Tulsa Community College NURS 2453 Nursing Promotion of Quality of Life i TCC Nursing Program NURS 2453 Nursing Promotion of Quality of Life Table of Contents I. Calendar ..................................................................................................posted on Blackboard II. Course Syllabus ....................................................................................................................1-14 III. Course Content A. Theory and Laboratory Learning Maps 1. Course Overview .......................................................................................................... A2 2. Impact of Chronic Illness .............................................................................................. A3 3. Palliative and End-of-Life Care .................................................................................... A4 5. Nursing Care of Client with Cancer ............................................................................ A5 6. Chronic Kidney Disease ............................................................................................... A6 7. Nursing Care of the Client Receiving Rehabilitative Care ........................................ A7-8 8. Alterations in Immunity: HIV and AIDS...................................................................... A9 9. Chronic Neurological and Neuromuscular Disorders ................................................. A10 10. Autoimmune and Connective Tissue Disorders ........................................................ A11 B. Clinical Practicum: Nursing Care of the Hospice Client 1. Clinical Learning Map .................................................................................................. B2 2. Practicum Overview................................................................................................... B3-4 3. Guidelines for Hospice Critical Incident ................................................................... B5-6 4. Hospice Critical Incident Evaluation Criteria ............................................................... B7 C. Clinical Practicum: Rehabilitation 1. Care of Clients with Altered Functional Ability and Lifestyle ................................. C2-3 2. Care Plan Forms and Evaluation Criteria ................................... to be distributed in class D. Clinical Practicum: Care of Clients with Cancer 1. Clinical Practicum Guidelines .................................................................................... D2 2. Guidelines for completion of Care Map .................................................................. D3-4 3. Care Map Evaluation Criteria ...................................................................................... D5 E. Learning Activity Laboratory 1. Palliative and End-of Life Care Learning Map: Learning Activities Lab I & 2 ............E2 3. Guidelines for Learning Activity Laboratory ................................................................E3 3. Guidelines for Laboratory Group Project ......................................................................E4 3. Learning Activity Laboratory Evaluation Criteria .........................................................E5 F. Student Performance Evaluation Profile/Formative Evaluation 1. Rehabilitation SPEP ....................................................................................................... F2 2. Oncology SPEP .............................................................................................................. F3 5. Preceptor Evaluation ...................................................................................................... F4 ii TCC Nursing Program NURS 2453 Nursing Promotion of Quality of Life Spring 2014 Syllabus – Sections 101 and 102 I. PLACEMENT – Level 3 of the nursing curriculum II. CREDIT HOURS – Three (3). The credit hours are allocated as follows: 2 credits 1 credit Theory and Learning Activity Laboratory Theory: 1.75 credits = 28 hours (including 10 minute breaks each hour) Laboratory: 0.25 credits= 8 hours Clinical Practicum/Learning Activities Laboratory (2:1 ratio=32 hours): 12 hours 8 hours 12 hours III. COURSE PRE-REQUISITES NURS1457 NURS1421 BIO2164 PSY2023 IV. Nursing of Adults with Major Health Disruptions Nursing Issues & Perspectives 2 Microbiology Developmental Psychology COURSE CO-REQUISITES NURS2423 NURS2433 POS1113 V. Clinical Practicum: Hospice Clinical Practicum: Oncology Clinical Practicum: Rehabilitation Nursing Care of Childbearing Families Nursing Care of Children and their Families American Federal Government COURSE CATALOG DESCRIPTION The focus of this course is the care of individuals who are experiencing changes in their quality of life and fluctuation in levels of health. Nursing theory and skills related to the specific needs of clients with long-term physical disabilities and terminal illnesses are presented. In a variety of rehabilitation and community-based settings, students collaborate with other healthcare professionals to plan and implement nursing care that assists clients and their families in the promotion and maintenance of health and end-oflife challenges. VI. COURSE OUTCOMES At the end of this course the students will be able to: A. Client Needs Demonstrate knowledge, skills, and attitudes specific to clients and their families who are experiencing temporary or permanent changes in lifestyle. B. Communication Formulate professional and therapeutic relationships among and between the client, family and multidisciplinary healthcare team. 1 C. Critical Thinking Utilize assessment data to identify client needs in various settings that care for clients who are experiencing changes in quality of life and fluctuations in health. Examine various strategies to maximize the individual’s quality of life in the midst of a temporary or permanent interruption in lifestyle. D. Informatics/Technology Apply technology and information management tools to support safe processes of care. Use internet and electronic resources to enhance personal learning. VII. NURSING DIVISION Dean of Health Sciences : Midge Elliott, R.N., M.A., M.S., J.D Office: MC605 Phone: 595-8920 Email: midge.elliott@tulsacc.edu Associate Dean of Nursing: Rick Hollingsworth, Office: MC256 Phone: 595-7188 Email: rick.hollingsworth@tulsacc.edu VIII. FACULTY Susan Goldsmith, RN, MS Office: MC 435 Phone: 595-7194 Email: susan.goldsmith@tulsacc.edu Radonna Tims Office : MC 433 Phone : 595-8929 Email : radonna.tims@tulsacc.edu Part-time Faculty: Crystal Williams, RN, BSN Johnna Langston, RN, BSN IX. TEXTBOOKS Ackley, B. J. & Ladwig, G. B, (2010). Nursing diagnosis handbook: An evidence-based guide to planning care (9th ed.). St. Louis, MO: Elsevier Mosby. Berman, A. J., Snyder, S., Kozier, B., & Erb, G. (2012). Fundamentals of nursing: Concepts, process, and practice. (9th ed.). Boston, MA: Pearson. Deglin, J. H., & Vallerand, A. H. (2011). Davis’s drug guide for nurses (12th ed.). Philadelphia, PA: F.A. Davis. 2 Gahart, B. L., & Nazareno, A. R. (2009). Intravenous medication 2009: A handbook for nurses and allied health professional (23th ed.). St. Louis, MO: Elsevier Mosby. Kee, J.F., Hayes, E.R., & McCuistion, L.E. (2009). Pharmacology: A nursing process approach. (6th ed.). St. Louis, MO: Saunders Elsevier. Lewis, S. M., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & Camera, I.M. (2011). Medical surgical nursing: Assessment and management of clinical problems, (8th ed.). St. Louis, MO: Mosby Pagana, K. D., & Pagana, T. J. (2009). Mosby’s diagnostic and laboratory test reference (4th ed.). St. Louis, MO: Elsevier Mosby. X. TEACHING – LEARNING STRATEGIES Teaching-learning activities include a variety of learning opportunities emphasizing cognitive and affective domains of learning. Instructional strategies include small group work, audio and visual aides, on-line journaling, lecture and discussion, observational experiences and simulation, role-modeling and direct, hands-on care of clients. XI. SYSTEM FOR STUDENT GRADING AND EVALUATION A. Grading Scale: The grading scale for the Tulsa Community College Nursing Program is: 100 - 90 = A 89 - 80 = B 75 - 79 = C 60 - 74 = D 59 & below = F Successful completion of this course and eligibility for progression to the next clinical nursing course is determined by: Satisfactory completion of all clinical components of the course. An earned score of 90% on the Level 3 medication dosage calculation competency examination. The dosage exam is administered in the NURS 2433 Nursing Care of Children and Their Families Course. 3 B. Percentage Grade Calculation: All examinations Rehabilitation Care Plan Oncology Care Map Hospice Critical Incident Laboratory Assignment Total 68% 8% 8% 8% 8% (100%) C. Requirements for Successful Completion of NURS 2453 1. Earn 75% on the examination average A total of 3 unit exams will be administered. Examinations are calculated on a total point system. The number of possible points for each exam may differ. The sum of the earned examination points divided by the points possible equals the examination average. The examination average must be 75% or higher to pass the course. There will be no rounding of examination grades. If the examination average is 75% or greater, the examination average is weighted at 68% of the course grade. If the examination average is less than 75%, grades earned for other course requirements will not be included in the final course grade. The final course grade will be the examination average ONLY when a 75% is not achieved. A computerized test through HESI is required by all student at the completion of the course. Up to 3 test points (not percentage points) will be awarded based on passing performance. Any student who scores below a 700 on the HESI exam will be required to meet with faculty to review the results. 2. Satisfactory completion of all required projects and written papers: Rehabilitation Care Plan The student will formulate a care plan for a client who has experienced a change in functional ability. The student must utilize the Nursing Process to make clinical decisions and formulate a plan of care for the client, with the primary focus being on functional ability. This assignment is worth 100 points and is calculated as 8% of the final grade. Oncology Nursing Care Map Students develop a nursing care map for one client based on assessed psychosocial and physical needs. The client is selected in the oncology setting. The case study explores both the pathophysiology and epidemiology of the disease process, and its impact on the selected client. This assignment is worth 100 points and is calculated as 8% of the final grade. Hospice Critical Incident This two-part exercise allows the student to think critically and reflect upon a selected personal learning moment and on the critical incidents experienced by other students while in the clinical setting. Students will: 1) initiate an on-line discussion using their critical incident as an initial posting; and 2) post a meaningful response 4 to fellow student’s postings. This assignment is worth 100 points and is calculated as 8% of the final grade. Laboratory Grade The laboratory grade is calculated based on the completion of four components. The lab components are as follows: 1. Participation in LAL #1 group activities; 2. Toolkit for Nursing Excellence at End of Life Transition (TNEEL) mythbuster assignment; 3. Simchart unfolding case study assignment; and 4. Group project presentation in LAL #2. Each clinical group will develop a presentation based upon the virtual hospice client presented on Blackboard®. The group will identify a priority problem and develop a care plan with appropriate teaching for the problem. Each group will have the client phase assigned based on clinical picture portrayed on BlackBoard®. The total laboratory grade is worth 100 points. This score is calculated as 8% of the final grade. 3. Satisfactory performance of all pass/fail clinical performance requirements. Clinical Performance Evaluation Profile (SPEP) Students are expected to demonstrate professional behaviors, critical thinking and the nursing process in the care of clients during all clinical practicum experiences. Each week the student’s clinical performance is evaluated. A description of expected behaviors is presented in the STUDENT PERFORMANCE EVALUATION PROFILE. The procedure used to record student performance of the SPEP is described in section XII. XI. STUDENT PERFORMANCE EVALUATION PROFILE (SPEP) The STUDENT PERFORMANCE EVALUATION PROFILE (SPEP) identifies objectives that reflect desired professional behaviors that are categorized in the roles of the Associate Degree Nurse. After the completion of each clinical week, the STUDENT PERFORMANCE EVALUATION PROFILE is used by the faculty to record the student’s ability to demonstrate: Safe and effective nursing care Professional responsibility Commitment to learning and self-development A cumulative evaluation of “Satisfactory” on the STUDENT PERFORMANCE EVALUATION PROFILE is required to pass the clinical portion of the course and to progress to Level 4 of the Nursing Program. A. Evaluation of student performance will be based on how consistently performance objectives are met. A summary of student performance is computed weekly. 5 B. If performance of a clinical practicum objective is consistently demonstrated by the student, achievement of the objective is “Satisfactory.” A check mark is placed beside that objective on the STUDENT PERFORMANCE EVALUATION PROFILE. C. When a student demonstrates excellence in the performance of a particular objective, a plus sign (+) is placed beside that objective on the STUDENT PERFORMANCE EVALUATION PROFILE. D. If a student is unable to demonstrate consistent performance of a particular objective or an objective is not applicable during a certain week, or if the student’s performance of an objective is not observed by the faculty, one of the following symbols is recorded on the STUDENT PERFORMANCE EVALUATION PROFILE: + = Exceeded expectations on completion of object = Objective met I = Objective inconsistently met N = Objective not met NA = Objective not applicable for the week O = Objective not observed by instructor * = Starred objective: Considered a critical objective and must be met satisfactorily or may convert to a “U” for the week E. If the student earns an “N” for two or more clinical performance objectives, the student’s grade for that clinical week may be recorded as a “U,” indicating unsatisfactory performance. F. When a student consistently demonstrates achievement of all clinical objectives with fewer than two “N’s” for that clinical week, clinical performance is satisfactory and an “S” is recorded that week’s clinical grade. G. If the student earns a “U” for any clinical week, a counseling form documenting student performance and recommendations for improvement may be composed by the clinical instructor(s) and discussed with, and signed by, the student. A copy is then placed in the student’s permanent file. H. If two weeks of unsatisfactory performance in the clinical practicum is achieved during the semester, then the student is placed on probation. Three clinical weeks of unsatisfactory clinical performance during the semester constitutes failure of the clinical practicum of NURS 2453. (Refer to the current TCC Nursing Program Handbook for more information regarding unsatisfactory clinical performance). I. Some clinical performance objectives are starred, (*). If a student does not satisfactorily meet a starred objective, the student will receive an “N” for that objective and may/will receive a “U” for that clinical week. 6 J. The student is expected to demonstrate progressive development in the performance of clinical skills and problem-solving during the clinical practicum throughout the semester. Students should strive to demonstrate satisfactory achievement of all objectives by the completion of the course. K. The student is expected to sign all SPEPs at the completion of the course. It may be necessary for the student to make an appointment with faculty in order to sign the SPEP. Failure to sign may result in an Incomplete (I) for the course grade. 7 XII. STUDENT PERFORMANCE EVALUATION PROFILE NURS 2453 Nursing Promotion for Quality of Life Clinical Evaluation Student name: CWID: Section________Semester_____________________Year____________________________ Date Clinical experience Total I’s Total N’s Clinical S/U # hours absent Completion of Clinical Objectives: ____ Satisfactory ____ Unsatisfactory ____ Probation Clinical hours absent: Notes: Dates made up: Oncology Care Map ___________________ Rehabilitation Care Plan ________________ Hospice Critical Incident________________ Laboratory Grade_______________ Student signature: Faculty Signatures: Symbols used in evaluation: Objective consistently met “satisfactorily” + Exceeded expectations on completion of objective I Objective inconsistently met N Objective not met NA Objective not applicable for this week O Objective not observed by instructor * Objective MUST be met satisfactorily. If unmet an “N” will be recorded for that objective, and may result in a clinical “U” for the week 8 XIII. POLICIES AND PROCEDURES FOR NURS 2453 A. TCC Standards 1. Course Withdrawal: The deadline to withdraw from a course shall not exceed 3/4 the duration of any class. Check the TCC Academic Calendar for the deadline that applies to the course. Begin the process with a discussion with the faculty member assigned to the course. Contact the Advisement Office at any TCC campus to initiate withdrawal from a course (‘W’ grade) or to change from Credit to Audit. Withdrawal and/or change to an audit from a course after the drop/add period can alter the financial aid award for the current and future semesters. Students may receive an outstanding bill from TCC if the recalculation leaves a balance due to TCC. Students who stop participating in the course and fail to withdraw may receive a course grade of “F,” which may have financial aid consequences for the student. 2. Communications: a. Email communications: All TCC students receive a designated TCC email address (ex: jane.doe@mail.tulsacc.edu). All communications to you about TCC and course assignments will be sent to your TCC email address; and you must use TCC email to send email to, and receive email from, the instructor regarding this course. IF YOU DO NOT ROUTINELY READ YOUR TCC E-MAIL, FORWARD E-MAIL TO YOUR PERSONAL E-MAIL ACCOUNT. NO EXCUSES WILL BE ACCEPTED RELATED TO LOST OR UNCHECKED E-MAIL. b. Inclement Weather: If extreme weather conditions or emergency situations arise, TCC always gives cancellation notices to radio and television stations. This information is also posted on the TCC website (www.tulsacc.edu). Students may not attend clinical experiences if the college is closed. 3. General Education Goals: General Education courses at TCC ensure that our graduates gain skills, knowledge, and abilities that comprise a common foundation for their higher education and a backdrop for their work and personal lives. TCC’s General Education goals are: Critical Thinking, Effective Communication, Engaged Learning, and Technological Proficiency. Classroom Etiquette: The faculty encourages open and mutually respectful communication of varied opinions, beliefs, and perspectives during classroom or online discussion. The class will start on time. Students are expected to sit at classroom tables. Cell phones must be silenced and put away during any class, lab, or clinical time. If a student is observed to be using a cell phone during class, lab or clinical they may be asked to leave. In an emergency situation a student can be contacted through the campus police office (595-7263). 4. Syllabus Changes: Occasionally, changes to the syllabus may be necessary. Students will be notified of any changes to the syllabus in writing. 9 Disability Resources: It is the policy and practice of Tulsa Community College to create inclusive learning environments. Accommodations for qualifying students in compliance with the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act are available. To request accommodations, contact the Education Access Center (EAC) at eac@tulsacc.edu or call (918) 595-7115 (Voice). Deaf and hard of hearing students may text (918) 809-1864. 5. Academic Dishonesty: Academic dishonesty (cheating) is defined as the deception of others about one’s own work or about the work of another. Academic dishonesty or misconduct is not condoned or tolerated at campuses within the Tulsa Community College system. Tulsa Community College adopts a policy delegating certain forms of authority for disciplinary action to the faculty. Such disciplinary actions delegated to the faculty include, but are not limited to, the dismissal of disrespectful or disorderly students from classes. In the case of academic dishonesty a faculty member may: Require the student to redo an assignment or test, or require the student to complete a substitute assignment or test; Record a "zero" for the assignment or test in question; Recommend to the student that the student withdraw from the class, or administratively withdraw the student from the class; Record a grade of "F" for the student at the end of the semester. Faculty may request that disciplinary action be taken against a student at the administrative level by submitting such request to the Dean of Student Services. 6. Institutional Statement: Each student is responsible for being aware of the information contained in the TCC Catalog, the TCC Student Policies & Resources Handbook, and semester information listed in the class schedule. All information may be viewed on the TCC website: www.tulsacc.edu B. TCC Nursing Standards 1. College/Program Policies The student in NURS 2453, Nursing Promotion for Quality of Life, is responsible for knowing and complying with all of the policies published in the current edition of the TCC Student Code of Conduct and Policy Handbook, and the current TCC Nursing Program Student Handbook. The student should review both policy books periodically during the semester. Students of the TCC Nursing Program retain the right to have grievances addressed in a fair and timely manner, and will be accorded full due process by the faculty and administration of the program and college. In a similar manner, the TCC Nursing Program also has the right to address unprofessional behaviors (according to the “Uniform Health Sciences Academic Standards, Probation, Temporary Exclusions, Dismissals, and Readmission Procedures”) and inadequate academic progress (according to the “Academic Grievance Procedure and Due Process Guidelines”) as outlined in the TCC Nursing Program Student Handbook and posted on Nursing Connections. This statement serves as notification of these policies and of the student’s responsibility to follow these guidelines in respect to these events. 10 2. Pregnancy A student who believes she is pregnant must notify the Course Facilitator within the first week of class or immediately upon confirmation of the pregnancy. Pregnant students must be able to perform all nursing activities in a manner which will not harm herself, her fetus or compromise client safety. For the protection of the pregnant student and fetus, NURS 2453 Course Facilitator must receive a Health Status Release Statement from a licensed healthcare provider during the pregnancy. Refer to the TCC Nursing Program Student Handbook. 3. Unsafe Nursing Practice and Unprofessional Conduct If a student demonstrates unsafe nursing practice or unprofessional conduct as defined and described in the current TCC Nursing Program Student Handbook, faculty will impose any one or more of the sanctions identified. 4. Course Announcements Announcements, notifications of changes in course activities or other necessary correspondence with students will placed on Blackboard. It is the responsibility of the students to access this information daily. No excuses will be accepted for students not knowing information that is communicated on Blackboard. 5. Student Attendance Policy for Clinical and Laboratory Courses The TCC Nursing Program expects that its students will recognize that they have entered a profession in which commitment to full participation in the learning environment is an essential component of what will become a style of life-long learning. Attendance is expected for all educational activities, and is required for seminars and laboratory sessions. In all clinical/laboratory courses, attendance is required as students are considered to be part of the nursing team. Student absences for professional, personal, or family events may be granted at the discretion of the course faculty. The requests will be reviewed by the associate dean if necessary. This policy is designed for special circumstances and it should not be considered a guarantee that a student will be granted the permission. Clinical Absences The student must notify the clinical instructor and the clinical facility prior to the start of the clinical shift and call the Nursing Division office. Students who fail to notify any of the above are considered “No show/No report” and will receive a clinical “U”. Clinical makeup is determined in consultation with the clinical faculty. If a student does not meet the clinical objectives, the course must be repeated. Laboratory Absences Learning Activity Laboratory is another required learning experience with objectives a student must achieve in order to be successful in the course. The student must call the instructor prior to the start of the scheduled lab. Make-up labs will be determined and scheduled by course faculty. Students are responsible for communicating with faculty so that all course objectives are completed for the lab portion of any course by the end of the semester. If a student does not meet these objectives, the course must be repeated. 11 Excessive Absence or Non-Attendance Faculty may initiate an administrative withdrawal (“AW”) for student non-attendance or excessive absences in any component of the course. If absences are excessive, as determined by faculty, a counseling form documenting the absences & recommending plans for improvement in attendance is composed by the instructor(s) and discussed with, and signed by, the student. An administrative withdrawal from the course may be initiated by faculty if absences continue. An official withdrawal from the course, regardless of the reason, prevents the student from attending any further course activities. 6. Late Written Assignments/Incomplete Assignments – Written work is due at the time/date designated. Work that is submitted after the due day/time will not be accepted unless prior arrangements have been made with the instructor. If late work is accepted there will be up to a 10% deduction if turned in after the due date and time. If a written assignment is evaluated with a score below 75%, the student will be notified. The student will be required to consult with faculty to identify areas of weakness or knowledge deficits, and may have the opportunity to redo the assignment. Students must demonstrate in the assignments appropriate use of the Nursing Process in planning client care. The highest possible grade for a second attempt is 76%. 7. Clinical Practicum Preparation – A student who reports to the clinical practicum experience unprepared or who demonstrates unsatisfactory conduct and/or appearance may be dismissed for that day at the discretion of the faculty. An unsatisfactory weekly performance (“U”) will be recorded on the STUDENT’S PERFORMANCE EVALUATION PROFILE. Arrangements must be made with the clinical instructor to make-up missed clinical time due to the absence. 8. Examinations a. Scantron -It is the student’s responsibility to read and follow the directions printed on each test. Students may write on the test booklet, however, the Scantron® computer answer sheet is the final and only testing record that will be scored. Students should give careful attention to insure that the Scantron® computer answer sheet accurately reflects the intended response to each test question. b. Preparation for Examinations – Students may prepare one (1) 4X6 inch index card with hand written notes from content presented in theory class and learning activities laboratory. One card, with notes on the front and back only, may be used during each examination. This index card, with the student’s name on it, will be turned in at the end of the exam. It will not be returned to the student. No card will be used for the HESI test. 12 c. Tardiness for Examinations – Students who arrive 10 minutes late or more will NOT be allowed to take the examination at the scheduled time with the class. The examination will be placed in the TCC Testing Center by noon on the day of the scheduled examination. The missed examination must be taken no later than one week after the original examination date. d. Absence from Examinations – If a student cannot attend an examination, the Nursing Division Office, not the exam coordinator or faculty advisor, is to be notified prior to the start of the examination. Students must contact an examination coordinator immediately after the absence to make arrangements for a make-up examination. e. Make-up Examinations – Make-up exams MUST be completed within one week of the administration of the original scheduled examination. The make-up exam will be different from the original exam and may include essay questions. All make-up exams are taken in the Testing Center unless students are informed of an alternate location. Time allowed and conditions for testing are the same for the original administration of the exam. The student must arrive in the testing center early enough to allow sufficient time to complete the exam before the center closes. Students are REQUIRED to bring and surrender a Photo ID, such as a driver’s license for the duration of the testing session. No one is allowed to test without the required identification. f. Testing in the Education Access Center – Students who test in the Education Access Center must contact the Instructors during the first week of the semester. g. Review of Examinations – Students have the opportunity to review exams following each exam. Exams must be reviewed prior to the administration of subsequent exams. It is the responsibility of the student to request assistance from faculty for learning enhancement activities. h. 9. Posting of Examination Scores on Blackboard® – Scores will be posted after the NURS 2453 faculty has reviewed the exam and analyzed the statistical results. Examination scores will be posted within one week following administration of an examination. Taping of Classes/Lab Students may audiotape classes with the consent of the instructor and peers. Consent to tape, duplicate or transcribe recorded information is for the use of currently enrolled students only. Posting to the internet for use by other than enrolled students is prohibited. Taping and selling tapes for profit is considered unprofessional conduct. 13 10. Presence of Children in the Classroom or Clinical Facility It is a TCC policy that children are not permitted in any classroom or laboratory. Unattended children are not permitted in any TCC building. Children are also not to accompany a student to or be left unattended at any clinical practicum facility. 13