Course Title

: HOSPICE CARE: DEALING WITH PATIENTS WHO ARE TERMINALLY ILL.

Course Description

: This course deals with the concepts, principles and theories of human behavior and the hospice care amongst terminally ill patients in different settings.

Contact hours Course Objectives

: 45 hours : At the end of the course and given actual clients, population group who are under hospice care, the student should be able: (1) To find out how nurses cope with daily confrontation with the death and suffering of dying patients, (2) To identify whether nurses feel it is important to have communication skills in order to assist the terminally ill patient, (3) To estimate nurses' degree of work satisfaction, and (4) To explore the humane aspects of nursing assistance to the dying.

Name of the Institution Unit/Area Assigned Description of the Learners

: Medical Center Imus, Inc. Palico IV , Imus City, Cavite : ICU (Intensive Care Unit) : The students belong to the novice group. Who had finished their concepts course (Bachelor of Science in Nursing), have successfully passed the Philippine Licensure Examination and an employee of Medical Center Imus.

Description of the Setting

: The clinical exposure will take place at the Intensive Care Unit of Medical Center Imus, Inc. situated at the 4th floor of the old building of the hospital.

Length of Exposure

: The students will be exposed for 45 hours. Shifting may be morning/night/graveyard within the length of 8/12 hours in Medical Center Imus, Inc. Imus City, Cavite.

Method of Evaluation:

CABEROY A.; CALITIS E.; PEREZ D. ACT 200 CLINICAL TEACHING PLAN

Knowledge (33.33%) RLE exam Bedside Conference Case Study Case Presentation 45% 25% 15% 15%

Skills (33.33%) Delivery of Care OSCE 70% 30%

Attitude (33.33%) Attendance Decorum 30% 70%

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Matrix:

OBJECTIVES

BEHAVIORAL SIGNS (STUDENTS)

MENTORING PROCESS (CLINICAL INSTRUCTOR)

ASSESSMENT STRATEGIES

At the end of the shift in the area, the student will be able to:

1. Discuss all about the policies, procedures and protocols in the hospital, specifically in the ICU.

- Acts in accordance with the established norms of conduct of the institution. - Acts how the procedure MUST be implemented specially when handling patients.

Orientation/Briefing - The Clinical Instructor will conduct a general orientation program for the students. The Training Officer and/or the Operating Manager of the ICU of the hospital will be asked to discuss the policies, Standard Operation, unit activities, and procedures during the activity. Learning Plan Patients Assignment: Overall patient care (1 patient at a time)

2. Discuss all about the course objectives. - Identifies advantages and disadvantages for the given schedules Lecture schedules Duty Schedules Delegation of tasks - Determining ways to finish the course with great plans - Sets attainable objectives to enhance

Pre-conference - The clinical instructor will discuss SMART course objectives, schedules (lecture/duty), requirements and grading system specific for the course. - The clinical instructor will now explain the How do you promote safe environment and safe and quality nursing care of the Reflective Learning Journal

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and responsibilities Requirements Grading System

nursing knowledge, skills and attitude - Identifies strengths and weaknesses for the tasks and responsibilities given - Assesses own performance based on the ideals

specific tasks and responsibilities and will assign it to the students in a timely manner. - The clinical instructor will formulate a group for brainstorming once a week. (This brainstorming will include all students learning within the week. Whether, it was a learning based on lecture, duty or even incidental.)

patient?

3. Describe the learning environment for the clinical experience

- Respectfully following all rules and regulations as well as the standard operating procedure when: Entering the hospital premises Entering the ICU Approaching Patient Leaving ICU Leaving Hospital premises -

Tour in the Area The clinical instructor will let the student look for all the premises located inside the hospital (e.g. nurses station, medication, working, hand washing, waste disposal areas). As well as the prohibited areas where students cant access without permission. The clinical instructor will specifically show and present the intensive care unit where most of the students time will be spent. He/ She will present the devices used inside the unit (e.g. Defibrillator, Cardiac Monitor, Suction Machine)

ARFA (Reflective Journal)

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The clinical instructor will then again review the rules and regulations but this time, specific for the Intensive Care Unit (e.g. Using of PPE every time going to the patients bedside, wearing of gowns whenever going out of the ICU, etc.)

4. Promote safe and quality nursing care to the ICU patient at risk/with problems (KRA: Safe and Quality Nursing Care)

Identifies the health needs of the patient

Development of a Health Education Plan The clinical instructor asks the student to carefully Health Education Plan or Session design for the Health Education

Explains the health status of the patient

examine the patient and identify his/her health needs at the moment. From the data, the clinical instructor asks the student to develop a health education plan to explain the health status of the patient.

Identifies wellness potential and/or health problems of the patient

SIDE-BY-SIDE TEACHING

Bedside Questioning

The clinical instructor may act as a role model Gathers data related to the health when he/she is performing an assessment as

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condition of the patient

needed.

Analyzes the data gathered

The clinical instructor observes the student while obtaining information from the adult or family

Selects appropriate action to support/enhance response of the patient

member and identify and address challenges. The clinical instructor may alternate with the student duties of examining the patient, writing

Monitors the progress of the action taken to the patient

relevant information to countercheck students outputs.

Performs safety measures in all aspects of care to the patient

DIRECT OBSERVATION

Actual Student Evaluation

The clinical instructor observes the student in the Performs comfort measures in all aspects of care to the patient performance of safety measures, comfort measures and measures to ensure privacy.

Give emphasis on these measures during the Performs measures to ensure privacy in all aspects of care to the patient skills laboratory These measures must be emphasized during the skills laboratory of the student. In all procedures, these must be observed always CABEROY A.; CALITIS E.; PEREZ D. ACT 200 CLINICAL TEACHING PLAN

Identifies the priority needs of the patient

The clinical instructor must be present during the assessment of the student and identify with the student the priority needs of the adult.

Bedside Conference Asks the students how to prioritize the needs of the patients?

Analyzes the needs of the patient Assists the student in the analysis of the data Determines appropriate nursing care to address priority needs/problems gathered.

Asks the student the model he/she may utilize (e.g. ABC, Maslow Hierarchy)

Refers identified problem to the clinical instructor, staff nurse or any appropriate individual

The clinical instructor gives the patients assignment to the charge nurse-on-duty.

Nursing Care Plans

The clinical instructor must see to it that the Establishes means of providing continuous care to the patient. Conforms to the 10 Golden Rules in medication administration and health therapeutics Initially, the clinical instructor reviews with the student the 10 golden rules in medication administration and health therapeutics The clinical instructor directly observes the student in the preparation of medications until the student has already been given the medication to the CABEROY A.; CALITIS E.; PEREZ D. ACT 200 CLINICAL TEACHING PLAN student is assigned to the same patient as of the duty (except if the patient is already discharged) DIRECT OBSERVATION OSCE

patient.

SIDE-BY-SIDE TEACHING

Bedside Conference

Obtains informed consent from the significant others if not from the patient

- The clinical instructor may act as a role model when he/she is performing an assessment as needed.

Completes appropriate assessment forms - The clinical instructor observes the student Performs appropriate assessment techniques for a patient while obtaining information from the client and identify and address challenges.

Obtains comprehensive information from the child/significant others

- The clinical instructor may alternate with the student duties of examining the patient, writing relevant information to countercheck students

Maintains privacy and confidentiality

outputs.

Identifies health needs of the patient

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Includes the patient and family in care planning

Development of Nursing Care Plan (NCP) Submission of Nursing Care The clinical instructor assists the students in the Plans

Collaborates with other members of the health team

development of NCP

The NCP is submitted by the student everyday States expected outcomes of nursing intervention (except the first day) and checked by the clinical instructor

Develops comprehensive care plan for the patient maximizing opportunities for prevention of problems and/or enhancing wellness response

The NCP is evaluated by the student and the CI guides the students in the evaluation of patients outcomes

Accomplishes a patient-centered discharge plan

Explains interventions to the patient and family before carrying them out to

BEDSIDE TEACHING (defined as teaching and reinforcing skills at

Bedside Conference/questioning

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achieve identified outcomes

patients bedside)

Implements nursing intervention that is safe and comfortable

The clinical instructor can watch the student interact with patients and family

Acts to improve the health condition or human response of the patient

The clinical instructor guides and supervises the student in the actual performance of nursing activity.

Performs nursing activities effectively and in a timely manner The clinical instructor can experience what the student does and how he/she act with patient Uses the participatory approach to enhance patient-partners empowering potential for healthy lifestyle and wellness The clinical instructor models important clinical skills, attitudes, and communication in the context of patient care as well as observes students performance. firsthand.

Monitors effectiveness of nursing intervention

The clinical instructor guides the students in the evaluation of patient care

Nursing Care Plans

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Revises care plan based on expected outcomes

During evaluation of patient care, the clinical instructor must be present at the bedside to ensure validity of the clinical evaluation made by the student

A revised care plan may be asked as needed

SUMMARY OF ACTIVITIES TIME TABLE Pre-conference: Pre-conference: Pre-conference: Pre-conference: Pre-conference: DAY 1 DAY 2 DAY 3 DAY 4 DAY 5

>Prayer 5:45am6:00am >Prayer 1:45pm2:00pm >Self-awareness >Self introduction. >Checking of attendance, grooming and paraphernalia

>Prayer >Checking of attendance and paraphernalia >Checking of uniform and grooming

>Prayer >Checking of attendance and paraphernalia >Checking of uniform and grooming

> Prayer >Checking of attendance, grooming, and paraphernalia.

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9:45pm10:00pm

(getting to know). >Checking attendance paraphernalia. >Checking uniform grooming. Orientation Delegation Individual Functions Responsibility and >Assigning of of students individual or respective tasks, and individual responsibilities of and of and

>Receiving endorsement from outgoing shift

>Receiving of endorsement

>Giving of individual assignment and responsibilities

>Assigning of students' individual work in admission, vital signs monitoring, and medication

>Assigning of students individual or respective tasks, individual responsibilities.

>Receive 6:00am6:30am 2:00pm2:30pm endorsement from outgoing shift. >Conduct rounds. nursing

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10:00pm10:30pm

>Orientation staff

to nurses,

physician on duty and other health personnels. >Orientation to ICU set up, equipments, facilities drugs,admission procedures hospital and and

protocols

and policies. >Assigning of

students to their respective individual tasks, patient,

and responsibilities.

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Supervise students Supervision and in: monitoring of students: >vital signs 6:307:00am 2:303:00pm 10:3011:00pm >Assessing patient's condition. >Taking vital signs. >Preparation administration and of >Checking of IVF, >oral and parenteral regulate to its medication rate, > >nursing documenting the interventions level and assessing > >admission, charting, appropriate the site. and documentation

Supervision and monitoring of students: >vital signs >oral and parenteral medication >nursing intervention >admission, charting and documentation

Supervision and monitoring of students: >vital signs >oral and parenteral medications >nursing interventions> admission, charting and documentation

Supervision and monitoring of students: >vital signs >oral and parenteral medication >nursing interventions >admission, charting and documentation

oral or parenteral medications treatment. >Reading patient's or

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chart. >Carrying Doctor's order. >I and O out

monitoring. >Pain management. >Arranging and scale

completing the data of the chart.

7:008:00am 3:004:00pm 11:00pm12:00am

>Individual Conference >Pretest

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8:008:15am 4:004:15pm 12:0012:15am

>Break

for

first >First batch break

>First

batch

>First

batch

>First

batch

batch (snack) with (snack) proper endorsement second batch to

break (snack)

break (snack)

break (snack)

8:158:30am 4:154:30pm 12:1512:30am

>Break for second >Second batch break batch (snack) with (snack) proper endorsement first batch to

>Second batch break (snack)

.>Second batch break (snack)

>Second batch break (snack)

8:30-

>Conference for the >Individual beside requirements and care NCP

>Discussion

>Discussion with evaluative test

>Post test and Rationalization

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11:00am 4:307:00pm 12:303:00am

activities >Preparation administration and of

> Checking of sample charting ( small notebook)

>Quiz >Continue supervising and assisting the students

>Bedside care >Self evaluation > Checking of sampling charting > Continue supervising and assisting the students

oral or parenteral medications treatment. or

11:0011:30am 7:007:30pm 3:003:30am

>Break

for

first >First batch (meal)

>First batch (meal)

>First batch (meal)

>First batch (meal)

batch (meal) with proper endorsement second batch to

11:3012:00nn 7:30-

>Break for second >Second batch (meal) batch (meal) with proper

>Second batch (meal)

>Second batch (meal)

>Second batch (meal)

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8:00pm 3:304:00am

endorsement first batch

to

12:001:00pm 8:009:00pm 4:005:00am

>Checking sample charting

of > Continue supervising and assisting students

>Checking of sample charting >Counter signing of final charting and to be noted by the C.I >Closing of charts, I&O and I.V

>Checking of sample charting >Closing of I & O, and IV.

>Continue supervising and assisting students. >Checking of charting and counter signing. >Closing of charts, I&O and IVF

>Counter sign final charting and to be noted by the clinical instructor

> Checking of charting and countersigning > Closing of charts, I

>Latest vital signs and O, and IV taking recording results on and the the

patient's chart >Closing of charts, I and O and IVF

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2:303:00pm

Post- Conference:

Post Conference:

Post-conference:

Post-conference:

Post-conference:

> Endorsement on 10:3011:00pm 6:307:00am >Reminding on the incoming shift >Reminding students the incoming shift >Endorsement regarding the submission of all the students regarding requirements and the submission of also the activities for all requirements the next day and also the things >Evaluation of to be expected for students by asking the next day feedback (action >Evaluation of the students by asking reflection time) >Prayer >End of the duty

>Evaluation of students by asking feedback >Prayer >End of Duty

> Evaluation of students by asking feedbacks.

>Reminding students about the activities for the next day. >Evaluation of

>Closing Prayer

students by asking feedback (action

>End of Duty

reflection time) >Prayer >End of Duty

CABEROY A.; CALITIS E.; PEREZ D. ACT 200 CLINICAL TEACHING PLAN