The University of California, Irvine
Program in Nursing Science
Academic Year: Fall 2014
Course Number: Nur Sci 132
7 units (Course and Clinical)
Course Title: Pediatrics: Care of Children and Families
Faculty of Record:
Kathy Saunders MSN, RN, CPN, CNS- Pediatrics
Associate Clinical Professor
Office: 284 Berk Hall
Phone: (949) 824-9694
E-mail: ksaunder@uci.edu
Office hours: By appointment
Course Description:
Provides didactic and clinical experiences in nursing management of infants, children,
and adolescents with acute, chronic and/or life-threatening conditions. Incorporates
concepts of family-centered care, teamwork and collaboration, patient safety, quality
improvement and informatics, utilizing an evidence-based practice approach.
Course Goals:
Upon completion of the course, the student is able to:
1. Incorporate knowledge of normal physical, intellectual, and emotional growth and
development into care of the child from birth to adolescence across all healthcare
settings.
2. Demonstrate understanding of the acute and chronic alterations in biologic functions
that occur in infants, children and adolescents.
3. Apply nursing assessment and management concepts to pathophysiologic processes
in the acute or chronically ill infant, child, and adolescent.
4. Demonstrate understanding of healthcare issues affecting infants, children, and
adolescents including wellness, health promotion, and health education.
5. Synthesize social, cultural, and ethical influences on family roles in childrearing into
supportive care for families.
6. Verbalize importance of prevention, early detection, intervention, treatment, and
reporting requirements for child abuse and neglect.
7. Integrate recent research findings in Pediatrics to provide safe, evidence-based care of
children and their families.
Prerequisites: Nur Sci 120 and 140
Class Times: Mondays and Wednesdays; 12:00- 1:50pm
Class Location: PSCB 120
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Clinical: As assigned. Each student will have 1) a 5 week clinical rotation in a Pediatric
acute care setting and 2) additional clinical hours in ambulatory settings for a total of 90
clinical hours. Clinical learning objectives and assignments are posted on EEE.
Clinical Agencies:
Peds- CHOC Children’s Hospital, CHOC at Mission, El Sol Academy (Santa Ana),
Irvine Unified School District, and Pretend City (Irvine).
Clinical Instructors: Kathy Saunders MSN, RN, CNS, CPN; Julia Afrasiabi BSN, RN,
CPEN; Raquel Campos MSN, RN, WHNP-BC; Mindy Nelson MSN, RN; Nancy
Neudorf MSN, FNP; Dottie Tagan MSN, RN, CPNP; and Mini Thomas MSN, RN.
Direct all questions related to clinical to your Clinical Instructor (Example: clinical
conferences, scheduling, assignments, etc.) The Clinical Instructor will contact the
Faculty of Record as needed. This will help avoid confusion and misunderstandings
between students and faculty.
Course Requirements and Grading:
Examinations:
- Exam 1 (15%)
- Exam 2 (15%)
- Final cumulative exam (30%)
Assignments: Growth & Development assignment (5%), Attendance & active EEE
participation (15%), Peds PCO (10%), and completion of Kaplan practice reviews &
testing (10%). Clinical assignments will also include weekly journals (see prompts) and a
minimum of 4 PCOs during the rotation- the student will select their best PCO for
grading by the FOR.
Clinical scores are assigned by the Clinical Instructors utilizing the Clinical Evaluation
Tool (posted on EEE). The clinical components of this course are graded on a Pass/Fail
basis*.
*You must pass all components of NS 132 with a minimum score of 74%. A failure
in either didactic or clinical is a failure in the entire course (NS 132). Attendance
and informed participation in both the course and clinical is an expectation.
Standard grading scale for all Nursing Science courses:
A+
A
A_
B+
B
B_
F
2
97 and up
94.0-96.9
90.0-93.9
87.0-89.9
84.0-86.9
80.0-83.9
60 and below
C+
C
C_
D+
D
D_
77.0-79.9
74.0-76.9
70.0-73.9
67.0-69.9
64.0-66.9
60.1-63.9
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ADA Accommodations: Any student seeking ADA Accommodations under the
American with Disabilities Act should contact the UCI Disability Services Center to
register for services. Student needs to meet with faculty members within the first week of
the quarter so that appropriate accommodations may be arranged.
Expectations: Students should review the Program in Nursing Science Student
Handbook and the UC Irvine catalog regarding student expectations and policies on
academic honesty.
Course exams are proctored by faculty and staff to ensure academic honesty and integrity
during the examination process. Students will be assigned seats on the day of
examination by the faculty or staff proctoring the exam. Access to items such as
backpacks, purses, cups, water bottles, phones, PDA’s, laptops, other electronic
equipment, and miscellaneous items as defined by the faculty will be restricted during the
examination. Students will be allowed to have a pencil, pen, eraser and calculator if
applicable at their seat. Breaks will be determined by individual faculty/staff that are
proctoring the exam. It is strongly advised that you use the restroom before the exams as
you may not have the opportunity to do so during the exam.
ADA Accommodations: Any student seeking ADA Accommodations under the
American with Disabilities Act should contact the UCI Disability Services Center to
register for services. Student needs to meet with faculty members within the first week of
the quarter so that appropriate accommodations may be arranged.
Required Texts: (Texts/e-texts and I-Clicker are also required for classroom
activities)
Bowden, V. & Greenberg, C. (2013). Children and their families: The continuum of
care (3rd ed.). Philadelphia: Wolters Kluwer: Lippincott, Williams, & Wilkins.
Recommended Texts (optional):
American Psychological Association. (2009). Publication Manual of the American
Psychological Association, (6th ed.). Washington, DC.
Bowden, V. & Greenberg, Cindy S. (2012). Pediatric Nursing Procedures (3rd ed.).
Philadelphia: Wolters Kluwer: Lippincott, Williams, & Wilkins.
Taketomo, C., Hodding, J. & Kraus, D. (2013 or 2014 edition). Pediatric &
Neonatal Dosage Handbook: A Comprehensive Resource for all Clinicians Treating
Pediatric and Neonatal Patients. Hudson, Ohio: Lexi-Comp.
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Additional Readings: (* indicates required reading)
*Adverse Childhood Experiences at www.cdc.gov/violenceprevention/acestudy/
Select any one of the published health outcomes and address it in your journal entry
on child abuse.
*Bardossi, K. (2014) Toxic childhood stress changes gene expression. Contemporary
Pediatrics. Published online Aug. 7 2014.
Bartlett, J. (2014) The Most Important Vaccine, 1980- 2014. Available at
http://www.medscape.com/viewarticle/828530
Halvorson, M., Yasuda, P., Carpener, S. & Kaiserman, K. (2005). Unique challenges
for pediatric patients with diabetes. Diabetes Spectrum, 8 (3), 167-173.
Herman, Judith. (2005). The teen brain as a work in progress: Implications for
pediatric nurses. Pediatric Nursing, 31(2):144-148.
Jacobson, G., Riesch, S., Temkin, B., Kedrowski, K., and Kluba, N. (2011). Students
feeling unsafe in school: Fifth graders’ experiences. Journal of School Nursing,
27(2), 149-159. Published online Oct 18, 2010. doi: 10.1177/1059840510386612
Klein, D., Goldenring, J., & Adelman, W. (2014) HEADSSS 3.0: The psychosocial
interview for adolescents updated for a new century fueled by media. Contemporary
Pediatrics. Available at www.ContemporaryPediatrics.com/HEADSSSresourcecenter
Other Internet Resources:
American Academy of Pediatrics - www.aap.org
Parenting information- www.healthychildren.org
Association of Women’s Health, Obstetrics and Neonatal Nursing - www.awhonn.org
Bright Futures- www.brightfutures.org
http://brightfutures.aap.org/clinical_practice.html
http://brightfutures.aap.org/nutrition_3rd_Edition.html
Institute of Pediatric Nursing- www.ipedsnursing.org
Institute for Safe Medication Practices- www.ismp.org
Kids Data- www.kidsdata.org
March of Dimes- www.marchofdimes.com
National Association of Neonatal Nurses - www.nann.org
National Center for Adolescent Health & Law- www.adolescenthealthlaw.org
National Maternal & Child Oral Health Resource Center- www.mchoralhealth.org
National Network for Immunizations- www.immunizationinfo.org
Resolve through Sharing - http://bereavementservices.org
Society of Pediatric Nurses – www.pedsnurses.org
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Week 1
10/6 & 10/8
Week 2
10/ 13 &
10/15
Week 3
10/20 &
10/22 Quiz 1
Week 4
10/27 &
1029
Schedule of Classes
Perspectives on Pediatric Nursing & Family Centered Care; Effects
of Illness & Hospitalization;
Pediatric Growth & Development Overview- Eileen Andrade CCLS
Bowden & Greenberg Chapters 1 & 3
Pediatric Nursing Care: Assessment, Pain Assessment, Safety
Well Child care- Bright Futures
Pediatric Oral care With Diane Limbo MSN, RN, CPNP
Bowden & Greenberg Chapters 8, 9, & 10. Chapter 11, pp. 396403.
Nursing Care of the Child with Altered Neurological and Sensory
States; Mental Health challenges
Bowden & Greenberg Chapters 21, 28, & 29
Nursing Care of the Child with Musculoskeletal & Orthopedic
Disorders; Child Abuse- Dr. Sandra Murray
Bowden & Greenberg Chapters 20 & 29 (pp. 1555-1562)
Week 5
Nursing Care of the Child with Respiratory Illness or Dysfunction;
Pediatric Emergencies
11/3 & 11/5
Bowden & Greenberg Chapters 16 & 31
Week 6
Nursing Care of the Child with Gastrointestinal and Genitourinary
Disorders; Alterations in Fluid & Electrolytes
11/10 &
11/12
Bowden & Greenberg Chapters 17, 18, & 19
Week 7
Children with Special Health Care Needs;
11/17 Quiz 2 Nursing Care of the Child with a Cardiovascular Disorder- Jenny
Peterson MSN, RN, CNS
& 11/19
Bowden & Greenberg Chapters 12 & 15
Week 8
Nursing Care of the Child with Immunologic Disorders; Infectious
Disease
11/24 &
*Completion of Peds Nutrition Module (due 12/3 by 12noon)
11/26 no
class
Bowden & Greenberg Chapters 24
Week 9
Nursing Care of the Child with Endocrine and Integumentary
disorders
12/1 & 12/3
Bowden & Greenberg Chapters 25 & 26
Week 10
Nursing Care of the Child with Hematologic Disorders & Cancer;
12/8 & 12/10 Pediatric Palliative Care, Death and Dying
Bowden & Greenberg Chapters 13, 22 & 23
12/3 or
Kaplan Testing- OB & Peds
Berk Hall Computer Lab
12/10
Testing sessions will be combined2:30students attend only 1 which will be
5pm
assigned alphabetically.
12/15/14 Final Exam 1:30- 3:30pm
Location TBA
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Student Responsibilities in Class:
It is imperative for you to purchase the textbooks for class. Students must come prepared
for engaged discussion and activities, having reviewed the assigned readings for each
week. Completing the reading before class will prepare you to take good notes and to
fully master course content. This is extremely important as you progress through the
curriculum and as you prepare for the nursing licensing exam (NCLEX). Please see
instructor for any questions related to the reading.
In addition to reading class material and active informed participation in class
discussions, we expect the following:
 Class attendance is an expectation; an unexcused absence will result in loss of
participation points. If you are ill and unable to attend you must inform the
instructor prior to class.
 Arrive on time to class. When you arrive late to class, you disrupt faculty and
other students.
 Taking notes on your laptops in class is allowed. Students observed using their
laptops for any other purpose (surfing, shopping, e-mailing or texting) will be
asked to leave class and will lose participation points.
 Ask the permission of the instructor before you tape any lecture- this is for your
personal use only.
 Do not sleep in class- you may be asked to leave the class.
 Avoid having conversations with others during lecture.
 Do not bring visitors to class (friends, family, etc.) without prior approval of
instructor.
 Turn off beepers and cell phones while in class.
Academic Honesty: You are expected to behave with professional and personal
integrity at all times in class as well as in clinical. Any form of academic dishonesty
will not be tolerated. This includes plagiarism, cheating or not doing your own
work. Please read and understand the UC Irvine policy on academic honesty as well
as the Nursing Science Programs student handbook. Please discuss any issues,
questions, concerns that you have with faculty. We are here to help you learn this
material so that you can have a successful career in nursing.
Overview of Clinical Experiences in Pediatric Nursing:
UCI nursing students will participate in a 5 week clinical experience in both pediatric
acute care and ambulatory settings. You will function in collaboration with the staff
nurse at the bedside and under the supervision of the clinical instructor. Please follow the
guidelines in the syllabus to ensure your safety as well as the safety of patients and
families.
Cutting across all weeks of clinical experience, students are expected to approach patient
care from a holistic perspective that is sensitive to the patient’s biological, psychological,
social, cultural, and spiritual being. Student clinical conduct is expected to follow the
ANA Code of Ethics.
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Clinical Requirements, Assignments and Grading:
1. Integration of knowledge and skill in the nursing management of assigned patients
2.
3.
4.
5.
7
a. Students will work with staff and faculty to manage the care of assigned patients,
to assure safety, and to support the patient/family. Faculty and staff will
contribute to the education of the student and interact with the student to assure
the integration of knowledge and skills. The clinical evaluation form will be used
to assess student achievement of the course objectives.
PCO, Care Plan, and Evidence-based Article Review
a. Students are responsible for submitting their best PCO with their instructor’s
comments to the Faculty of Record (FOR) by Week 4 (1st group) or Week 9 (2nd
group). The EBP articles used must be current, appropriate to the nursing plan of
care, and be referenced within the PCO. An explanation for the selection of this
article will be included with the PCO.
b. The FOR will independently review and grade the submitted PCO.
Clinical Conference participation and Journal submissions
a. As directed by their Clinical Instructor, students are expected to participate in the
conferences following clinical experiences by relating and synthesizing EBP
research and their patient care. Through case presentations, assigned topics, and
clinical scenario reviews, students will share with peers their integration of theory
and clinical practice.
b. Presentations in Clinical Conferences: students are expected to present and
critique care plans or concept maps; review their nursing care and research
articles to examine evidence-based practices; and discuss their journal entries as
directed by the Clinical Instructor.
c. Journal prompts must be followed and thoughtful journal entries submitted to
Clinical Instructors weekly. Entries are to be a minimum of one page and will
vary according to actual clinical experiences.
Pediatric Alternative Experiences--Details posted on EEE
a. All students will have 2 eight hour days at a pre-school setting and these
assignments will be sent to students within the first week. There is a posted 2
page assignment due one week following this experience to your instructor at that
clinical site.
b. Students will need an additional four hour alternative experience and these
opportunities will be posted on EEE for student sign-up shortly after quarter
begins. Students will need to have time cards signed for alternative activities &
return these to the faculty of record.
Successful Completion of Kaplan
a. Students are expected to take the 3 Peds practice tests prior to the scheduled
Kaplan testing date(s). These will be most effective if spaced out and taken
between weeks 8 - 10.
b. Following completion of the integrated testing session, the faculty of record will
determine the passing score for Peds (per Kaplan). If the student falls below the
determined passing score, they will need to remediate before the end of the
quarter to earn full points. Failure to complete the assigned practice tests, failure
to take the integrated test, or failure to remediate as directed will result in a
reduction of points.
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Clinical
Topics
PEDIATRICS
Journal Prompts
Topic 1
Examine the role of the nurse in the
pediatric setting. Focus on the nurse’s
interaction with the patient and the
family. Does the nurse perform as an
advocate for the patient or encourage
the parent(s) in this role?
Topic 2
Focus on patient safety. Examine how
nurses integrate patient safety into the
patient care plan. Seek out policies
and procedures that support a safe
environment i.e. medication safety, or
SBAR for communication.
Topic 3
Concentrate on your pain assessment
of the pediatric patient. What policies
and procedures does the organization
have for assessment and management
of pain? How does the RN help
prevent procedural pain? What
methods of pain management did you
witness and/or participate in?
Topic 4
Observe the characteristics of the
organization you are in with regard to
how they practice Family Centered
Care. What services and supports are
available to families? What are the
positive aspects of FCC? How does it
contribute to the child’s recovery?
Analyze the role of nursing in cases of
child abuse. Pay close attention to any
screening or assessment information
that would alert healthcare staff that
child abuse is occurring.
Topic 5
*See required readings on child abuse
from Course syllabus.
8
Write about your observations of the
nurse that you collaborated with or a
nurse that made an impression on
you because of a patient/family
interaction you witnessed. How was
this nurse an advocate for the
patient? Did the nurse collaborate
with other members of the team? Is
there something you thought
could/should have been done?
Describe how safety was integrated
into the patient care setting. How did
you play a role in maintaining a safe
environment? Did you witness
anything that could have or actually
did put the patient at risk for injury?
How does communication
contribute to safe care?
Describe a patient encounter in
which you participated or observed
pain management. How did you
assess the patient’s pain? Was the
assessment tool evidence-based?
What challenges do developmental
considerations pose to nurses caring
for pediatric patients and managing
their pain?
Discuss how you feel about having
parents and family members at the
bedside at all times? What benefits
did you observe today? How would
you describe the Family Centered
Care you observed?
Discuss how you would handle
interacting with a parent that was
suspected of abusing their child?
What do you think would be most
difficult for you? What is the
nurse’s responsibility when child
abuse is suspected?
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Student Responsibilities in Clinical Education:
Attendance: Clinical rotation hours are dictated by course units and approved by the
Board of Registered Nursing (BRN). Missing clinical time places you in jeopardy of
failing the course and makes you ineligible to take the Board exam for nursing. There are
no planned opportunities to make-up for missed clinical days. Decisions to allow a
student to make up a single day will be made on a case by case basis in collaboration with
the Faculty of Record and the facility. In case of illness or a serious emergency, the
instructor and the unit to which the student is assigned must be notified prior to the
beginning of the clinical experience. Multiple clinical absences may result in failure or
the need to withdraw from the course.
Students are expected to arrive 15-30 minutes early for their clinical experiences so they
can receive their assignments and get ready for report. Lateness will not be tolerated—it
is critical that you be present for morning report on your patients. Students who are late
will get a warning the first time, and if it happens again they will be dismissed from
clinical for the day. Please call or page your clinical instructor if you have an emergency
which may make you late for clinical.
Students are expected to actively participate in all scheduled clinical conferences.
Active participation includes actively listening to your clinical instructor, taking notes as
appropriate, actively participating in discussions, reflecting on your clinical experience
that day and raising relevant issues/questions/concerns for group discussion.
Ethical Behavior: Nursing students are expected to follow the ANA Code of Ethics
when caring for patients. Your primary responsibility is to those requiring nursing care. It
is important to recognize and use your authority as a health professional ethically. The
ethical charge of nursing is to promote good, and prevent and remove harm from our
patients. It is your responsibility as a caring health professional to promote and respect
your patients’ autonomy, which means respecting your patient’s role in setting goals,
making plans, deciding upon treatments, and freely choosing to act on these decisions.
You must also respect your patients’ individual, family, and community rights, customs,
values, and beliefs. In your role as patient advocate you are obliged to maintain a nonjudgmental, nondiscriminatory attitude towards all patients.
The nurse-patient relationship is a therapeutic relationship. Communication is the
cornerstone of providing excellent, compassionate care. Building a relationship that
engenders trust, faith in one another, truthfulness, and open communication is important
for building a strong, healing relationship with your patients.
As codified in HIPAA, confidentiality and privacy are critical to maintaining your
patient’s dignity and autonomy. Information about your patient should only be shared
with your clinical instructor and other professionals in private settings (e.g., the clinical
seminar or rounds). Do not discuss your patients in public places in the hospital or in
surrounding areas. You must take responsibility for your actions, and report to your
clinical instructor any doubts, concerns or issues that you have in delivering care to your
assigned patients. HIPAA violations may result in individual fines up to $50,000 and/or
imprisonment up to 1 year.
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Unethical behavior (e.g., omission of informed consent, breach of confidentiality, undue
coercion, failure to maintain professional boundaries) render our patients more vulnerable
and will result in dismissal from the clinical rotation.
You will be required to submit comprehensive PCOs (with Health histories, Physical
assessments, Lab and procedure reviews) and evidence-based care plans tailored to each
patient. To do this you will be required to use research studies, peer-reviewed articles,
clinical guidelines, and nursing protocols. You are expected to know and use APA format
for all your sources. You may not take nursing diagnoses verbatim from care plan books
and use them in your plan. Every nursing diagnosis should reflect your patient’s unique
needs; interventions must reflect appropriate clinical judgment of care priorities, you
must include research supporting the selected interventions; and you must document
accurate evaluation of the outcomes of care delivered. Your patient care will be partly
evaluated based on your unique PCOs and Care Plans. Thus you must work
independently on your care plans. This does not mean you cannot talk to your fellow
students about your ideas; it means your care plan must reflect the specific care provided
to your patient.
Professionalism and Team-based Care: Students must be appropriately and
professionally dressed in the required UCI Nursing Program uniform. If the nursing
leadership at the hosting institution prefers that you wear street clothes this must be
approved by your clinical instructor. In that situation, you will abide by the dress code
that applies to the professional RNs in that institution. Please refer to the Student
Handbook for additional information on dress code.
Students are expected to take initiative and express thoughts, feelings, learning needs,
and concerns directly with clinical instructor and staff as appropriate, and to function as a
member of a healthcare team. Active collaboration with clinical staff is important—do
not just wait for the staff members to tell you what to do. Show initiative by making
suggestions and asserting your professional development needs. Treat all staff and other
health professionals with respect and try to learn from their experience. At the same time
we encourage you to think critically about your patients’ needs and partner with the
hospital team to provide patient-centered care.
Safe Clinical Practice: The UC Irvine Program in Nursing Science maintains that
patient and student safety are paramount in all aspects of clinical education. If a student’s
clinical performance is unsafe, the student will be withdrawn from the clinical arena,
counseled, and sent home. Examples of behaviors that will be deemed unsafe are:
medication errors as a result of the student’s performance, negligent misconduct, and
professional misconduct. Clinical Instructor and RN working with the student will clearly
detail on a clinical evaluation and/or a Faculty Progress Note form what is deemed
“unsafe clinical practice”. Concise written guidelines and evaluations will be given to the
student. All safety cases will be referred to the Faculty of Record for the course who,
with the Director and Chair of the Program, will decide on a course of action. All
documentation and Faculty Progress Notes regarding student issues will be copied and
sent to the Student Affairs office and these forms will be placed in the student’s file. If at
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any time, the student is sent home for unsafe clinical practice, this will be considered an
unexcused clinical absence.
Guide for Clinical Supervision to Ensure Student and Patient Safety:
In the clinical area, you are responsible for your own learning and attainment of clinical
competency. Your clinical instructor acts as a facilitator and may coach, prompt, mediate
and help you in the process of integrating knowledge. You will be teamed up with a
nurse on the floor and your clinical instructor works with the staff to ensure that you have
a safe and highly educational clinical experience. For invasive procedures and
medication administration, your clinical instructor should have checked you off initially
PRIOR to performing the intervention under RN staff supervision. When in doubt, please
communicate clearly and directly with your clinical instructor. Below are some brief
guidelines to reinforce the need for safety as you perform some of the clinical skills in
your assigned clinical area. Again, this is only a guide; safe practice is the rule, so if
you are unsure about a procedure, you must seek direct assistance, review, and practice
from your clinical instructor before performing the nursing intervention.
Maximum Supervision Skills (Instructor must be present):
Medication administration:
Until competency is determined by Instructor, utilizing the medication administration
competency form on EEE- then student may be supervised by a staff RN. Students are
not to give medications without direct supervision by staff RN or Instructor.
Invasive procedures:
In Maternal-Child, all invasive procedures i.e. suctioning, insertion of catheters or tubes,
strip interpretation, etc. must be under direct supervision of staff RN or Instructor.
Berk Hall Hospital Bed Unit hours for Fall 2014:
MondayTuesday Wednesday Thursday -
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