SAN MATEO ABSN

Managing Care of the Adult I

N120, N120L Course Syllabus

Summer 2012 Course Manager: Garry Johnson, RN, MSN, CCRN

Course Outline Course Description This course focuses upon both caring for and caring about the adult client. Building upon the students previous knowledge, the course utilizes the nursing process in providing opportunity to integrate theory with practice in promoting each individual clients achievement of optimal health and comfort. Particular emphasis is placed upon the concept of wholeness, referring to the constant interactions of an individuals biophysical, emotional, sociocultural, spiritual, and environmental dimensions. Theory content for this nursing course addresses selected areas of health alterations that beginning nursing students will likely encounter in the clinical setting. These areas include problems with sensory input, immobility, oxygenation, gastrointestinal function, urinary function, selected regulatory mechanisms, and selected cellular dysfunction/proliferation. Theory content will also include the concept of death and dying as it relates to the nursing student, their adult clients, and their clients support systems. The course content is designed to assist the student in knowledge development of core competencies such as critical thinking, effective communication, ethics, diversity, professionalism, leadership, information management, and an appreciation for the global environment in which health care is provided. The course is further designed for the students acquisition of theory-based competency in performing selected psychomotor nursing skills as related to a clients oxygenation needs, nutritional needs, elimination needs, safety needs, mobility and movement needs, pressure ulcer prevention and treatment, medication administration, pain management, sterile dressings and wound care. Prerequisite: Successful completion of required coursework to date. Units: 2 units of theory and 3 units of clinical. Clinical units will take place in the acute care clinical setting. Course Manager and Theory Instructor: Garry Johnson, RN, MSN, CCRN Assistant Professor Office phone: 650-292-5581 Office hours: please make an appointment E-mail: gjohnson@samuelmerritt.edu

Course Objectives At the completion of the course, the student will: 1. Demonstrate beginning knowledge and skill in assessing health variations of an individuals biophysical, emotional, sociocultural, spiritual, and environmental dimensions. 2. Apply the nursing process to assist clients to achieve and/or maintain optimal health. 3. Provide nursing care that is compassionate and sensitive and to the clients personal identity, cultural affiliation, and environment. 4. Demonstrate behaviors that reflect professional accountability. 5. Demonstrate beginning socialization into the professional nursing role. 6. Use the components of effective communication to promote professional relationships. 7. Utilizing adult learning theory incorporates the teaching-learning needs of adult clients when planning and delivering nursing care. 8. Provide safe, therapeutic nursing care to an adult that is based on knowledge of theoretical rationales. 9. Apply knowledge of the adult clients stage of growth and development as it relates to clients current health situation.

Required Textbooks
Booklist for MCA 1 and MCA 2 Deglin, J.H., Vallerand, A.H., & Sanoski, C. (2010). Daviss drug guide for nurses Philadelphia: F.A. Davis (12 ed.) ISBN-13: 978-0-8036-2308-8 ISBN-10: 0-8036-2308-9 Lemone, P., Burke, K. & Bauldoff, G. (2011) Medical-surgical nursing: Critical thinking in patient th care. (5 ed.). Pearson: San Francisco ISBN-13: 9780135075944 Pagana, K.D. & Pagana, T.J. (2010). Mosby's manual of diagnostic and laboratory tests. (4th ed.) St. Louis: Elsevier Health Science. ISBN-13: 9780323057479 Perry, A.G. & Potter, P.A. (2010). Clinical nursing skills & techniques (7 ed.). St. Louis: Elsevier ISBN-13: 9780323052894

You can survive with any drug guide and lab guide. These are two that I have used and work well but many of the others are also fine. You need a drug guide and lab guide to complete Care Plans and learn new medications and lab values. All of these texts are valuable and you will continue to use them through your first few years of nursing. I strongly recommend that you buy these 4 books and keep them. They will become excellent references for your beginning years as a nurse as your transition from Novice to Expert!

Teaching Methods Teaching Strategies. 1. 2. 3. 4. 5. 6. 7. 8. Lectures Demonstration Questioning/inquiry Discussion, both in small groups and class Case Studies Audio-visual aids Course, unit, and clinical objectives Exams

Note: Blackboard will be used as a supplement to the course syllabus, clinical intervention materials, and for posting student scores.

Methods of Evaluation Grading is in accordance with the academic policies of Samuel Merritt College Undergraduate Grading Policy. The School of Nursing policy mandates students must achieve a final grade of 70% or greater average to pass the course. The theory grade will be evaluated based upon the following: Take Home Exams ATI Testing Case Study Final Exam 20% 5% 10% 65%

Letter grades are assigned as follows: Grades are rounded off. For example, 82.5 would become 83%. 82.4 would become 82%.

A AB+ B BC+ C CD F

93 - 100% 90 - 92% 87 - 89% 83 - 86% 80 - 82% 77 - 79% 73 - 76% 70 - 72% 60 - 69% < 60%

Examination information: A. Each exam will cover material assigned up to the point of the exam including information covered in clinical relevant to the theory topics. Each assigned topic carries approximately equal weight on the exams unless otherwise stated in class. B. All exams are to be taken as scheduled. (See exam schedule on the course calendar). Whenever possible, absence from exams must be cleared with the course faculty prior to the exam time. If a student is ill, he/she is encouraged not to take the exam. Make-up of a missed exam must be scheduled with the theory faculty. Examinations MAY NOT BE REPEATED. The student is responsible for marking (Scantron) exam answer forms accurately. Exams will not be returned, but correct answers on select material will be reviewed. Questions regarding the exam will not be discussed during lecture time. Please make an individual appointment with the instructor for any questions regarding material covered in the exam.

Any challenge over points assigned for an individual question must be made to the instructor for the content within one week of when the exam grade is returned. Students must bring a minimum of two acceptable references to an appointment to challenge a test/exam question.

C. To become familiar with the NCLEX test format uses of NCLEX review books/software are suggested. NCLEX materials may be found in the library. D. Discussion of exam content with other students who have not taken the exam is a violation of the Code of Ethics as written in the Samuel Merritt College Student Handbook. E. Health care terminology and mathematical calculations may be included in the exams after the topics have been introduced in theory and/or clinical. Calculators will not be allowed during exams, nor will any electronic devices belonging to students except during the math test where calculators are welcomed. F. Exam scores will be posted on Canvas. G. Any student scoring less than 70% on an exam must meet with the course faculty. H. Attendance for lecture is expected and essential for successful academic achievement. Clinical Objectives Upon completion off this course, the student will be able to: A. Demonstrate professional accountability and responsibility for nursing practice within legal and ethical standards of care. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Perform nursing procedures using currently acceptable standards of care. Administer medications safely to patients. Evaluate the effectiveness of drug therapy, taking appropriate action as necessary. Provide a safe environment. Initiate basic patient care in a timely manner. Complete all patient care within appropriate timelines. Function within the guidelines for the student role. Demonstrate professionalism in dress, behavior, and communication. Set daily goals and implement activities to meet learning needs. Chart clearly and thoroughly in patient records. Pass a medication exam with > 90% prior to administering medications.

B. Perform basic therapeutic and preventive nursing skills, based on a body of general and scientific knowledge. C. Demonstrate the ability to correctly administer accurate dosages of medications to adult clients of all ages by a variety of routes. D. Practice nursing skills that ensure a safe and hygienic environment as it relates to individuals and families in the acute care hospital and in the community. E. Articulate essential written and verbal communication for planning and documenting nursing care. 1. Focus on therapeutic communication versus social exchange. 2. Complete the clinical preparation sheet, integrating all data. 3. Discuss pathophysiology, daily comprehensive assessments, laboratory, diagnostics, and monitoring data integrating their relationship to patient care. 4. Pass assessment check-off. 5. Identify appropriate patient problems. 6. Plan, implement, and evaluate care based on patient problems. 7. Complete appropriate written nursing care plans. 8. Provide care that is sensitive to cultural and ethical values. 9. Daily discussion of the patients clinical status and response to care. 10. Prioritize care on an on-going basis. Assume personal responsibility for acquiring current, essential information and appropriate validation of decisions made to ensure safe clinical practice. Clinical Skills This course provides the student with theory and practice of skills used by the professional nurse in the care of adult clients. Using the problem solving process, the student will apply knowledge gained from a variety of sources to the practice of a selected series of skills in the clinical setting. The student is accountable for demonstrating beginning competence with the following: medication administration via a variety of routes, dosage calculation, maintenance of a safe and hygienic environment, attention to correctly and safely mobilizing clients, assessment and management of acute and chronic pain, dressings and wound care, promoting gastrointestinal function, intubation and maintenance, oral and enteral feeding measures, capillary blood glucose monitoring, urinary catheterization and care. The student is also accountable for demonstrating comprehension of basic principles of teaching/learning, nursing documentation, and medical and surgical asepsis. If you do not feel prepared to perform any or all of the aforementioned skills, please allocate time to visit the skills lab to practice these skills. You are expected to know the theory and purpose of the skills you perform and must demonstrate this knowledge prior to performing these skills in the clinical setting.

Clinical: The clinical experience provides an opportunity to create knowledge from a theoretical base for the planning and implementing of nursing care for clients. Each student will care for a variety of adult clients in the acute care setting. Attendance: Attendance in the clinical setting is required. Absence is to be handled according to the policies stated in the Student Handbook. Clinical Preparation: The student will complete one clinical worksheet per week due on Fridays with the exception of the last week of clinical. Reflection: Students are expected to reflect on the clinical experience to synthesize knowledge and further their personal learning goals. This can be negotiated with individual clinical instructors. Each student is expected to generate at least one reflection about their clinical experiences each week. See guidelines for clinical reflection. Evaluation: Students are evaluated according to the course/clinical objectives listed at the beginning of the syllabus. These objectives have additional clinical behaviors and are referenced in the clinical evaluation form attached to the course syllabus. Students must do a weekly self-evaluation on the clinical preparation sheets. If, at any time during the term, the clinical faculty believes the student is not making sufficient progress toward meeting the clinical objectives, a counseling session will be held. At that time, the student will be advised of the behaviors necessary to achieve successful performance. Prior to the completion of the course, clinical faculty and each student will complete the evaluation tool included in the syllabus. The original copy of the written evaluation remains with the students file in the School of Nursing. . Academic Integrity Samuel Merritt College affirms the belief that integrity, truth, respect and honesty are the foundations for our interactions as an academic institution. All students are expected to abide by the policies of academic honesty and integrity as outlined in the Samuel Merritt College Catalog. Since dishonesty in any form harms the individual, other people, the community, and the College, policies on academic integrity will be strictly enforced. We expect you to be familiar with the guidelines for behavior, to follow them, and to know the consequences of violating these standards of ethical behavior.

Critical Behaviors: Critical Behaviors, which if proven, may immediately result in failure of a course, as well as disciplinary action by the College. They can include: Purposeful falsification of a client record. Blatant disregard of client confidentiality Denying responsibility for ones own deviation from standards of practice. Act or threat of intimidation, harassment, or physical aggression. Actions, which places the client or others in physical or emotional jeopardy. Abusive behavior toward clients. Failure to disclose actions, which places a client or others in physical or emotional jeopardy. Ignoring the need for essential information before intervening.

NOTE: Students may be removed from the clinical setting during the investigation of the unusual occurrence. Academic Accommodations Samuel Merritt College will make reasonable accommodations for persons with documented disabilities. Students with disabilities, whether physical, learning, or psychological, who believe that they may need accommodations in this class, are encouraged to contact Diane Hansen, Coordinator of Academic Support and Disabled Student Services, as soon as possible to ensure that modifications are implemented in a timely fashion. You are encouraged to make an appointment early so the faculty members have adequate time (at least two weeks) to help provide the needed accommodation. The student is responsible for providing each faculty (theory and clinical) with a copy of the letter from the Coordinator of Academic Support and Disabled Student Services outlining course adaptations or accommodations. Accommodations or adaptations will not be made unless the above named procedure is followed. Note: 1) Email - if you cannot get into your email account, contact the helpdesk via email helpdesk@samuelmerritt.edu or 510-869-6836. 2) Blackboard - if you cannot get into your Blackboard account, contact Vicki Davis, the Online Education Coordinator via email vdavis@samuelmerritt.edu or 510-869-6721 or 800-709-7110.

N120 MANAGING CARE OF THE ADULT I ABSN Clinical Evaluation Form

STUDENT NAME______________________________________DATE_____________ INSTRUCTORS NAME________________________________________

MIDTERM EVALUATION PROGRESS: SATISFACTORY_________ NEEDS IMPROVEMENT________ UNSATISFACTORY________

ABSENCES:

FINAL EVALUATION PROGRESS: SATISFACTORY_________ NEEDS IMPROVEMENT_________ UNSATISFACTORY________

ABSENCES:

Excused Hours________ Unexcused Hours___________ Make up hours completed__________

Excused Hours________ Unexcused Hours___________ Make up hours completed__________

Signature:

Signature:

Date:

Date:

Legend: S = Satisfactory Progress demonstrates the expected level of competency to achieve clinical objectives by end of rotation. I = Needs Improvement minimally meets level of competency but is not proficient. U = Unsatisfactory Progress Does not demonstrate the level of competency required to achieve clinical objectives by end of rotation.

CLINICAL OBJECTIVES

MIDTERM EVALUATION Student Instructor

FINAL EVALUATION Student Instructor

1. Demonstrates beginning knowledge and skill in assessing health variations of an individuals biophysical, emotional, sociocultural, spiritual, and environmental dimensions. 2. Applies the nursing process to assist clients to achieve and/or maintain optimal health. a. Formulates nursing diagnosis statements based on relevant, documented assessments. b. Prioritizes nursing activities to meet the needs of adult clients. c. Identifies adult client outcome objectives. d. Plans interventions individualized to the adult clients requirements. e. Evaluates effectiveness of care provided. 3. Provides nursing care that is compassionate and sensitive to the adults personal identity, cultural affiliation and environment. 4. Demonstrates behaviors that reflect professional accountability. a. Prepares for clinical by completing pathophysiology flowsheet prior to entering the clinical setting. b. Consistently punctual to

CLINICAL OBJECTIVES

MIDTERM EVALUATION Student Instructor

FINAL EVALUATION Student Instructor

the clinical setting. c. Adheres to appropriate dress code. d. Assumes responsibility and take initiative for own learning. e. Practices within the legal and ethical boundaries of nursing practice. 5. Demonstrates beginning socialization into the professional nursing role. a. Identifies own strengths and areas for growth, informally on a weekly basis and formally in writing at final evaluation with clinical instructor. 6. Uses the components of effective communication to promote professional relationships. a. Reports to appropriate person at the beginning and end of assignments. b. Reports abnormal findings to the appropriate person in a timely manner. c. Communicates with other members of the health care team to coordinate care. d. Documents nursing assessments, interventions and other client related information appropriate in terminology and form for the clinical setting. e. Maintains confidentiality. f. Assesses the clients need

CLINICAL OBJECTIVES

MIDTERM EVALUATION Student Instructor

FINAL EVALUATION Student Instructor

for PRN medication and treatments. g. Accurately calculates drug doses in the clinical environment. h. Provides for a safe client environment based on individual patient needs and assessment i. Follows universal precautions in all clinical settings. 7. Utilizing adult learning theory, incorporates the teaching-learning needs of adult clients when planning and delivering nursing care. a. Incorporates learning needs of client/support system appropriately into nursing care plan. 8. Provides safe, therapeutic nursing care to adults that is based on knowledge of theoretical rationales. a. Safely administers medications. b. Discusses the purpose of pharmacological treatment as it relates to the clients health status. c. Assesses the presence of therapeutic and non therapeutic effects of medications. d. Assesses the clients need for PRN medication and treatments. e. Accurately calculates

CLINICAL OBJECTIVES

MIDTERM EVALUATION Student Instructor

FINAL EVALUATION Student Instructor

drug doses in the clinical environment. f. Provides for a safe client environment based on individual patient needs and assessment. g. Follows universal precautions in all clinical settings. 9. Provides nursing care appropriate to the adult clients stage of growth and development as it relates to the clients current health situation.

N120: Managing the Care of the Adult Progress Summary Comments

STUDENT:_______________________________________________________ DATE MIDTERM - STUDENT COMMENTS Areas of Strength:

Areas to Work On:

MIDTERM - FACULTY COMMENTS Areas of Strength:

Areas to Work On:

N120: Managing the Care of the Adult Progress Summary Comments

STUDENT:_______________________________________________________ DATE FINAL - STUDENT COMMENTS Areas of Strength:

Areas to Work On:

FINAL - FACULTY COMMENTS Areas of Strength:

Areas to Work On:

Guidelines for Clinical Reflection

Reflection is crucial for student learning. It allows students to grow and process clinical experiences. Building of what you have learned in Introduction to Nursing and using your knowledge of yourself with regards to Myers-Briggs Personality Type, Ethical Values systems and American Nurses Association Code of Ethics, you are required to reflect on your clinical learning experiences by answering the following questions: 1. What went well in my clinical experience this week? 2. What were my primary misconceptions? 3. Did I miss anything in report or other information that might have made me act more effectively as a nurse? 4. Evaluate your knowledge and skills to manage your clinical experience and identify areas that require further practice. 5. What was correct? Appropriate? Safe? 6. What will I do differently next time? 7. What are some goals for next week?