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SCHOOL OF NURSING Bachelor of Science in Nursing

NURS 3715.06: Clinical Integration 3 (6CR)

Course Professor: Betty MacIsaac RN MN Contact Information: Email: betty.macisaac@dal.ca Phone: (902) 233-6627 Office Location: Dentistry Building, Room 5203 Office Hours: By appointment

Laboratory Instructors:

Kim Hebert RN MN NP: kim.hebert@dal.ca Shauna Houk RN MN: shauna.houk@dal/.ca Betty MacIsaac RN MN: betty.macisaac@dal.ca Carol Ritchie RN MN: carol.ritchie@dal.ca

Teaching Assistants:

Jeremy Burton BScN: je.burton@icloud.com Jami Gillis BScN: jamileighgillis@gmail.com

Class times and locations

BScN: jamileighgillis@gmail.com Class times and locations Thursdays @ 0830-1530, CLSC and CHEB (as per weekly

Thursdays @ 0830-1530, CLSC and CHEB (as per weekly schedule) **Simulation sessions, clinical placements as per clinical schedule (refer to Brightspace)

Clinical Placement Groups: posted on the N3715 Brightspace site

Course Description

Using simulation and clinical experiential learning students apply knowledge related to caring for clients with acute, episodic illnesses from birth to death. Interprofessional practice and evaluation of the impact of collaborative care will be a focus.

Format Laboratory and Clinical Experiential Learning equivalent to 220 hrs/term. This is a 6 credit clinical integration course (May 4-July 21). Clinical Integration will take place on Thursdays from 0830-1530, CLSC and CHEB (as per weekly schedule). There will be a four week clinical experience included. The clinical experience will begin June 19 and end July 14.

Pre-Requisite/Co-Requisites Clinical Integration 2 Professional Formation of Nursing Practice: Leadership Perspectives

Nursing and Episodic Illness: Preventative Care and Interventions Student Learning Objectives 1. Apply the nursing

Nursing and Episodic Illness: Preventative Care and Interventions

Student Learning Objectives

1. Apply the nursing process, critical thinking, relational practice and evidence-informed decision making in acute care settings with clients of various ages and stages of development

2. Analyze the impact of the determinants of health upon the physical, emotional and social

wellbeing of clients experiencing acute, episodic illness

3. Engage clients in the development of strategies for health promotion and prevention of illness

4. Use therapeutic communication skills to develop collaborative relationships with clients, families and other health care team members to achieve professional healing relationships

5. Apply the principles of legal, ethical and professional accountability in the practice of nursing

6. Implement health promotion and prevention activities for a variety of clients

7. Demonstrate leadership to promote safety culture.

8. Evaluate the impact of interprofessional care in acute health interactions with clients and families.

9. Analyze the impact of organizational policies on care delivery in acute settings.

Required/ Suggested Textbook(s), readings, materials including electronic resources Canadian Nurse Association. (2008). Code of ethics for registered nurses. Ottawa, ON: Author. CBU Open Online Learning (MIKM2701 - http://www.cbu.ca/indigenous-affairs/unamaki-

SafeMedicate - https://www.safemedicate.net/login/login.php College of Registered Nurses of Nova Scotia. (2012). Standards of practice for Registered Nurses. Halifax, NS: Author. Gregory, D., Raymond-Seniuk, C., Patrick, L., & Stephen, T. (2015). Fundamentals:

Perspectives on the art and science of Canadian nursing. Philadelphia: Wolters Kluwer. Halter, M. (2014). Varcarolis’s Canadian psychiatric mental health nursing. (1st Canadian Ed.). St. Louis: Saunders. Hartrick Doane, G., & Varcoe, C. (2015). How to nurse: Relational inquiry with individuals and families in changing health and health care contexts. Philadelphia: Wolters Kluwer. HESI (2016). HESI Elsevier Adaptive Quizzing. Elsevier Inc. http://evolve.elsevier.com

HESI (2016). HESI RN Case Studies with Practice Test. Elsevier Inc. http://evolve.elsevier.com

Institute for Healthcare Improvement (IHI) - http://www.ihi.org/education/ihiopenschool/Pages/default.aspx Nursing Central from Unbound Medicine (2014) Point of care resources. Retrieved from http://nursing.unboundmedicine.com/nursingcentral Paul, P., Day, R., & Williams, B. (2016). Brunner & Suddarth's Canadian textbook of medical- surgical nursing. (3 rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Perry, E.P., Hockenberry, M.J., Lowdermilk, D.L., Wilson, D., Keenan-Lindsay, L., & Sams, C. (2017). Maternal child nursing in Canada. (2 nd ed). Toronto, ON. Elsevier Canada.

Recommended Additional Supportive Resources Resources from Unbound Medicine OR

Supportive Resources Resources from Unbound Medicine OR A Current Manual of Laboratory and Diagnostic Tests A

A Current Manual of Laboratory and Diagnostic Tests

A Current Handbook of Nursing Diagnosis

A Current Drug Reference Text

Major Course Concepts

I. People Centredness

a. Diversity: uniqueness of each persons’, families health care interface experience; culturally sensitive practices

b. Interprofessional: immersion opportunities

c. Health Literacy: client health education

d. Nursing Practice (Psychomotor skills, lifespan, promotive, restorative, preventative, rehabilitative, and palliative): application of nursing science and critical thinking in acute care settings with various ages and stages of development;

e. Communication: collaborative, professional relationships

f. Relational Practice

g. Theory

h. Evidence

II. Health Systems and Social Care

a. Primary health care (Across a variety of settings): health promotion

b. Determinants of Health: impact of the social determinants of health upon the physical, emotional and social wellbeing of clients experiencing episodic interface with the health

care system

c. Activism: health policy

d. Safety: self, client

e. Advocacy: children and families rights to health care

III. Professional Formation

a. Accountability: legal, ethical, professional; reflective thinking in evaluating personal progress in the course, approaches to care and the need for further learning

b. Collaboration

c. Leadership

d. Confidence and competence

e. Transition to Practice: beginning proficiency in nursing practice

Weekly Topic List:

Weekly Topic List: Dates Topics Week 1 Orientation to N3715 May 4, 2017 1. Mobility Labs

Dates

Topics

Week 1

Orientation to N3715

May 4, 2017

1. Mobility Labs

2. IV Insertion Competency Lab

3. Venipuncture Competency Lab

4. HESI Case Studies

Week 2

1. CVADS Competency Lab

May 11, 2017

2. Guided Case Study Lab: Respiratory Management

3. Chest Tubes, Trach’s & Suctioning Competency Lab

4. Simulation Session

Week 3

1. Guided Case Study Lab: Nasogastric Tubes, Enteral

Feeding, TPN, Ostomies

May 18, 2017

2. Simulation Session

3. HESI Case Studies

Week 4

1. Pediatric Simulation

May 25, 2017

2. Open Lab Practice

3. HESI Case Studies

Week 5

1. Maternity Simulation

June 1, 2017

2. Guided Case Study Lab: Peritoneal Dialysis, Bladder

Irrigation, Nephrostomy Tube, Ileal Conduit

 

2. HESI Case Studies

Week 6

1. Simulation Session

June 8, 2017

2. Guided Case Study Lab: VAC Dressing, Traction, Amputee

Care, Burn Management (wound, airway and fluid)

 

3. Open Lab Practice

4. HESI Case Studies

Week 7

Simulation Sessions

June 15, 2017

Open Lab Practice/Independent Study

Weeks 8-11

 

June 19-July 14, 2017

Clinical Placements

Week 12

 

July 17-21, 2017

Exam week

Required Preparation

Required Preparation Students are required to complete the preparation for clinical integration activities each week (as

Students are required to complete the preparation for clinical integration activities each week (as outlined in the course manual and posted weekly on Brightspace). This includes readings, videos, review of policies & procedures, etc.

Assessment Components

All students must successfully complete the theory and clinical components of the course. A minimum of 65% is required for the theory component, a minimum of 80% in simulation (OSCE testing), and a pass in the clinical. A failure to achieve a pass in all components will result in the need to repeat the course and a failure to progress to the next semester.

1. Simulation Concept Map

10%

Concept Map Assignment students are required to complete a concept map during clinical simulation sessions. The clinical information for the simulated case will be posted on Brightspace prior to the simulation date. The student will complete a concept map for a selected client (you will be assigned to work with a student in your clinical group and submit one concept map per pair).

Instructions and examples for concept mapping posted on N3715 course site. Due Date: Submit a copy to the Brightspace Dropbox no later than 1600 hrs on the Friday of your scheduled simulation.

2. Midterm Examination

30%

A midterm examination comprised of NCLEX style questions (multiple choice, audio, matching,

prioritizing, ordering, hot spots, and select all that apply).

computer lab over 1 ½ hour exam Date: Friday May 26 1030-1200 DUNN Lab (Weeks 1-3 inclusive does NOT include content from week 4)

This 50 question exam will be held in

3. Clinical & Simulation Reflective Analysis

5%

The purpose of this written assignment is to develop one’s critical appraisal skills for analysis and reflection following participation in clinical and simulation experiences. In this assignment the student is to describe their reaction to the situation presented during a clinical situation. It is expected that each student completes this assignment on their own without collaboration. Students are required to submit 5 journals for review and feedback. Theory Block: Week 2, 4 & 6 and Clinical Block: Week 1 & 3

Due Date: Friday by 1600 in the Brightspace Dropbox

4. Clinical Case Study Presentation:

10%

Each student in a clinical group will do a case study presentation about a client they have cared

for. This assignment is to be communicated in an oral presentation and will include a concept

map. Presentation dates will be decided by the clinical instructor. Guidelines will be posted on

Brightspace.

.

5.

Final Exam

5. Final Exam 40% A comprehensive final exam designed with NCLEX style questions. This is a

40%

A comprehensive final exam designed with NCLEX style questions. This is a cumulative exam

that will cover content from the entire course. It will be conducted in a computer lab during the last week of the course. 75 questions over 2 hours.

Date:

Week July 17-21 Date to be confirmed

6. Elsevier Adaptive Quizzing

5%

Students are required to complete EAQ practice quizzes and achieve Mastery level 3 in the assigned content topics. Students will have practice with critical thinking questions and the program is adaptive to each student’s learning and progress. Students can access the Elsevier Adaptive Quizzing program at http://evolve.elsevier.com

EAQ Topic: Medical-Surgical Nursing

Sub-topics: 1. Cardiovascular, Hematologic & Lymphatic Systems

2. Gastrointestinal System

3. Neurologic & Sensory Systems

4. Musculoskeletal System

5. Renal, Urinary & Reproductive Systems

Due Date: July 20, 2017

7. Learning from Knowledge Keepers of Mi’kma’ki – MIKM 2701

CBU Open Online Learning (MIKM2701 - http://www.cbu.ca/indigenous-affairs/unamaki-

You will be responsible to complete Modules 7-12 this term (Weeks 1-7).

8. Institute for Healthcare Improvement (IHI)

PS 203: Partnering to Heal:Teaming Up Against Healthcare-Associated Infections (due: week 4) PS 204: Preventing Pressure Ulcers (due: week 7) Submit completed module certificates to the Brightspace Dropbox as per the assigned dates.

9. safeMedicate Dosage Calculation Test

safeMedicate - https://www.safemedicate.net/login/login.php Students will successfully complete a clinical calculations test (safeMedicate) prior to administering medications during clinical experiences as per Dalhousie University School of

Nursing policy. This test will be administered prior to the beginning of the clinical practice associated with this course and students must achieve a minimum grade of 95%, in a maximum

of three writings. Calculators are permitted while writing this test.

10. Clinical Practice - PASS/FAIL

11. OSCE Testing during exam week: a student must achieve 80% to pass PASS/FAIL

Grading

A+

90-100

A

85-89

A-

80-84

B+

77-79

B

73-76

B-

70-72

C+

65-69

F

<65

B 73-76 B- 70-72 C+ 65-69 F <65 Late Assignment Practice All Assignments are due by

Late Assignment Practice All Assignments are due by 1600 hours on the required due date and are to be submitted electronically on Brightspace or placed in the 'N3715 Assignment Box' in the Main Nursing

Office, Forrest Building.

Late submission without penalty is permitted when students:

(a) are ill. Students who are ill are required to advise the course professor of their illness and

request an extension of the due date. Medical confirmation of illness may be requested.

(b) have negotiated an extension with the course professor at least 2 days prior to the due date.

Student Support Services Dalhousie University endeavours to provide a broad range of support services to all of its students. For more information please visit:

Academic Support: http://tinyurl.com/DALacademicsupport Accessibility / Accommodation: http://tinyurl.com/ObtainAccom

AS A STUDENT IN THE NURSING PROGRAM, YOU ARE RESPONSIBLE TO READ AND BE AWARE OF THE FOLLOWING DALHOUSIE UNIVERSITY AND SCHOOL OF NURSING POLICIES.

School of Nursing Policies

Student Handbook: http://tinyurl.com/NursingHandbook Student Attendance Policy Supplemental Exam Policy Dress & Uniform Policy Dosage Calculations Competency Policy Adverse Event Reporting

Dalhousie University Policies

University Regulations: http://tinyurl.com/UniversityRegs

There are other important regulations about academic integrity that affect how you do your course

There are other important regulations about academic integrity that affect how you do your course work, and write midterms and final exams. The regulations are in the university calendar at Academic Dishonesty under University Regulations (Intellectual Honesty) at

If you are unsure about academic integrity and your work, ASK your course instructor, see a librarian, and find out about writing workshops (www.writingcentre.dal.ca ).

Dalhousie University is committed to a welcoming and respectful working and learning environment that is free from harassment and discrimination. We encourage open dialogue, however members of the class are expected to refrain from speaking or behaving in ways that are harmful to others, through racism, homophobia, sexism, or other derogatory treatment based on characteristics protected under the Nova Scotia Human Rights Act. Please do not hesitate to speak with the course professor if you have questions or concerns, or see http://www.dal.ca/dept/dalrespect.html for further information on resources and supports.

Bibliography As this is a clinical course, article readings in addition to the theoretical textbook readings will be directly related to clinical care situations and environments. Students will be expected to utilize relevant text resources from previous courses as required.

NURS 3715.06: Concept Map

Rubric

NURS 3715.06: Concept Map Rubric Criteria Exceptional Good   Satisfactory Failure 80-100% 73-79%

Criteria

Exceptional

Good

 

Satisfactory

Failure

80-100%

73-79%

65-72%

< 65%

Pathophysiology

Thorough demonstration of the pathophysiological mechanisms of the primary medical diagnosis and how it relates to the past medical history if known.

Partial demonstration of the pathophysiological mechanisms of the primary medical diagnosis and some evidence of how it relates to the past medical history if known.

Minimal demonstration of the pathophysiological mechanisms of the primary medical diagnosis and lack of

connections about how it relates to the past medical history

Insufficient demonstration of the pathophysiological mechanisms of the primary medical diagnosis and how it relates to the past medical history if known.

20%

 

if

known.

 

Pharmacology &

Thorough demonstration of how drugs and diagnostic findings relate to primary medical diagnosis, past medical history and key assessments.

Partial demonstration of how drugs and diagnostic findings relate to primary medical diagnosis, past medical history and key assessments.

Minimal demonstration of how drugs and diagnostic findings relate to primary medical diagnosis, past medical history and/or key assessments.

Insufficient demonstration of how drugs and diagnostic findings relate to primary medical diagnosis, past medical history and key assessments.

Lab/Diagnostic

Tests

20%

Concepts and

Accurate development of the nursing process with strong relationships demonstrated among the nursing process development, the primary medical diagnoses, past medical history, physical assessments and patient assessment of his/her illness.

Mostly accurate development of the nursing process with some relationships demonstrated among the nursing process development, the primary medical diagnoses, past medical history, physical assessments and patient assessment of his/her illness.

Some accurate statements reflecting development of the nursing process with

Insufficient or inaccurate development of the nursing process with

Nursing Process

30%

a

few relationships

poor relationships demonstrated among the nursing process development, the primary medical diagnoses, past medical history, physical assessments and patient assessment of his/her illness.

demonstrated among the nursing process development, the primary medical diagnoses, past medical history, physical assessments and/or patient assessment of his/her illness.

Identification of

Accurate and measurable health care team goals in the plan

Health care team goals are mostly accurate and some are not stated in measureable terms.

Broad but immeasurable health care team goals in the plan.

Unrelated and unclear health care team goals related to the plan.

Health Care

Team Goals

15%

9

Interventions/ Outcomes 15% Clear and measurable nursing interventions (> 4- 5) related to the plan.

Interventions/

Outcomes

15%

Clear and measurable nursing interventions (> 4- 5) related to the plan.

Clear and measurable nursing interventions (> 4- 5) related to the plan.
Clear and measurable nursing interventions (> 4- 5) related to the plan.

Broad and may or may not be measureable nursing interventions (< 4).

Broad and may or may not be measureable nursing interventions (< 4).
Broad and may or may not be measureable nursing interventions (< 4).

Broad but immeasurable nursing interventions (< 3) related to the plan.

Broad but immeasurable nursing interventions (< 3) related to the plan.
Broad but immeasurable nursing interventions (< 3) related to the plan.

Unrelated and unclear nursing interventions (< 2) related to the plan.

Unrelated and unclear nursing interventions (< 2) related to the plan.
Unrelated and unclear nursing interventions (< 2) related to the plan.

10

NURS 3715.06: Case Presentation Rubric Criteria Exceptional Satisfactory Failure 80-100% 65-79% <

NURS 3715.06: Case Presentation Rubric

Criteria

Exceptional

Satisfactory

Failure

80-100%

65-79%

< 65%

Client

The majority of vital information is present relating to the clients reason for referral and major salient points.

Most of vital information is present relating to the clients reason for referral and major salient points. Aspects are unclear.

The majority of vital information is missing relating to the clients reason for referral and major salient points.

Information

25%

Assessment

The assessment and evaluation is clear and the plan with recommendations includes the client’s wishes and is consistent with best practices.

Several areas of assessment and evaluation are not listed, some of the plan is missing, and/or there are recommendations that are inconsistent with the client’s wishes and/or are harmful for the client.

The key areas of assessment and evaluation are not listed, the majority of the plan is missing, and/or there is a recommendation that is potentially harmful for the client.

and Plan

25%

Application of

Thorough discussion of available evidence including best practices. Application of evidence to the client situation. Discussion of when there is deviation from the norm for this client.

Some discussion of available evidence including best practices but key pieces of evidence may be missing. Application of evidence to the client situation is lacking. Discussion of when there is deviation from the norm for this client may be incomplete.

Little discussion of available evidence with key pieces of evidence missing. Poor application of evidence to the client situation. Discussion of when there is deviation from the norm for this client is lacking.

Evidence

25%

Presentation

The oral presentation was seamless. The presenter appeared calm and in command of the information. Exceptional delivery. Exceptional discussion initiated and maintained to facilitate learning. The presentation material was clear and understandable. Material was exceptionally detailed, organized, logical;

The oral presentation was mostly seamless, few verbal pauses. The presenter appeared calm, had a general grasp of information. Proficient discussion initiated/maintained. The choice of material used was somewhat organized. Included some appropriate images, clear and medium font. The information contained generally applied to the topic being discussed.

The oral presentation was choppy, difficult to follow. Presenter did not have a grasp on the information. Frequent pauses for him/her to find their place. Too much reading. Needs mote interaction and discussion of questions. The choice of presentation made it difficult to understand and difficult to read. Few images utilized. Information at times

25%

include images, video and large font. The information contained was directly applicable to the topic
include images, video and large font. The information contained was directly applicable to the topic

include images, video and large font. The information contained was directly applicable to the topic being discussed.

contained was directly applicable to the topic being discussed. did not seem to be related to

did not seem to be related to the topic being discussed.

NURS 3715.06: Clinical & Simulation Reflective Analysis The purpose of this written assignment is to

NURS 3715.06: Clinical & Simulation Reflective Analysis

The purpose of this written assignment is to develop one’s critical appraisal skills for analysis and reflection following participation in clinical and simulation experiences. In this assignment the student is to describe their reaction to the situation presented during a clinical or simulation experience. It is expected that each student completes this assignment on their own without collaboration.

Submissions are to be no longer than 2 double-spaced pages.

Purpose of this reflective analysis to:

Demonstrate application of critical reflection regarding the experience.

Clearly understand the situation Articulate one’s reaction to the clinical situation

Questions to help frame your reflection:

What was the situation briefly describe

How did you feel before, during and after the simulation or clinical? This includes

your thoughts, feelings and apprehensions.

Did you feel prepared to participate in the simulation or clinical experience

explain.

What aspect of the experience had the most meaning for you?

How will this impact your future nursing practice?

Purpose:

Purpose: Self-Reflective Journals Self-reflective journals are learning tools that emphasize the human science of nursing.

Self-Reflective Journals

Self-reflective journals are learning tools that emphasize the human science of nursing. If used effectively journals can increase one’s ability to observe and describe. Journals are student centered, providing a place for you to write about your learning experiences, clinical and academics. You choose the topics you wish to write about and your Instructor/Preceptor responds as a coach or mentor, through written professional opinion, comment or question. This exchange provides a space for students and Instructor/Preceptors to engage in a dialogue, thereby facilitating and understanding the perspective of the other.

Reflective Journal Process:

Contemplate events and reactions to events Gain perspective and insight Pose questions Answer questions Seek Clarification Communication tool between you and your Instructor Identify conflicts between what has been taught and the “real world” of practice Work through ethical dilemmas Identify links between theory and practice Direct your own learning by developing a reflective practice Develop critical inquiry and thinking skills Begin developing a personal philosophy and framework of nursing practice

**Helpful hint-write your entries at the end of each clinical day

Journals are NOT:

Written itineraries of the tasks and activities performed during your day or academic papers that require attention to grammar, spelling and referencing.