COURSE: Nursing 202 TITLE: Client Assessment SYLLABUS COURSE DESCRIPTION Determining and measuring variables relevant to assessment of psychosocial and physical functioning COURSE OVERVIEW This course focuses on the assessment phase of the nursing process. Students develop a beginning awareness of factors that influence health. This course emphasizes age-specific health promotion recommendations as supported by clinical practice guidelines and the role of the nurse in primary, secondary and tertiary prevention.. Students gain experience in obtaining health histories, performing nutritional assessment and comprehensive physical assessments. COURSE OUTCOMES Upon completion of the course the student will: Level II Outcomes 1) initiate the assessment phase of the nursing process by the accurate collection of subjective and objective data. 2, 5 2) use appropriate interviewing techniques to obtain accurate and complete health histories. 1, 2, 5 3) identify family and genetic history, lifestyle factors and other risk factors that increase risk for disease and disability. 2, 3, 5, 9 4) formulate a list of client problems and risk factors based on holistic health assessment. 2, 5, 9 5) articulate the role of the nurse in primary, secondary and tertiary prevention. 10, 11, 13 6) use evidenced based clinical practice guidelines to identify age specific health promotion recommendations. 2, 8, 9 7) perform a nutritional analysis using nationally defined recommendations for weight and nutrient intake. 2, 5, 9 8) perform a complete and systematic physical exam using the techniques of inspection, palpation, percussion and auscultation. 2, 5, 7 9) demonstrate the skillful use of examination equipment in the performance of the physical exam. 2, 5 10) apply appropriate techniques for assessing and monitoring vital 2, 5 signs. 11) Apply knowledge of anatomy and physiology to the assessment of body systems (e.g., skin, hair, nails, head/neck, eye, ear, nose, mouth, throat, lymphatics, thorax/lungs, heart, peripheral vascular, breast, abdomen, male/female genitalia, urinary, and neuromuscular systems). 2, 5 12) distinguish between normal and abnormal assessment findings. 2, 5 13) identify assessment findings that reflect normal developmental changes and changes of aging. 2, 5 14) identify assessment findings that are influenced by ethnic, cultural and socioeconomic status. 3, 5 15) document assessment findings in an accurate, concise and organized way. 5, 7 Level Outcomes Level II Level III Level IV Upon completion of the first year the student will: 1.2 Relate liberal educational experiences to core competencies in professional nursing practice. 2.2 Utilize selected scientific professional and contextual knowledge in the application of the nursing process. Upon completion of the second year the student will: 1.3 Recognize the application of liberal education experiences into professional nursing practice. 2.3. Analyze selected scientific, professional and contextual knowledge in the application of the nursing process with families and groups. Upon completion of the second year the student will: 1.4. Apply an integrated liberal educational experience in developing clinical judgment. 2.4. Use the nursing process, scientific, and contextual knowledge in the delivery of nursing care. 3.2 Understand human diversity as it applies to health and illness. 3.3 Use knowledge of human diversity in planning care for individuals and families. 4.2 Begin to demonstrate fundamental nursing care based on the central professional value of caring. 4.3 Incorporate the central professional value of caring in planning care for individuals and families. 5.2 Demonstrate critical thinking, communication, assessment, and technical skills in the provision of nursing care. 5.3 Integrate critical thinking, communication, assessment, and technical skills in the planning of care for individuals and families. 3.4 Demonstrate the ability to deliver nursing care in a variety of settings among diverse populations. 4.4 Demonstrate the central professional value of caring by delivering. compassionate, appropriate and culturally sensitive care. 5.4 Consistently use critical thinking, communication, assessment, and technical skills in the delivery of nursing care. 6.2 Develop an awareness of one’s ability to perform as a professional nurse and seek assistance when necessary. 7.2 Develop an awareness of the professional values of altruism, autonomy, human dignity, integrity and social justice as the foundation for professional practice. 8.2 Develop an understanding of teaching learning theory in its application to patient care. 9.2 Develop an awareness of research based knowledge from nursing and the sciences as the foundation for professional nursing practice. 10.2.1 Develop an awareness of the roles of the professional nurse as provider of care, designer/manager/coordinator of care and member of the profession. 10.2.2 Recognize the practice of professional nursing requires a commitment to life long learning. 11.2 Identify the role of the professional nurse and the various members of the health care team and describe their functions. 12.2 Recognize the leadership role in the nursing profession. 13.2 Gain awareness of health care resources available within the community. Approved Level Outcomes July 12, 2005 6.3 Demonstrate and accepts responsibility for contributing to one’s own learning and critically appraises ability to perform as a professional nurse. 7.3 Demonstrate in clinical practice professional values, behaviors and standards. 6.4 Demonstrate accountability for nursing practice. 8.3 Incorporate teaching learning theory in the delivery of nursing care to individuals and families. 9.3 Analyze the relationship of research based knowledge to the delivery of nursing care. 8.4 Use teaching-learning theory appropriately in nursing practice. 10.3 Demonstrate an understanding of the present and emerging role responsibilities of the professional nurse. 10.4 Accept responsibility for professional growth and life-long learning in consonance with the emerging role of the nurse in a changing society. 11.3 Participate as a team member in providing health care to patients utilizing the knowledge and principles of interdisciplinary models of health care delivery. 12.3 Develop beginning leadership skills in clinical settings. 13.3 Identify social, economic, and political agendas affecting the delivery of health care. 11.4 Collaborate with patients and interdisciplinary health care teams to plan, manage and influence health care standards, methods, and systems. 12.4 Demonstrate leadership behaviors within one’s scope of practice. 13.4 Support agendas that enhance awareness of the social, economic, and political agendas that influence health care delivery. 7.4 Incorporate professional values and standards of practice as the foundation for nursing practice. 9.4 Incorporate research as a foundation for evidence-based practice. Course Credit/Hours: 4 units; 2 hours lecture, 6 hours lab Faculty: S. Hadley, Ph.D, APRN, GNP, ANP-BC Office: HT 170 E-mail: shadley@mail.sdsu.edu Laboratory Instruction D. Burns, MSN, APRN, FNP-BC B. Brock, MSN, RN L. Fitzsimmons, Ph.D, APRN, FNP, ANP-BC P. Gray, MSN, FNP S. Hadley, Ph.D, APRN, GNP, ANP-BC L. Long, MSN, FNP Required Texts Jarvis, C. (2012). Physical examination and health assessment (6th ed.). Philadelphia: W. B. Saunders. Jarvis, C. (2012). Student laboratory manual for physical examination and health assessment (6th ed.). Philadelphia: W. B. Saunders. Important: the lab manual must be new. Used, marked copies will NOT be acceptable. Optional Texts Jarvis, C. (2012). Pocket companion for physical examination and health assessment (6th ed.). Philadelphia: W. B. Saunders. Websites Nutrition information http://caloriecount.about.com http://calorieking.com Physical Assessment http://meded.ucsd.edu/clinicalmed http://stanford25.wordpress.com Heart Sounds http://depts.washington.edu/physdx/heart.html/tech Required Equipment/supplies Stethoscope Metric ruler Watch with second hand Examination gown Sports bra or bathing suit for women Teaching Methods Lecture/Demonstration/Discussion Audiovisuals Required readings Campus laboratory activities Utilization of the nursing process Grading Criteria There will be 4 exams in the course. Exam 1: 50 questions Exam 2: 50 questions Exam 3: 50 questions Final Exam: 90 questions To successfully complete the course, the student must: 1) achieve 174 points out of 240 exam points (73%). Extra credit is NOT an option for failure to achieve the minimum points. 2) demonstrate proficiency on the Midterm Performance Evaluation (MPE) and Final Performance Evaluation (FPE). • Satisfactory achievement is determined by performing ≥ 85% of the physical exam techniques correctly. • The MPE and FPE may be repeated one time for failure to achieve 85%. • Failure to achieve an 85% by the second attempt will preclude successful course completion. • The MPE and FPE are evaluated on a satisfactory-unsatisfactory basis and will not be calculated in the final grade. 3) demonstrate satisfactory performance in laboratory activities as noted below: • document weekly assessment data in the laboratory manual • accurately complete the nutrition self-assessment • prepare for and participate in the simulation laboratory • gain proficiency in health assessments/physical exams Grading Scale: Final grades will be determined using the following grading scale: POINTS PERCENT GRADE 222-240 93-100% A 215-221 90-92% A- 208-214 87-89% B+ 198-207 83-86% B 191-197 80-82% B- 184-190 77-79% C+ 174-183 73-76% C 167-173 70-72% C- 160-166 67-69% D+ 150-159 63-66% D 143-149 60-62% D- < 143 < 60% F Preparation for the Clinical Laboratory Maximizing the clinical laboratory experience requires that the student be prepared for each laboratory session. The student should complete the required readings and on-line lectures prior to each lab. The minimal expectation is that the student has read the required readings and has a beginning understanding of the skills required to perform the required physical assessments in the laboratory. Failure to consistently show adequate preparation for the laboratory will result in failure to meet course outcomes and subsequent course failure. Some physical examination techniques require close physical contact (e.g., auscultation of heart and lungs) however, efforts to protect modesty are encouraged by the use of appropriate examination clothing (e.g., examination gowns). Synthetic breast models are available for performance of the breast exam. Laboratory Attendance Attendance is expected for all laboratory sessions except for serious or extenuating circumstances. Students should not make outside commitments that require absence from lab. Appointments and other commitments should not be scheduled during lab hours and this includes elective healthcare appointments. Employment/work commitments do NOT justify an excused absence. Absence from lab not only affects the individual student but potentially affects the student's lab partner. An absence from lab is taken very seriously and an unexcused absence will result in a grade point reduction. More than one unexcused absence will result in course failure. For an absence to be excused, the student must provide appropriate written documentation justifying the absence (e.g., a note from a healthcare provider, a letter from the court, a time/dated receipt showing automobile breakdown en route to lab, etc.). Failure to provide appropriate documentation will result in an unexcused absence. If you have any doubt about whether an absence will be excused or what type of documentation is needed to justify an excused absence, you should discuss this with the course coordinator prior to the absence. Oversleeping or “failure of the alarm clock to go off” does NOT justify an excused absence. There will be no exceptions to this policy. The written documentation for the absence must be presented to the course coordinator or placed in her mailbox (HT 58) on the first day that the student returns to school. Evidence of falsifying documents will be treated as academic dishonesty and will be subject to University sanctions and may include dismissal from the University. • An unexcused absence will result in a loss of 7 points in the calculation of the final course grade. In some cases this could drop the total points below the minimal passing score for successful course completion. • A second unexcused absence will result in course failure. IMPORTANT. If it becomes necessary to miss lab, a student must email the course coordinator and contact his/her lab instructor prior to the absence. If this is not possible he/she should make contact on the same day of the absence. Failure to do so may result in an unexcused absence. Excessive absences (even if justified) may result in failure to meet course outcomes. Please contact the course coordinator if you are having problems that affect your attendance in lecture or lab. Tardiness Arriving late to lab is disruptive and potentially affects the learning of others. Late arrival to lab will be handled in the same way as an unexcused absence (e.g., appropriate documentation). Tardiness will result in final grade point deductions as follows: 5-30 minutes late = 1 point penalty 31-59 minutes late = 2 point penalty 1-3 hours late = 3.5 point penalty More than 3 hours late = 7 point penalty Please note. More than 10.5 penalty points from unexcused absences and/or tardiness will result in course failure. Examination Attendance No provision is made for examinations that are missed because of unexcused absences. An unexcused absence will result in a grade of F (0%) for the exam. In order to avoid an unexcused absence, the course coordinator should be notified prior to the absence. For an absence to be excused, the student must provide appropriate written documentation justifying the absence as noted above. If a make-up examination is necessary, it may differ in format and content from the original exam (e.g., essay, short answer, or other test forms may be given). Please note that examinations are “timed tests”, therefore, arriving late to class on exam days will limit the amount of time available to complete the exam. Classroom/Laboratory Etiquette The use of electronic devices (computers, smart phones, ipads, etc.) may only be used to access course-related information. These devices may not be used to send or receive text messages/email during class or lab time. Cell phones should be turned off or on vibrate mode and are not to be used during class or lab. You may use these devices during designated break times. Students With Disabilities Students who need disability accommodation should provide documentation of their disability to Student Disability Services at 619-594-6473 (Calpulli Center, Suite 3101), and receive authorization for academic or clinical accommodations. After accommodations have been authorized by SDS, students are responsible for notifying faculty in advance of the need for accommodation. This can best be accomplished by making an appointment to meet privately with the faculty member early in the semester, or as soon as possible in the event that a disability is diagnosed during the course of the semester. Confidential Information In the course of your professional education you will encounter personal and sensitive information about others. It is your legal and ethical responsibility to maintain the confidentiality of this information and to protect the anonymity of those involved. This includes, but is not limited to, avoiding discussions that would allow others to identify the subject of the information and removing patient names from course papers/class assignments. Failure to protect the privacy of others may have serious repercussions. Lost or Damaged Laboratory Supplies/Equipment The student is responsible for the replacement of lost or damaged laboratory supplies and equipment. Final grades will be held until laboratory items are returned or replaced. Other “This course may require students to participate in field trips, research, or studies that include course work that will be performed off-campus. Participation in such activities may result in accidents or personal injury. Students participating in off-campus activities are aware of these risks, and agree to hold harmless San Diego State University, the State of California, the Trustees of the California State University and Colleges and its officers, employees and agents against all claims, demands, suits, judgments, expenses and costs of any kind on account of their participation in the activities. Students using their own vehicles to transport other students to such activities should have current automobile insurance.”