North Seattle Community College Practical Nursing Program NEO 111: Clinical Nursing Practice and Skills 1 I. Course Information Course Prefix and Number: NEO 111 Course Title: Clinical Nursing Practice and Skills – 1 Course Credits: 5 Course lab Start Date: Saturday, January 08, 2011 Course lab End Date: Saturday, January 29, 2011 (last day of Lab) Course clinical Dates: variable, 1/28 to 3/16 Course Location: North Seattle Community College IB 1313/1414 and Richmond Beach Rehabilitation Center Course Times: Lab: 0800-1630 Clinical 6:30-3:30 Required Textbooks and Resources: TITLE Fundamentals of Nursing: The Art & Science of Nursing Care AUTHOR Taylor ED. th 7 ed ISBN 9.78078E+12 Required Course Equipment: Uniform or scrubs for lab: You may wear any healthcare uniform or scrubs for lab. Your shoes should be clean, low closed heel, and closed toe. You should also wear your name tag (NSCC picture ID) on a quick release lanyard. Equipment bag purchased through Orion Medical Supplies and supplemented with additional supplies from NSCC Stethoscope with a bell and diaphragm Watch with a second hand Pen light Computer and Internet access Highly recommend a simple four function calculator Electronic Resources: North Seattle Community College: http://www.northseattle.edu/ ANGEL: http://northseattle.angellearning.com/ Logon =Student ID and Password = Student ID II. Instructor Information Lead Instructor: Instructor: Melanie Jorgenson, RN, BSN Email: via ANGEL, mjorgenson@sccd.ctc.edu Office Hours: by appointment only Contact Number: 425-765-4123 Mary Kangas Instructor: Instructor: Instructor: Instructor: Email: mkangas@sccd.ctc.edu Office Hours: by appointment only Terry Heldreth Email: theldreth@sccd.ctc.edu Office Hours: by appointment only Mandy Vichas Email: amanda.vichas@hotmail.com Office Hours: by appointment only Pat Guidon Email: pguidon@sccd.ctc.edu Julie Grosnick Email: jgrosnick@sccd.ctc.edu Email through ANGEL is the preferred communication route. We will make every effort to get back to you within 48 hours. Tardiness or absence requires the student to call and notify the unit instructor prior to the start of class. See Attendance under Section VI Course and Classroom Policies for additional details. What the student can expect from instructors: Learning experiences designed to facilitate the student’s achievements of course outcomes. A safe learning environment that is responsive to individual student’s learning styles and needs. Clearly communicated expectations. Active listening and respect. What instructors expect from the students: An assumption of responsibility for learning through the completion of all assignments and clarification of those things not understood. Active participation in class sessions. Active listening and respect. Teaching and Learning Strategies: 3 Discussion groups Case studies with and without simulations Demonstration of skills Lectures Directed readings Cooperative learning (students working in groups) Reciprocal teaching (students teaching one another) Web enhanced learning The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s CommunityBased Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. Page |4 III. Course Content: Course Description: A course in nursing skills and procedures which includes demonstration and laboratory practice. Provides opportunities to apply knowledge gained in NEO 101 and to develop skills in the performance of nursing care in the role of caregiver, collaborator of care, decision-maker, communicator, teacher and professional, with a focus on the older adult patient. Topical Outline and/or Major Divisions: Upon successful completion of this course the student should be able to: Adhere to standards of professional practice appropriate to this level of education Demonstrate professionalism in client care settings Implement basic Nursing Procedures learned in NEO 101 Communication skills with clients and the health care team Introduction to patient care including safety, asepsis, wound care, care plans, nursing diagnosis and documentation Correctly administer medications by selected routes including oral, sublingual, topical, eye, ear, transdermal, intermuscular and rectal. Discuss the scope of practice of a student nurse including protecting confidential client information Identify normal and abnormal findings Utilize the nursing process in providing individualized holistic nursing care IV. Course Outline and Schedule (Also available on ANGEL Calendar) Date & Time Topic Skills Points The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. Unit 1 0800-0900 Participation Saturday, Syllabus Review January 8 0800-1630 0900-1000 Lecture (Personal Hygiene & Protective Equipment) Page |5 50 1000-1015 Morning Break 1015-1215 Personal Hygiene& Protective Equipment 1015-1045-Demo 1045-1115-Practice 1115-1215-Skills Check Personal Hygiene & Protective Equipment 27-1 Performing Hand Hygiene using soap and water 27-2 Using Personal Protective Equipment 100 1215-1245 Lunch 1245-1345 Lecture (Patient Hygiene) 1345-1400 Afternoon Break 1400-1600 Patient Hygiene 1400-1430-Demo 1430-1500-Practice 1500-1600-Skills Check 1600-1630 Wrap Up Patient Hygiene 31-1 Giving a bed bath 31-2 Assisting a patient with oral care 31-3 Providing oral care for the dependent patient 31-4 Making an unoccupied bed 31-5 Making an occupied bed 33-1 Applying and removing antiembolism stockings 33-2 Assisting a patient with turning in bed 33-3 Moving a Patient Up in Bed with assistance 50 The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. Unit 2 0800-0900 Participation Monday, Brief Review of Previous January 10 Skills- Key points 0800-1630 0900-1000 Lecture (Patient Comfort/Mobility/Restraint) Page |6 50 1000-1015 Morning Break 1015-1200 Patient Comfort/ Mobility/ Restraint 1015-1045-Demo 1045-1115-Practice 1100-1200-Skills Checks 1200-1230 Lunch Patient Safety, Comfort, & Mobility 33-4 Transfer from bed to stretcher 33-5 Transfer from bed to chair 33-6 Providing Range of Motion Exercises 37-2 Assisting with a bedpan 37-3 Assisting with a urinal 00-0 Specimen Collection 50 1230-1330 Lecture (Vital Signs) 1330-1345 Afternoon Break 1345-1530 Vital Signs 1345-1415-Demo 1415-1445-Practice 1430-1530-Skills Checks Vital Signs 24-4 Assessing a Brachial Artery Blood Pressure 24-2 Assessing Peripheral Pulse by Palpation 24-3 Assessing Respiration 24-1 Assessing Body Temperature 39-1 Using a Pulse Oximeter 50 1530-1600 Open Lab Practice 1600-1630 Wrap Up The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. Unit 3 0800-0900 Participation Saturday, Review of Skills learned last January 15 meeting 08001630 0900-1000 Lecture (Health Assessment Part 1) Page |7 50 1000-1015 Morning Break 1015-1200 Health Assessment-Part 1 1015-1045-Demo 1045-1115-Practice 1100-1200-Skills Checks Health Assessment – Part 1 00-0 Head to toe assessment- Part One - The Head - The Eyes & Ears - The Nose & Sinuses - The Mouth & Throat 1230-1300 Lunch - The Neck - The Posterior and Lateral Thorax - The Anterior Thorax 1300-1400 Lecture (Health Assessment - The Heart Part 2) 50 1400-1415 Afternoon Break 1415-1600 Health Assessment-Part 2 1415-1445-Demo 1445-1515-Practice 1500-1600-Skills Checks 1600-1630 Wrap Up Health Assessment – Part 2 00-0 Head to toe assessment- Part Two - The Arms, Hand, & Fingers - The Abdomen - The Legs, Feet, and Toes - The Musculoskeletal & Neurological System 50 The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. Unit 4 0800-0830 Participation Tuesday, Review of Skills learned last January 18 meeting Group A&B 12:30-2:30 0830-0930 0800-1630 Lecture (Sterile Environments/ Basic Wound Care) Page |8 50 0930-0945 Morning Break 0945-1200 Sterile Environments 0945-1000-Demo 1000-1100-Practice 1100-1200-Skills Checks Sterile Environments 50 27-3 Preparing a sterile fields/ adding items to sterile field 27-4 Putting on Sterile Gloves & Removing Soiled Gloves 1200-1230 Lunch 1230-1330 Lecture (Basic Wound Care/ Basic Wound & Surgical Drain Care 32-1 Cleaning a wound/ applying a dry, sterile dressing Surgical Drain Care) 32-2 Applying a saline-moistened dressing 32-3 Performing irrigation of a wound 1330-1345 32-8 Applying an external heating pad Afternoon Break 32-9 Applying a warm compress 32-4 Caring for a Jackson-Pratt drain 1345-1600 Basic Wound Care/Surgical 32-5 Caring for a Hemo-vac drain Drain Care 1345-11415-Demo 1415-1515-Practice 1500-1600-Skills Checks 50 1600-1630 Wrap Up The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. Unit 5 0800-0830 Participation Saturday, Review of Skills learned last January 22 meeting 08001630 0830-0930 Lecture (Respiratory, GI & GU Care) Page |9 50 0930-0945 Morning Break 0945-1200 Respiratory, GI & GU Care 0945-1015-Demo 1015-1115-Practice 1100-1200-Skills Checks 1200-1230 Lunch Respiratory, GU & GI Care 39-3 Administering oxygen by nasal cannula 39-4 Administering oxygen by mask 38-1 Administering a large volume cleansing enema 37-1 Bladder Scanner 37-4 Applying an external condom catheter 37-5 Catheterizing the female urinary bladder 37-6 Catheterizing the male urinary bladder 50 Blood Glucose Testing 36-4 Capillary blood sample for glucose testing 50 1230-1300 Lecture (Blood Glucose Testing) 1300-1515 Blood Glucose Testing 1300-1330-Demo 1330-1430-Practice 1415-1515-Skills Checks 1515-1530 Afternoon Break 1530-1600 Open Lab Practice 1600-1630 Wrap Up The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. Unit 6 0800-0830 Participation Saturday, Review of Skills learned last January 29 meeting 0800-1630 0830-0930 Lecture (Medication Admin. Part 1) P a g e | 10 50 0930-0945 Morning Break 0945-1200 Medication Admin. Part 1 0945-1015-Demo 1015-1115-Practice 1100-1200-Skills Checks Medication Administration – Part 1 29-1 Administering oral medications 29-2 Removing medications from an ampule 29-3 Removing medications from a vial 29-4 Mixing medications from two vials in one syringe 75 Medication Administration – Part 2 29-5 Administering an intradermal injection 29-6 Administering a subcutaneous injection 29-7 Administering an Intramuscular injection 75 1200-1230 Lunch 1230-1330 Lecture (Medication Admin. Part 2) 1330-1345 Afternoon Break 1345-1600 Medication Admin. Part 2 1345-1415-Demo 1415-1515-Practice 1500-1600-Skills Checks 1600-1630 Wrap Up Clinical Course Outline/Agenda: Day 1 Syllabus/Assignment briefing IPC Power Point Presentation Dementia Article review RBR documentation (MDS, VS, I&O, MAR, and treatment sheets) Tour of the facility and unit Introduction to nursing staff and assigned patient The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 11 Look at patient’s chart to get information on diagnoses, treatments, and medications. Seek skill checklist experiences Day 2 Total care of assigned patient, complete treatments Vital signs, head to toe observed by instructor Document vital signs, blood glucose results and treatments in the patient’s chart Seek skill checklist experiences Day 3 Due at the end of clinical: Learning Log Agenda: Total care of assigned patient Compare head to toe findings from previous day Cardio/respiratory of one other patient Braden Risk Assessment Scale Document vital signs, blood glucose results and treatments in the patient’s chart Seek skill checklist experiences Day 4 Administer medication for one pass for assigned resident Total care of assigned patient Compare head to toe findings from previous days Abdominal assessment of one other patient Document vital signs, blood glucose results and treatments in the patient’s chart Create goals to seek additional experiences to complete first quarter skills checklist Day 5 Total care of assigned patient Medication administration for assigned resident Compare head to toe findings to previous day Document vital signs, blood glucose results and treatments in the patient’s chart Create goals to seek additional experiences to complete first quarter skills checklist The student may also seek additional experiences to complete skills for second quarter skills checklist with the instructor’s permission Day 6 Total care of assigned patient Medication administration for assigned resident Compare head to toe findings to previous day Document vital signs, blood glucose results and treatments in the patient’s chart Create goals to seek additional experiences to complete first quarter skills checklist The student may also seek additional experiences to complete skills for second quarter skills checklist with the instructor’s permission The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 12 Day 7 Due at the end of clinical: Introductory client care Braden scale Learning Log At the end of clinical: Complete course evaluation Final course evaluation Agenda: Administer medications for one patient Total care of assigned patient Document vital signs, blood glucose results and treatments in the patient’s chart Create goals to seek additional experiences to complete first quarter skills checklist The student may also seek additional experiences to complete skills for second quarter skills checklist with the instructor’s permission V. Student Learning Outcomes NSCC General Education Learning Outcomes and/or Related Instructional Outcomes Met by Course: Outcome 1: Knowledge. Methodologies, facts theories, and perspectives within and across disciplines Outcome 2: Intellectual and Practical Skills. Critical thinking and problem solving. Communication and selfexpression. Quantitative reasoning. Information literacy. Technological proficiency. Collaboration: group and team work. Course Outcomes/Learning Objectives: 1. Initiate holistic care for the older adult within an ethical, legal and diverse framework under the designated health care provider within the scope of practice of the practical nurse. 2. Initiate education and communication with the older adult patient, patient families and the health care team. 3. Initiate in the older adult data gathering, problem identification, planning, implementing nursing care and contributing to evaluation within a variety of settings utilizing appropriate technology. VI. Student Learning Assessment 1. The Seattle Community College District uses a numerical grading system. A cumulative 2.0 grade point average is mandatory in all required general education, science and nursing courses to enter and to continue in the program. 2. The NEEDL program requires a minimum of 2.0 (77%) average for ALL UNIT EXAMS (weighted), MIDTERM & FINAL EXAMINATIONS in each category order to pass the course. All exams listed above will be calculated prior to adding in other assignment grades. Examination grades below 2.0 (77%) are not passing grades for the NEEDL program. Decimal grades 0.5 and higher will be rounded up to the nearest whole number and grades 0.4 and lower will be rounded down. 3. Numerical grades may be considered equivalent to letter grades as follows: The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 13 Letter grade→ A A A A A AAAAB+ B+ B+ B B B BBBBC+ C+ C+ C C Percentages → Decimal grades 100% 99% 98% 97% 96% 95% 94% 93% 92% 91% 90% 89% 88% 87% 86% 85% 84% 83% 82% 81% 80% 79% 78% 77% 4.0 4.0 4.0 4.0 3.9 3.8 3.7 3.6 3.5 3.4 3.3 3.2 3.1 3.0 2.9 2.8 2.7 2.6 2.5 2.4 2.3 2.2 2.1 2.0 4. All courses that are designated as “linked” must be taken and passed concurrently, with a grade of at least 2.0 in each course. These include the following linked theory/clinical/lab courses, which must be taken together: NEEDL LPN Program: NEO101/111, NEO 102/112, NEO 103/113, NEO 104/114 Course Grading Breakdown NEO 111: NEO 111 skills lab is graded as a pass/fail course. Students must earn at least 770 points to achieve the 77% it takes to pass the course. Lab is 44% of the grade, and clinical is 56%.The student will be graded on two sections that include: Lab Section 1: Participation (300 points total) 25 points (per class): Attendance (required at all Lab sessions). Tardiness and unexcused absences will affect the student’s grade and could result in failure of the course. Refer to section VI Course and Classroom Policies under Attendance for additional details. You must be present at the beginning of class sessions, actively participate in all sessions throughout the day, and not leave class early in order to earn all participation points. The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 14 25 points (per class): Participation It is expected that you arrive to lab prepared. All course material should be reviewed on ANGEL, and the confirmation or review completed. It is also expected that the student participate by contributing ideas, interacting with peers and instructors, engaging in class activities, maintaining attention to class work, brining needed supplies to class as specified and adhere to student classroom expectation outlined below. Failure to adhere to class participation guidelines will result in zero participation points for the day. Lab Section 2: Skill Set Evaluations: (700 points total) There are twelve skill sets. Nine of the sets are worth 50 points each; two of the sets are worth 75 points each, and one skill set is worth 100 points. (See course outline and schedule) Students are expected to practice and prepared for testing during the allotted practice sessions. The student will then sign up for evaluation. *Each student must pass each skills set on either the first or the second attempt. Each skills test must be performed correctly, in a timely manner, and with a maximum of two cues. A cue is considered a prompting by the instructor for omitted information critical to the skill, or recognition of a failed or omitted step in the procedure in which the student is unable to identify and correct. Should the student not pass the skill set on the second attempt, the student will not earn the 5 points allotted for that skill. However, the student will be asked to work with a tutor or instructor in order to practice the skill and have it verified by a course instructor before the student can advance to the next skill set. Section Factor Section 1 Attendance/ Participation Section 2 Individual Evaluation of Skills Grading Tool IPC Clinical Evaluation Summary Total Score Possible (0-4.0 scale x 15 Evaluation objectives x 6 days = 360 highest score) Scores 0-4.0 scale x 6 days = 24 Assignments/ # due Introductory client care (1) Braden Scale (1) Learning log (2) 0-4.0 scale x 6 days = 288 Clinical performance, student’s comprehension and reflection of meeting course objectives as evidenced by learning log, ICC and student’s verbal and written feedback Clinical skills checklist (1) Participation (6) 0-4.0 scale x 6 days = 24 0-4.0 scale x 6 days=24 % of Section Pass/Fail 30% Pass/Fail Maximum of two attempt* 70% Percent of Course Grade 100% Percent of Course Grade 1/15 = 6.6% 12/15 = 80% 1/15 = 6.6% 1/15 = 6.6% The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 15 Criteria for Participation: Please see Professional behavior and responsibility on the Clinical Evaluation Summary. This course unit strives to maintain an enthusiastic student/instructor team-like, partnership. Equitable student participation is an expectation. Contribute ideas, interact with peers and instructor, engage in class activities, maintain attention on class work, and come prepared for class (completed reading and assignments). Expect to be called upon at any time during the course to respond to thought-provoking questions. Criteria for Preparation: Please see Preparation on the Clinical Evaluation Summary. For a positive clinical experience it is recommended to bring the required equipment, a nursing drug reference and skill procedure reference. Come to clinical prepared. Please be prepared with your required assignments for your assigned patient. Be prepared to answer questions about your client's condition, medical diagnosis, medications, allergies, and treatments with your instructor each day. Criteria for the Clinical skills checklist: Please see Skill application on the Clinical Evaluation Summary Course Withdrawal: Official withdrawal is the responsibility of the student but it is highly encouraged to contact the instructor prior to doing so. The last day to withdrawal during Winter Quarter, 2011 is February 25th. Incomplete Grade: Incomplete grades are submitted at the discretion of the instructor. VII. Course and Classroom Policies Guidelines for Student Conduct: Students are expected to comply with student conduct policy and procedure. Refer to 9.3 WAC 132F-121-020 Students Rights, Freedoms and Responsibilities in the Practical Nursing and Licensed Practical Nurse to Registered Nurse Ladder Programs Student Handbook available online at : http://webshares.northseattle.edu/healthmedical/LPN-Resources/ Student Misconduct: Refer to 9.3 in the Practical Nursing and Licensed Practical Nurse to Registered Nurse Ladder Programs Student Handbook and or the link above. Student Classroom Expectations: Maintain a safe working environment. Adhere to OSHA requirements, NSCC injury policy and NSCC dress code. Be prepared for class o Purchase book prior to the start of the course o Review Skills and course material prior to attending class o Complete work on time o Utilize class time effectively The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 16 o Obtain notes, handouts and instructional information from peers if you are absent. It is NOT the responsibility of the instructor to provide missed information to absent students. Maintain a professional environment o Be on time to class o Respect classroom diversity and inclusion: The instructor and student share the responsibility to foster a learning environment that is welcoming, supportive, and respectful of cultural and individual differences. Open and respectful communication that allows for the expression of varied opinions and multicultural perspectives encourages us to learn freely from each other. o Respect college, instructor and student property. Help us keep our environment clean. No smoking is allowed within 25 feet of public places o You may be asked to leave the classroom if you are causing a distraction. Follow the Practical Nursing and Licensed Practical Nurse to Registered Nurse Ladder Programs Student Handbook policies and procedures Attendance: Guidelines: 1. Absences will jeopardize meeting daily objectives and therefore success. 2. A student is allowed one medical or family emergency absence from clinical/lab each quarter not to exceed 33% of that clinical/laboratory experience (for example, if OB is 3 days, a student can not miss more than 1 day for emergency purposes and pass the course ). Any additional absences OR a tardy greater than 45 minutes OR absences that are not a medical emergency (unexcused) will result in a 0 for the day which in clinical/lab may result in failing the course. 3. Two tardies of greater than 5 minutes in clinical/laboratory will constitute an absence and a zero for the day which may result in failing the clinical/laboratory course. 4. There is no scheduled “make up” laboratory or clinical days. 5. In the case of an absence, the student must: a. Call their instructor a minimum of 1 hour before the start of clinical/lab and report the absence and reason why. Sending a message with a fellow student will not be accepted. b. Provide a note in writing to the Director of Nursing explaining the reason for the absence. c. Any injuries or change in health status requires a healthcare provider’s release to attend clinical and lab courses. A “No Call, No Show” is a serious offense and is not permitted at the clinical facility sites by students. Not calling or showing may be grounds for dismissal and will be referred to the Director of Nursing, Dean of Health & Human Services and/or the Vice President of Student Services. Injury Policy: Should an injury or needle stick/bodily-fluid contamination occur, complete the following steps: 1. Student will wash site immediately with soap and water and/or complete any first aid care needed. 2. Student will immediately report exposure and/or injury to the faculty member overseeing the student’s activities. The faculty member and/or student will complete an injury report that will be forwarded to the Nursing Program Director’s office. Section 9.6 has a copy of the NSCC injury report form. 3. The student may be referred to a health care facility for further evaluation/follow-up. 4. If the incident occurred on a clinical facility’s site, that facility’s protocol must also be completed. If the incident occurred on the North Seattle Community College’s campus, the NSCC Accidental Injury Report form must also be completed and a copy must be submitted to the Security office. The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 17 Academic Integrity: Each student is responsible for his/her own learning and personal integrity in the learning process. Cheating is defined as giving or receiving inappropriate assistance from another person such as giving and/or receiving answers to test questions, or failing to give credit to sources, homework or care plan assignments. Giving credit to sources means that any copying, whether it is from a book or the internet, is plagiarism. In other words, the work you do must be your own. Any act of course related dishonesty, including but not limited to cheating or plagiarism will receive a zero for the assignment or exam. The zero will be averaged into the grade for that section. The matter may be referred to the V.P. of Student Services. Each student must demonstrate academic integrity by doing his/ her own work in each class, except as the instructor specifically directs otherwise. See Section 4.7. Cheating and plagiarism violate the student conduct code at NSCC. See WAC 132F-121-110, WAC 132F-121-120 (Section 9.3), and other applicable rules. When an instructor determines that cheating, plagiarism, or other dishonesty has occurred, the instructor need not give credit and may adjust accordingly the student’s grade on the work product in question. In addition, disciplinary sanctions may be imposed separately under the cited WAC rules. Academic dishonesty could involve but is not limited to: 1. Having a tutor or friend complete a portion of your assignment 2. Having a reviewer make extensive revisions to an assignment. 3. Copying or obtaining work submitted by another student. 4. Providing work to another student for use as their own. 5. Using information from online information services without proper citation (plagiarism). 6. Taking exam answers from another student’s paper. 7. Using unauthorized materials to answer exam questions. Examination Conduct: Students are expected to complete examinations without the use of reference materials, notes or classmates unless otherwise instructed in writing on a quiz or exam. Dress Code: 1. Non-distracting, appropriate clothing, with no cleavage on women showing and all pants secured at the waist and undergarments should be not be visible 2. Shoes and shirts/blouses must be worn. Students are to wear scrub shirts and pants to skills lab. 3. Scents should not be worn as some people are sensitive to chemicals and scents. 4. A watch with a sweep second hand; 5. Hair must be kept off the collar and neat; 6. Beards, sideburns, and mustaches are to be trimmed and neat. Male students without beards are expected to shave daily; 7. Fingernails are to be kept short and clean without artificial nails or polish; 8. Jewelry is not allowed except wedding rings and small post earrings. Rings must be removed at the discretion of the instructor, for safety reasons; 9. Light make-up only, and again, no scents are allowed; 10. Gum chewing is not allowed; 11. Smoking in uniform is permitted only in designated areas of the college or agency. Smoking is discouraged, however, as many clients find the lingering smell offensive; 12. All students are to be well groomed, clean, and non-offensive to others 13. Wear low-heeled, slip-proof, closed toe shoes to prevent accidental injury to self or lab partners The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 18 14. General body cleanliness, hygiene, and fresh breath are expected. CLINICAL DRESS CODE/APPEARANCE 1. The approved NSCC Nursing program student uniform is to be worn for all clinical practice or data collection in any health care agency. If there are any exceptions to this, students will be informed by the instructor. 2. The approved Practical Nursing and Registered Nursing student uniform consists of: Dress Code in 4.11 A forest green scrub shirt with the NSCC logo embroidered on the upper left chest; you may also wear a white lab jacket over the shirt Forest Green scrub pants-no jeans, sweats, or visible undergarments. Conservative, flat, slip proof shoes with closed toes Proper NSCC Nursing Program approved identification is required. Hair shall be clean, combed and neatly trimmed and not be distracting. Hair shall not be dyed a human unnatural color; All tattoos covered. Only small posts in ear lobes allowed. No facial piercing jewelry. White lab coat if desired Stethoscope Cell Phones: No cell phone use is allowed during theory classes, lab or clinical. On breaks, the student is allowed to check and use cell phones outside the classroom. If a student has a serious problem that may require contact, the instructor should be informed, the cell phone placed on “vibrate”, and the student should exit the room before answering the phone. Recording and Video Devices: Recording and video devices may be used with permission of the instructor during instructional or lecture oriented class times only. Recording and video devices are prohibited during pre and post test review sessions. American Disability Act: Academic accommodations, if reasonable and appropriate, are provided to students with a documented permanent or temporary physical, mental, or sensory disability. Students with disabilities are strongly encouraged to contact Disability Services prior to enrollment if they have any type of disability that impacts their academic performance. There is no minimal or baseline disability that one must have to receive services. Support services are available for enrolled students and those planning to enroll. If you need classroom accommodations because of a disability or if you need to share emergency medical information, contact the instructor as soon as possible. Accommodations require documentation from the NSCC Educational Access/Disability Services Office at the beginning of the quarter. http://www.northseattle.edu/services/disability/ College Closure: If conditions necessitate delay or cancellation of day classes, notification on radio and television stations will begin as soon as conditions on campus can be evaluated. A closure decision is based on conditions at the main campus or a specific off-campus site adversely impacted. The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 19 General Disclaimer: The lead instructor may modify the terms of this syllabus in the event the instructor believes such modification will improve the student’s learning experience. Any changes will be communicated to the students in writing as soon as is practical. Students are responsible for all changes once they have been communicated in writing. For additional information, consult the Practical Nursing and Licensed Practical Nurse to Registered Nurse Ladder Programs Student Handbook. Student Support Services Please refer to the Student Handbook and/or College Website for a complete list of support services and additional details on the following resources. Academic Advising: http://www.northseattle.edu/enroll/advise/ Counseling Services: http://www.northseattle.edu/services/counseling/index.htm Counseling Services: Emotional/Academic Self Help This site provides publications on Time Management, Stress Management, Dealing with Depression, Ways to Approach Decision Making, Dealing with Perfectionism, Study Skills, Study Tips for the First and Second Week of Classes, How to Prepare for Exams, and Strategies for Oral Participation for Students Who Feel Uncomfortable Speaking in Class http://www.northseattle.edu/services/counseling/selfhelp.htm Counseling Services: Career Counseling This site provides publications on Building Your Resume, Writing Your Cover Letter, Interview Resources and Resume Banks http://www.northseattle.edu/services/counseling/jobsearch.htm Disabilities Services: This site provides information on types of disability services available, including academic accommodations, and how to receive service. http://www.northseattle.edu/services/disability/index.htm Financial Aid: This site provides information on student aid eligibility, types of aid available, and policies/guidelines for federal, state and institutional programs. http://www.northseattle.edu/enroll/finance/ The Loft Writing Center: The Loft offers free assistance with any reading, writing, listening or speaking assignment. The loft has a computer lab and tutors on site. http://www.northseattle.edu/services/loft / Clinical Assignments: Assignments will be graded and returned to you ASAP. Clinical assignments will be scored using the same score system as the clinical evaluation tool (0-4). Clinical assignments will also be used as input when grading the other clinical objectives on the evaluation tool. Late clinical assignments will not be accepted. 1) Introductory Client Care (ICC): One complete ICC sheet is due at the end of the last day of clinical. No blank areas should be present on the assignment. Date and document on the physical exam form, each assessment. Please compare assessment findings that have changed from day 1 to 2 or day 2 to 3, and etc. Also write the treatment and procedure that was completed on the ICC. Comprehensively, these sheets are intended to assist the PNS in using the nursing process and critical thinking skills to develop an understanding of client care. They The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 20 focus on the rationales that support reasoning for assessments and interventions. Please state the significance of assessments and interventions related to the care of the client. The ICC sheets should reflect your understanding of the client's condition, the nursing process and the plan of care as it relates to the client. Please read the recommended electronic resources to become familiar with this patient population and their basic care needs. This assignment is due at the end of the last clinical day. The assignment can be hand delivered to the instructor at the end of clinical. 2) Braden Risk Assessment Scale: Please complete the Braden risk assessment scale on your patient. Total the score to determine if the client is at risk for a pressure ulcer. This assignment is due on the last clinical day (December 1) please hand deliver to the instructor at the end of clinical. 3) Learning log and reflective journal: This assignment is due: day 3 and 7. The learning log may be submitted by hand to the instructor at the end of clinical. Keeping a daily reflective journal allows you reflect on your clinical experiences, and document progress of your learning throughout the quarter. It includes reflecting on experiences and data that have been pertinent or helpful in your clinical practice. Guided reflection assists you to reflect on the clinical experience in order to become increasingly effective in the application of theory to practice. The reflective journal provides a window into your experience. Expectations on Patient Assignments: Each student is to introduce him or herself to their assigned patient and/or family member and obtain the patient’s verbal consent to be their nursing student. If the patient and/or family refuse, please notify your instructor. Students should identify themselves promptly to the co-assigned LPN/RN and get report on their patient(s). It is your responsibility to let the instructor and LPN/RN know what you can and cannot do for your patient. It is also your responsibility to let your instructor and LPN/RN know when to be present or help with anything and what is happening with your patient and your progress in providing care throughout the shift. DON’T WAIT FOR THE INSTRUCTOR/LPN/RN TO COME TO YOU! Procedures, Treatments & Medications: Students are expected to notify instructor of all upcoming procedures, treatments and medications due for assigned patients. Students will perform procedures and treatments with either the instructor or the nurse assigned to the patient. Students should NOT perform any procedure/treatment independently without first obtaining permission from the instructor. Failure to do so will result in immediate dismissal for the day and disciplinary action. Medications may ONLY be administered to assigned patients after reviewing each medication with instructor and receiving permission to administer medications. You should be prepared to discuss each medication in detail, including: classification; purpose of medication; side effects; and nursing considerations. In addition, you must demonstrate knowledge of the medication administration process. We will start medication administration on day 4. You can only administer meds after adequately preparing and demonstrating knowledge of the resident’s meds, the use, actions and side effects. Lunch/Breaks/Off-unit Activities: The student must inform the RN/LPN and Instructor when leaving the patient care area and upon returning to the area. The following situations may require a student to leave the area: The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 21 1. 2. 3. 4. 5. Breaks/Lunch Assisting another student in another area of the unit Accompanying a patient to a test/procedure Errands that require the student to go off the unit Conferences with the instructor Please stay in assigned patient care area. Otherwise you are unable to determine if your patients’ call lights are on or if you are needed by your assigned patients Please respect this patient population religious belief of preparing and eating kosher foods. The nursing home requests that you store your food/drinks and eat your sack lunch in the staff lounge. Following this request will help us respect the residents’ religious beliefs. The staff lounge has vending machines for soda, chips and candy. Please bring a sack lunch and snacks to clinical. Reporting Changes in Patient Status: The student must report these changes to the instructor first! The student must page or report the following changes in a patient's status to the instructor and the LPN/RN: 1. 2. 3. Transfer of patient to another unit/facility Discharge of patient from facility Significant changes in a patient's condition Change in vital signs (Temp., RR, HR, BP, and O2 sat) Change in mental status Patients that is symptomatic. Symptoms may include; chest pain, shortness of breath, nausea, vomiting, diaphoresis, and hypotension. No output or output less than 240ml in 8 hours You must report (without exception): HR SBP less than 60 or more than 100 less than 100 or more than 140 (Or 20 points above or below the patient’s baseline) DBP less than 60 or more than 90 RR less than 14 (geriatric) or more than 24 O2 Saturation equal to or less than 92% or respiratory distress Temperature less than 97.6F or more than 100F RBR Documentation of Patient Care (See Clinical evaluation summary): Vital Signs sheet: Vital signs Nursing Progress notes: O2 Saturation, patient on room air or O2 in Liters Head to toe assessment Pain sheet: Pain Assessment I and O Sheets: Input: Amount patient drank and meals percentage ate Output: Emesis, Urine and Bowel Movements Medication Sheet: Blood glucose results and medications administered Treatment Sheet: Activity of Daily Living, care delivered Wound measurements and dressing changes The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 22 Procedures completed General Disclaimer: There are many internal and external factors that influence the development of a course. Assignments and forms are used with permission from NSCC faculty and staff. If there is a discrepancy between the course syllabi and the NSCC Nursing Handbook, the Handbook supersedes any and all documents. The instructors may modify the terms of this syllabus in the event the instructors believes such modification will improve the student’s learning experience. Any changes will be highlighted in yellow and announced in writing to the students on the website and by email as soon as possible. Students are responsible for all changes once they have been communicated in writing. NSCC and the instructors are not responsible or liable for any claim, loss or damage arising from the use, misuse or loss of this health care information. _____NORTH SEATTLE COMMUNITY COLLEGE________________________ NEO 111: CLINICAL NURSING PRACTICE CLINICAL EVALUATION SUMMARY STUDENT ____________________ INSTRUCTOR ___________________ LOCATION ___________________ DATES: FROM _______ TO _______ ABSENCES ____________ TARDIES Clinical Day: _________ 1 2 3 4 5 6 7 AVERAGE: CLIENT CARE: SAFETY INFECTION CONTROL & UNIVERSAL PRECAUTIONS PREPARATION SKILLS APPLICATION PRIORITIZATION& ORGANIZATION NURSING PROCESS: HEALTH ASSESSMENT PROBLEM IDENTIFICATION & NURSING DIAGNOSIS PLANNING &IMPLEMENTATION RELATING INFORMATION EVALUATION & FOLLOW-UP DOCUMENTATION: DOCUMENTATION OF PATIENT DATA & CARE ASSIGNMENTS & CLINICAL DAILY SHEETS COMMUNICATION: COMMUNICATION SKILLS FEEDBACK PROFESSIONAL BEHAVIOR: The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 23 PROFESSIONAL BEHAVIOR & RESPONSIBILITY TOTAL POINTS: _____ 53-60= MEETS EXPECTATIONS CONSISTENTLY WITHOUT PROMPTS/REMINDERS 45-52= MEETS EXPECTATIONS CONSISTENTLY WITH PROMPTS/REMINDERS 37-44= MEETS EXPECTATIONS INCONSISTENTLY WITH PROMPTS/REMINDERS <37 = DOES NOT MEET EXPECTATIONS <77% (FAIL) ____NORTH SEATTLE COMMUNITY COLLEGE_________________________ NUR 115: CLINICAL EVALUATION OBJECTIVES EVALUATION OBJECTIVES DESCRIPTION I. CLIENT CARE: SAFETY Demonstrate safe patient care for older adults Maintain a safe environment for self and patients. (Examples: side rails up, bed low & locked, transfers, fall prevention, patient identification, rights of medication administration, disposal of sharps) INFECTION CONTROL & UNIVERSAL PRECAUTIONS Demonstrate understanding of infection control and universal precautions in delivery of patient care for older adults PREPARATION Demonstrate beginning understanding of data gathering for the older adult patient Adheres to infection control precautions. Applies appropriate PPE for care and procedures. Demonstrates competency in use of aseptic & sterile technique for care and procedures. Disposal of waste in accordance to facility policy and procedure. Research patient diagnoses, medications, treatments, labs. Review medical record for patient history, labs, medications and physician orders. Review skills manual and/or facility policy and procedure prior to treatments and procedures. Review physician order and gather supplies for treatments and procedures. SKILLS APPLICATION Demonstrate competency in skills for older adult patients Practice and Demonstrate competency in basic skills and procedures learned in NUR 117. Performs skills and procedures with attention to patient safety. The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 24 PRIORITIZATION & Demonstrate beginning prioritization & organization of care for the older ORGANIZATION OF CARE adult patient Plan care for the shift; Adjust plan of care as needed; Prioritize tasks and care for 1 assigned patient; Seek assistance as needed. Complete care and documentation for assigned patient in timely manner. Collaborate with members of the health care team to meet patient needs. HEALTH ASSESSMENT Demonstrate beginning understanding of health assessment of older adult Complete head to toe physical assessment of assigned patient. Collect patient history data from medical record and/or patient. Perform psychosocial assessment. Review lab work and diagnostic test results. Compare assessment findings to patient baseline. PROBLEM IDENTIFICATION & NURSING DIAGNOSIS Demonstrate beginning understanding of problem identification of older adults PLANNING & IMPLEMENTATION Demonstrates beginning understanding of planning and implementation of care for older adults Identify significant patient problems and provide nursing care that reflects an understanding of those problems. Identify at least two significant nursing diagnoses for assigned patients. Write NANDA nursing diagnoses in correct format. Reviews plan of care and implements interventions and basic nursing care to assist assigned patient in meeting outcomes. RELATING INFORMATION Demonstrate use of quantitative reasoning processes to understand, analyze, interpret and solve problems of older adults Access, evaluate and apply information from a variety of sources and a variety of contexts. Identify significant and relevant assessment findings and relate these to the plan of care and implementation of interventions. EVALUATION & FOLLOW- Demonstrate beginning understanding of evaluation of older adult patient UP health status and response to interventions Identify and follow up with abnormal physical assessment findings. Identify and follow up with abnormal vital signs, lab and/or diagnostic test results. Evaluate and follow up with patient response to treatments and interventions. II. DOCUMENTATION DOCUMENTATION OF PATIENT DATA & CARE Demonstrate beginning understanding of documentation of care of older adults Document holistic care of the older adult within the scope of the practical nurse. Document relevant patient assessment data, nursing care, medications and treatments objectively and accurately in patient charts (paper and/or electronic). Document data in timely manner and according to facility policy and procedure. CLINICAL DAILY SHEETS Demonstrate daily clinical sheets accurately Assignments and clinical daily sheets are completed according to instructions & ASSIGNMENTS and turned in to instructor on due date. Assignments and clinical daily sheets are detailed and thorough showing evidence of understanding the patient condition, medications, treatments, labs and nursing care) III. COMMUNICATION The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 25 COMMUNICATION SKILLS Demonstrate effective communication with older adult patients and the health care team Reports changes in patient health status, abnormal vital signs, lab values and assessment findings to nurse preceptor and clinical instructor in a timely manner. Use effective interpersonal communication skills with patients, families and members of the health care team. Provide education to patients, families and members of the health care team with focus on health promotion. Identify patients’ health beliefs, knowledge level, and learning styles and incorporate these into the provision of education. Deal constructively with information, ideas, and emotions associated with such issues of diversity and conflict as culture, ethnicity, race, gender, religion, age, sexual orientation and abilities. FEEDBACK Seek, accept and utilize feedback to improve professional behavior and skills Respond positively to staff and/or instructor feedback and exhibit recommended behaviors. Response to feedback is positive & part of recommended behaviors exhibited (-1 point) Response to feedback is negative & part of recommended behaviors exhibited (negative compliance) (-2 points) Response to feedback is positive or negative but recommended behaviors not exhibited (zero points) Response to feedback is hostile or aggressive behavior is exhibited (zero points) IV. PROFESSIONAL BEHAVIOR & RESPONSIBILITY PROFESSIONAL BEHAVIOR & RESPONSIBILITY Demonstrate and exhibit professional behavior in the learning environment Adhere to established policies of the NSCC nursing program and of the clinical facility. (EX: Dress code; Confidentiality (HIPPA); Attendance & punctuality; Professional behavior; Student responsibilities & limitations). Accept responsibility for own actions and behaviors. Holistically care for self, others and community within an ethical, legal and diverse framework within the scope of practice of the LPN. ____NORTH SEATTLE COMMUNITY COLLEGE_________________________ NEO 111 EVALUATION TOOL SCORING Directions: Each of the clinical objectives is scored on each clinical day using The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 26 the following point scale* 4- Student meets expectations (objectives) consistently by performing previously learned tasks and providing client care with no prompting or reminders and performing newly learned tasks and client care with 1 reminder or prompting given throughout the shift. 3- Student meets expectations (objective) consistently by performing previously learned tasks and providing client care with no prompting or reminders and performing newly learned tasks and client care with 2 occasional reminders or prompting given throughout the shift. 2- Student meets expectations (objectives) inconsistently by performing previously and newly learned tasks and client care with 3 reminders or prompting given throughout the shift. 1- Student does not meet expectations (Objective). Student is unable to perform previously or newly learned tasks and provide client care unless provided with more than 3 reminders and/or step-by-step instruction from instructor. N/A- No opportunity to observe *Note: Partial points (ie. 0.5 or 0.25) may be given. Any score of <2 requires a separate anecdotal note to be written and placed with the student’s evaluation. The instructor should meet with the student to discuss the anecdotal note & inform the student of inconsistency in meeting the clinical objectives. The clinical expectations and objectives should be reinforced and the student assisted in forming a plan to meet those objectives. If during any clinical day or week the student receives a total of <37 points, the student may be dismissed immediately from the clinical rotation. This indicates that the student is not safe in the clinical setting. The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 27 ___NORTH SEATTLE COMMUNITY COLLEGE__________________________ NEO 111 CLINICAL EVALUATION This is the final evaluation for NEO 111. NEO 111 FINAL CLINICAL GRADE: ______________________ ________________________________ INSTRUCTOR SIGNATURE ________________ DATE (Signature indicates that you have reviewed this document with the student and provided an opportunity for the student to read the document and ask questions) ________________________________ STUDENT SIGNATURE ________________ DATE (Signature indicates that you have read this document and been offered the opportunity to ask questions) The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration. P a g e | 28 COMMENTS: Revision 1/4/2011 The Seattle Community Colleges are an equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. This project was funded in part by a grant awarded under the President’s Community-Based Job Training Grants, as implemented by the U.S. Department of Labor’s Employment & Training Administration.