how they are: a. Visits all assigned clients to ascertain their condition before beginning tasks of the day. b. Knows where clients are, reasons for their being off the ward or away from the bedside, and when they are expected to return. c. Knows current condition, as well as changes in past 24 hours, of all assigned clients, and can report plan for care of each. 4. 5. 6. 7. 8. 9. Maintains flexibility and changes organizational strategies in response to changing client needs. Demonstrates clinical decision making skills, while caring for the client and/or family experiencing transitions in health status. Consults with instructor/staff in providing care to clients. Notifies instructor or appropriate staff member of changes in the client condition. Collaborates with the health care team or staff members who support the organization of clinical activities. Identifies critical behaviors utilized by the professional nurse, to effect positive change in the environment and managing of client activities. STRENGTH Week 7 10 5 IMPROVE Week 7 10

10. Works effectively with the professional nurse to develop management skills and knowledge specific to the delegation and supervision of unlicensed assistive personnel. 11. 12. 13. Demonstrates effective clinical decision making skills. Notifies faculty, peers, clients, staff and/or families when unforeseen events inhibit or preclude completion of responsibilities. Verbally contributes to clinical conferences and/or group discussions through sharing of appropriate experiences and ideas.

14. Assists group to evaluate work accomplished and plan continued work. 15. Demonstrates respect to all members of the healthcare team and interacts effectively to accomplish client's goals.

16. Works collaboratively with individual peers, and in peer group work by contributing ideas, knowledge and assistance. 17. Other

COMMENTS:

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WCU NURS 211L Medical Surgical Nursing: Promoting Wellness in Older Adults - Practicum

NURS _____Registered Nursing Syllabus Receipt Form

This form is designed to ensure elements of the syllabus are discussed and presented to the student. Initial each item after you read and understand it. Ask questions if you need clarification. 1. ______ I have been informed about the syllabus in its entirety. I understand, accept and abide by all of its provisions. 2. ______ I understand the coursework requires consistent classroom attendance and active participation. 3. ______ I understand the course workload will be very high and I have factored this into my schedule. 4. ______ I will make note of any important dates on the Readings and Assignments Outline. 5. ______ I am aware of the policy concerning make-up examinations. 6. ______ I understand I am responsible for my own learning. 7. ______ I will stay current with the material, including completion of reading assignments. 8. ______ I understand cell phone use or texting, food in class, and liquids in non-screw top containers is forbidden in classrooms. If these are found, they may be confiscated by the instructor and reported to the Dean for disciplinary action. 9. ______ I understand in order to pass this class: a) I must maintain at least a 76% average overall on didactic examinations and non-

didactic material (papers, presentations, etc.) according to the Evaluation Method.

b) Successful completion of this course related HESI (or ATI) computerized examination with a minimum score outlined in this course syllabus is required in order to pass this course, independent of other course grades. c) The final HESI (ATI) exam is given before the last week of the term and I will have two (2) attempts ONLY to achieve the minimum score required for this course. d) If a second attempt on the HESI (ATI) is required, the maximum percent score allowed for calculation of the final course grade is 76% e) NURS 220 has a different scoring system and has three (3) attempts to achieve the minimum raw score of 850 for the Exit Examination needed for graduation. I understand the remediation and final examination time schedules are subject to change. I understand I have received many recourses fro mastering the course related objectives, such as books, course readers, HESI and ATI review books, CD's, DVD's, on line study material, sample tests and case studies, etc. These resources are a means to assist me with meeting the course objectives and prepare for the evaluation of my learning through the examination and/or clinical evaluation, HESI (ATI) Exams and the NCLEX. I understand that there are no make up assignments and late assignments must be requested in writing prior to the date due. If there was not a written request and/or it was not approved by the instructor, in writing, this may result in a grade of "0" for that assignment. I understand all written assignments are due on the assigned due date and delivered to the classroom. No other location or delivery method is accepted such as e-mail or fax unless otherwise directed, in writing, and approved, in writing, by the instructor.

10. ______ 11. ______

12. ______

13. ______

My signature verifies that I have received information about and understand the contents of the syllabus and this verification

_______________________

Printed Last Name: Printed First Name:

Signature:

Date:

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WCU NURS 2l1L Promoting Wellness in the Older Adult Client - Part -B Course Outline NURS 211 Part B Promoting Wellness in the Older Adult Client (Practicum) Week Dates Week 1 Learning Objectives 1. Analyze the system issues related to the client's experiences in accessing and navigating the current health care systems for adults with acute and complex health problems. 2. Integrate national and federal guidelines and standards, such as Agency for the Healthcare Research and Quality (AHRQ) and Nursing Practice Standards (NPS) into client care management. Content Outline Orientation to the hospital unit Syllabus review Gordon's 11 functional conceptual framework Teaching learning principles in relation to geriatric care Medication administration review 1. Assignments, Papers Due, Tests Schedule Select patients and be prepared for each clinical day, prior to shift report. This includes completing the Clinical Preparation Guide or case map through appropriate data collection, chart review, physician order verification (24 hour chart check) Review of the nursing literature as appropriate, and creation of a DRAFT of the interdisciplinary plan of care Complete pertinent study and the Clinical Preparation Guide prior to care. Medication work sheet Medication calculation examination Demonstrate daily preparation by discussing admitting diagnosis, surgery, medication, treatment, procedures, and diagnostic tests; and using the Nursing Process while caring for patients.

2.

Week 2

1. Demonstrate sensitivity for developmental state, socioeconomic status, diverse cultural values, and spiritual beliefs of all clients in the delivery of health care. 2. Conduct comprehensive nursing assessments of adult and geriatric clients experiencing acute and chronic transitions in health status. 3. Formulate the appropriate nursing diagnoses based on assessment findings for individual clients and families that will promote health and facilitate clients' return to the community.

Medication administration review Gordon's 11 functional conceptual framework Teaching learning principles in relation to medication administration Electronic documentation Review the six rights to medication administration Check the medication administration record for drug time schedules and make sure appropriate drugs are available

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WCU NURS 2l1L Promoting Wellness in the Older Adult Client - Part -B on the unit. Check stop dates and outdated medication orders. Have the RN call the MD to update all medication orders. Re-check with the RN for an update if you are responsible for giving the medication. Check appropriate resources for stop date policies for antibiotics, narcotics, steroids, Heparin, etc. Safely administer medications on assigned patients, demonstrating correct IV medication calculations 1. Medication Administration 2. Safe administration of medications is a requirement (drugs or fluids via any route). This includes knowledge of drug action, why the client is receiving the drug, the expected outcome, correct dosage, calculation of dose or rate, the proper route of administration, toxicity or side effects, any interactive effect with other drugs or food, and special nursing implications or observations. 3. During medication preparation check the medication against the medication administration record: when taking medication out of the drawer prior to opening the package immediately after opening the package or returning it to the shelf. 4. Check the medication administration record against the patient's ID band prior to the administration of medications. Carry out

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WCU NURS 2l1L Promoting Wellness in the Older Adult Client - Part -B special orders, such as checking BP and/or AP, and check lab values PRIOR to the administration of medications. Monitor and document all therapeutic infusions (lVs, IVPB, Gastro, PEG and NG feedings) your patient is receiving. Notify your instructor IMMEDIATELY when: you are going to administer any medications (IV, IVPB, PO, NGT, GT, SC, IM). you are going to perform a new procedure you injure yourself or the client is injured (ex. stick with a needle) there is a change in the client condition/vital signs Complete pertinent study and the Clinical Preparation Guide prior to care. Medication work sheet Care Plan # 1 Due Receive report on your patient(s) when you arrive on the unit the day of the clinical.

5.

6.

Week 3

1. Utilize, implement, and evaluate an interdisciplinary plan of care for clients experiencing transitions in health status (integrated care plan should reflect health services needed). 2. Apply transcultural nursing principles, concepts and theories when providing nursing care to patients (individuals,

Management and Assessment of patients with acute and chronic pain Fluid and Electrolyte evaluation PCA and epidural indications and management Perioperative assessment and management

1.

2. 3. 4.

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WCU NURS 2l1L Promoting Wellness in the Older Adult Client - Part -B families, groups, and communities 5. Check with the RN throughout the day concerning your patient. 6. Update him or her on the patient(s) progress. 1. Complete pertinent study and the Clinical Preparation Guide prior to care. 2. Medication work sheet 3. Care Plan # 2 Due 4. Perform a thorough initial head to toe assessment of your assigned patient(s). Document your findings within the first 2 hours of clinical. Perform follow up physical assessments, and expected documentation; according to the guidelines of the institution. 1. Mid-Term Evaluation 2. Complete pertinent study and the Clinical Preparation Guide prior to care. 3. Medication work sheet 4. Care Plan # 3 Due 5. Nutrition Case Studies begin 6. Check all supporting diagnostic data related to your patient(s) diagnoses, treatments, and medications

Week 4

Week 5

1. Collaborate with peers and/or interdisciplinary team to analyze outcome criteria, utilizing appropriate standards of care, critical pathways, AHRQ guidelines, or other quality indicators to measure clients' response to care delivery. 2. Demonstrate safe clinical skills in providing competent nursing care. 3. Demonstrate professional behavior and communication skills (including therapeutic, assertiveness, and conflict resolution), while interacting with faculty, peers, assigned client, families and other members of the health care environment. 1. Explain the pathophysiology and rationale for therapeutic interventions (including pharmacologic and nutritional) for clients experiencing acute and chronic transitions in health status. 2. Utilize evidence-based research as a basis for application of nursing therapeutics to care delivery. 3. Utilize teaching and learning principles for culturally appropriate client health

Continue Week 3 Topics

Management and assessment of patients with endocrine disorders Diagnostic test Blood glucose assessment Diabetes Management (pharmacological and nonpharmacological interventions)

Management and assessment of patients with urinary and renal disorders Foley catherization Urine specimen collection Diagnostic Tests Pharmacological and nonpharmacological interventions

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WCU NURS 2l1L Promoting Wellness in the Older Adult Client - Part -B education. 4. Assess, plan, implement, and evaluate appropriate client/family education to promote self-care and transition for discharge to the home and community settings. Week 6 1. Demonstrate the appropriate use of pain measurement instruments, and identify appropriate pain relief interventions for selected groups of patients across the life-span. 2. Utilize the nursing process and Gordon's Functional Health Patterns in the care of the older adult client in the acute care and community settings. 3. Demonstrate the use of leadership and management principles to coordinate care of assigned clients, utilizing licensed and unlicensed assistive personnel (UAP). Management and assessment of patients with digestive and gastrointestinal disorders Enteral feedings Occult blood stool specimens Enema administration Diagnostic Tests Pharmacological and nonpharmacological interventions 1. being administered; especially FS (finger stick) blood glucose results from 6 a.m. (12 noon or 3:00 p.m., if you are working evenings), K+ levels, digoxin levels, pre-op lab work, etc. Complete pertinent study and the Clinical Preparation Guide prior to care. Medication work sheet Identify individualized client discharge education needs that promote self-care and return to the community. Care Plan #4 Due Nutrition Case Studies Continue Integrate all the data gathered about the client into the complex care plan and organize care in consultation with other members of the health care team. Complete pertinent study and the Clinical Preparation Guide prior to care. Medication work sheet Nutrition Case Studies Continue Follow-up performance evaluation

2. 3.

4. 5. 6.

Week 7

1. Continue to address objectives from previous weeks 2. Demonstrate accountability for selfdirected learning and professional growth during the clinical rotation.

Management and assessment of patients with musculoskeletal disorders

Crutches and Cane assessment Cast management Traction management

1.

2. 3. 4.

Enema administration

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WCU NURS 2l1L Promoting Wellness in the Older Adult Client - Part -B 5. Update Care Plans or Care Maps, after discussion with the clinical faculty and/or your patient's RN. 1. Complete pertinent study and the Clinical Preparation Guide prior to care. 2. Medication work sheet 3. Nutrition Case Studies Continue 4. Community experience report due 5. Be aware of times when patients will be off the unit for testing; such as radiological procedures, Physical (PT), Occupational (OT), or Speech Therapy. 6. Complete pertinent study and the Clinical Preparation Guide prior to care. 7. Medication work sheet 8. Nutrition Case Studies Continue 9. Before the end of the shift, verify the following for completeness: All IV's have been charted All medications have been signed off Narcotics given are signed off in Narcotic Book

Week 8

1. Demonstrate proficiency in documentation according to agency policy. 2. Evaluate personal clinical performance throughout the semester, as evidenced by completion of the 211L Evaluation Tool, at mid-term and end of semester. Student is encouraged to keep weekly anecdotal records to document evidence of exceptional achievement of course objectives, as reflected in clinical evaluation tool. 3. Describe or demonstrate an assessment for a patient with a multisystem problem. 4. Explain the rationales for diagnostic procedures and therapeutic interventions utilized for patients experiencing multisystem problems.

Management and assessment of patients with immunologic disorders. Chemotherapy End of Life issues: Hospice and advanced directives Diagnostic Tests Pharmacological and nonpharmacological interventions Management and assessment of patients with issues affecting community Discuss the community referral process, agencies, and social services

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WCU NURS 2l1L Promoting Wellness in the Older Adult Client - Part -B I/0 sheets have been updated and completed Nurses notes are updated with concise & complete information (do not leave till end of shift) 1. Final Evaluation 2. Complete pertinent study and the Clinical Preparation Guide prior to care. 3. Medication work sheet 4. Report off to the RN for your patient(s); giving specific information including the patient's condition, psychosocial status, care given (i.e. tracheostomy care, IV's, foley drainage, chest assessment), and patient education.

Week 9

At the conclusion of the course the student will be able to: 1. Demonstrate comprehensive application of the nursing process using evidence based approach to develop, implement and evaluate multidisciplinary plans of care for patients with acute and complex health care needs and their families. 2. Effectively collaborate with peers and the interdisciplinary team to analyze outcome criteria and patients' responses to various therapeutic interventions. 3. Demonstrate clinical leadership by providing direction to ancillary health care team members, making referrals for consultation as needed, and advocating for the patient and family as appropriate.

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Microsoft Word - NURS 211 PART A 0110

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