RED DEER COLLEGE/UNIVERSITY OF ALBERTA
Collaborative Baccalaureate Nursing Program
NURSING 491
COURSE OUTLINE
Spring (May 1 – June 11, 2015)
Fall I (September 9-October 22, 2015)
Fall II (October 27-December 10, 2015)
Associate Dean
Date: April 28, 2015
Nursing 491
CALENDAR STATEMENT:
NURS 491 Nursing Practice VII *7 (fi 14) (either term, 3-26c-2 in 7 weeks).
Management and care of clients in ambiguous, complex, situations occurring over a variety
of settings. Pre- or co-requisite: NURS 490. Prerequisite, NURS 391, 394 and 395.
COURSE HOURS: LEC: 0
SEM: 21
CLINICAL: 182
LAB: 14
COURSE DESCRIPTION:
Opportunities will be provided for students to experience nursing practice with acutely ill
clients or clients in ambiguous complex situations over a continuous block of time, e.g., inpatient acute care, home care, or other complex community settings. Management and care
of clients with stable or unstable, predictable or unpredictable disruptions of health will be
the focus of this clinical course. In addition, management of health promotion and
prevention activities utilizing advanced interpersonal/communication skills, health
counselling, and teaching will be emphasized.
COURSE OBJECTIVES:
Levels of Independence
In evaluating objectives, the following levels of independence will be used:
With assistance: The student requires direction and information.
With minimal assistance: The student requires occasional direction and
information.
With guidance: The student requires clarification, prompting and confirmation.
With minimal guidance: The student requires occasional clarification, prompting and
confirmation.
Independently: The student works mostly on his or her own and seeks information,
clarification and consultation as appropriate.
Direction: Clinical tutor tells the student what to do, about what steps to take.
Information: Clinical tutor tells the student specifics about a concept or topic.
Clarification: Clinical tutor, through questioning and feedback, assists the
student to state their information in a different and clearer way, often with more
details. The student asks questions to increase their understanding; questions
asked demonstrate a sound knowledge base.
Prompting: Clinical tutor provides the student with a cue that answer is
incomplete or incorrect and how to resolve the lack of information. A prompt is
broader than a hint. Prompting is generally used to add breadth or depth.
Confirmation: Clinical tutor provides positive feedback for correct information
and direction provided by the student.
Consultation: The student provides clinical tutor with information and/or
direction and asks specific questions about the information or direction which
the instructor confirms.
Occasional: The clinical tutor provides input every now and then.
Objectives
Overarching statements:
Students are responsible to familiarize themselves with and refer to the Graduate Competencies
and Year-End Outcomes (with Cross Reference to courses) 2014-2015. Attention must be given to the
competencies that are identified as being relevant to Nurs 491.
Students must regularly refer to the document entitled Graduate Competencies and Year-End
Outcomes Condensed Version 2014-2015. Attention must be given to the Year 4 Column. This
document serves as the basis for the evaluation of students' clinical practice.
All students must practice in a manner that is consistent with:
 CARNA Nursing Practice Standards (2013) and all other CARNA standards,
 The CNA Code of Ethics for Registered Nurses (2008).
Students will:
1.
Demonstrate independently, the processes of self-directed learning, critical thinking,
and group process in utilizing context-based learning in all learning activities.
2.
Demonstrate independently or with minimal guidance, the ability to practice in
accordance with Year 4 competencies, as described in the document entitled: Graduate
Competencies and Year-End Outcomes Condensed Version 2014-2015.
3.
Demonstrate independently or with minimal guidance, the ability to provide evidencebased, competent nursing care to clients who are acutely ill and/or are in ambiguous
complex situations, in a variety of settings (primarily hospitals and home care).
4.
Demonstrate independently or with minimal guidance, the ability to manage health
promotion and prevention activities using advanced therapeutic/interpersonal
communication skills, health counselling skills, and teaching and learning principles.
5.
Demonstrate knowledge of the relevance of primary health care to all areas of practice.
6.
Demonstrate the ability to integrate knowledge into clinical practice.
REQUIRED LEARNING EXPERIENCES
Students are expected to implement previously learned nursing skills, as well as:
a. Provide nursing care in ambiguous complex situations in a rural acute care, home
care, paediatrics/NICU, Continuing Care, or community-based clinical setting with
adults and/or children.
b. Coordinate nursing care for 3-4 clients, where the clinical setting allows. Alternately,
in some placement settings such as pediatrics, home care, and specialty areas,
students will co-ordinate care for two-thirds to three-quarters of an RN’s optimal
case load for that setting. The emphasis should be on learning depth, breadth, and
client safety.
c. Participate in site-selected lab activities.
d. Use a nursing model to assess, prioritize, implement, and evaluate the nursing care
they provide their clients and their clients’ families.
e. Organize and implement client and family education.
f. Collaborate with clients, clients’ families, members of the community, nurses, and
members of the health care team.
NCLEX Preparation
An online NCLEX prep resource is available for students to purchase at the bookstore,
which will assist them with preparing for writing the RN registration exam. This resource
will provide students with a 1 year online review/prep course to use as they progress
through 4th year, as well as 3 NCLEX style prep exams to complete in the last 3 months of
their 4th year.
Labs and Seminars
1. Simulation labs: Proposed Dates
Spring 2015
May 12 & 13
Fall I 2015
September 21 & 22
Fall II 2015
November 9 & 10
Simulation provides students with an opportunity to prioritize and coordinate patient care,
practice nursing skills, and further develop critical thinking and problem solving skills in a
safe and supportive environment. Learning opportunities that may not be readily available
in some clinical settings are provided to support students’ broader learning.
A variety of scenarios from practice in home care, continuing care, emergency care,
pediatrics, and obstetrics will be offered. Students are expected to participate in several
simulations over the course of two days. Students will have an opportunity to sign up for
simulations ahead of time. In addition to simulations, a lab will be open for students to
practice skills they would like to strengthen. It is strongly encouraged that students spend at
least 2 hours practicing in the drop-in lab so as to prepare for the clinical setting.
2. Seminars: Proposed Dates
Spring 2015
May 4 & 5
Fall I 2015
September 10 & 11
Fall II 2015
October 28 & 29
Seminars provide students with an opportunity to develop their knowledge base, critical
thinking, and problem solving skills about various topics in a safe and supportive
environment prior to entering the practice setting. All students are expected to attend the
wound care and infection control seminars. Additionally, students will select and attend three
other seminars of their choice based upon their identified specific learning needs. Seminar
topics will include information relevant to rural acute care, pediatrics, continuing care, or
community practice.
OPTIONAL LEARNING EXPERIENCES
Students may have opportunities to observe or participate in:
a. Team leading
b. Follow-through care with less stable complex clients experiencing medical or surgical
procedures.
c. Discharge planning/referral from institutional settings.
Liaising with home care nurses.
Follow-up care with a client that may include telephone calls and/or a home visit.
d. Specific projects within institutional- or community-based practice.
e. A family conference and/or multidisciplinary conference.
f. Specialty activities related to the clinical setting.
Important Dates
Spring 2015
Fall I 2015
Fall II 2015
Last day to add or drop courses
May 4, 2015
Sept 15, 2015
Oct 30, 2015
Withdrawal date for 50% tuition refund
May 15, 2015
Sept 25, 2015
Nov 18, 2015
Last day to withdraw
without academic penalty
June 3, 2015
Oct 8, 2015
Nov 30, 2015
Faculty Office Hours
Instructors are in clinical full-time and their schedules vary depending upon the clinical
group and setting; therefore, office hours will vary. Students are to contact their instructor by
phone, email, text, or using Blackboard to set up meeting dates and times to discuss any
issues that cannot be resolved during clinical hours.
Dress Code
Students’ uniforms and/or dress must comply with the Red Deer College Nursing
Department policy and the dress code of the agency to which they are assigned. Please refer
to the student handbook for further information.
Clinical Tutors
Spring 2015
Mary Sabbe
Lorraine Way
Jean Smith
Marlee MacDonald
Section
K
L
M
N
Office
1208
1208
1210
1208
Office Phone
403-357-3635
403-357-3635
403-342-3421
403-357-3635
Cell Phone
403-845-0423
403-877-9580
Fall I
TBA
Marian George
Jean Smith
Wendy Motley
Sara Daniels
Section
A
B
C
D
D
Office
Office Phone
Cell Phone
1215
2210
1208
2221
403-314-2420
403-342-3421
403-357-3635
403-314-2464
403-357-0788
403-845-0423
403-350-7446
Fall II
Marian George
TBA
TBA
Wendy Motley
Sara Daniels
Section
E
F
G
H
H
Office
1215
Office Phone
403-314-2420
Cell Phone
403-357-0788
1208
2221
403-357-3635
403-314-2464
403-350-7446
Attendance
Lack of attendance may impact the students’ ability to successfully complete the course. Any
student who will be late or absent for any lab, seminar, or clinical experience must notify the
instructor and the agency at least one hour prior to the beginning of the experience. Make up
experiences for missed lab, seminar, or clinical shifts will be arranged on an individual basis
and may include written assignments in addition to other experiences.
Note: Make-up experiences may extend beyond the final scheduled course date.
It is highly recommended that a student not work as an Alberta Health Services or Covenant
Health Care undergrad in an area where he/she is a Nursing 491 student. Doing so can lead
to role confusion for the staff, patients, and student.
Nursing 491 is a full-time clinical commitment and will require preparation and reflection
outside of actual classroom and clinical time. To maintain fitness to learn and practice, a
student should not work another shift on the same day as he/she is working a clinical day.
Canadian patient safety statistics indicate that most errors occur after eight hours of clinical
practice or when nurses are working an extended stretch of shifts (Roger, 2004).
Roger, A.E., et al. (2004). The working hours of hospital staff nurses and patient safety.
Health Affairs, 23, 202-212.
Specialized Support and Disability Services
Personal Counselling, Career, Learning, and Disability Services are provided at RDC room
1402; phone number 403-343-4064. Learning resources may be available to students in
alternative formats. Students who require accommodations in this course due to disability,
vision, hearing, and mental or physical health are advised to discuss their needs with
Counselling, Career & Learning Services. It is the student’s responsibility to discuss learning
needs with his/her instructor.
COMMUNICATION:
Students must use their University of Alberta e-mail address and include a subject line when
communicating with faculty members/administration staff at the U of A. When
communicating with RDC Faculty, students will use blackboard/RDC email as their main
platform for communication (see below).
The content messages of both e-mail and voice mail must be delivered in a professional
manner. Inappropriate messages may be considered “harassment”. Refer to the Code of
Student Behavior Section 30.3.4(6) d. Inappropriate use of e-mail sent to fellow students
and members of the Faculty of Nursing and University community can result in disciplinary
action. Please refer to the Faculty of Nursing’s guidelines for e-mail etiquette at this link:
www.nurs.ualberta.ca/flex/email/Email_Ettiquette.html
The use of social networking services such as, but not limited to, Facebook, MySpace,
internet messaging, blogs and wikis, are subject to the professional and ethical
responsibilities outlined in the
 Canadian Nurses Association (2008) Code of ethics for Registered Nurses, Part I Nursing
Values and Ethical Responsibilities, Maintaining Privacy and Confidentiality, and the
 University of Alberta Code of Student Behaviour, Section 30.3.3 Inappropriate Behaviour in
Professional Programs.
Blackboard Communication
Blackboard will be used for email, document submission, and general communication at Red
Deer College. Students have a “central” course, 201540.NURS.491 03 (Spring 2015) and
201620.1856.1911: NURS 491 01 & 02 (Fall I and Fall II) and individual section courses,
both of which they are responsible to access for information sharing.
Students are expected to access their Blackboard site at the beginning of each term and on a
regular basis throughout the term. Failure to do so may result in students missing important
course-related information, resources, instructor feedback, and announcements.
Course information, important notices, course content, and correspondence relating to all
students in the course will be posted on the Central 491 Blackboard site. Students will have
access to their own clinical group section blackboard site so as to enable submission of their
weekly ENP’s and communication with their clinical instructor and peers.
Policy Statements (Code of Student Behaviour)
POLICY STATEMENTS
The course outline acts as an agreement between the student and the tutor of this class
regarding the details of the course. “Policy about course outlines can be found in Section
23.4(2) of the University Calendar” (p. 76).
http://www.registrarsoffice.ualberta.ca/~/media/registrar/pdfcal/12-13calendarpdf/RegsInfo.pdf
“The University of Alberta is committed to the highest standards of academic integrity and
honesty. Students are expected to be familiar with these standards regarding academic
honesty and to uphold the policies of the University in this respect. Students are to
familiarize themselves with the provisions of the Code of Student Behaviours (online at
www.uofaweb.ualberta.ca/secretariat/studentappeals.cfm) and must avoid any behavior that
could potentially result in suspicions of cheating, plagiarism, misrepresentation of facts
and/or participation in an offence. Academic dishonesty is a serious offence and can result
in suspension or expulsion from the University” (p. 76).
http://www.registrarsoffice.ualberta.ca/~/media/registrar/pdfcal/12-13calendarpdf/RegsInfo.pdf
For further information on plagiarism and cheating, visit the Academic Integrity, University
of Alberta page at www.uofaweb.ualberta.ca/TIE/index.cfm.
A plagiarism detection tool is used in this course.
Students have the right to appeal course assignment marks, course grades, academic
standing, and practicum interventions related to their undergraduate degree program.
Policies outlining appeal procedures are posted on eClass for each course under the UofA
Policies and Information icon.
Recording of Lectures is permitted only with the prior written consent of the professor or if
recording is part of an approved accommodation plan.
The Faculty of Nursing is committed to providing an environment of equality and respect
for all people within the University community, and to educating faculty, staff, and students
in the development of teaching and learning contexts that are welcoming to all. The Code of
Student Behaviour also identifies that inappropriate behaviours include disruption,
discrimination, or violations of safety and dignity towards members of the University
community.
The Faculty of Nursing recommends that students and staff use inclusive language to create
a classroom atmosphere in which students' experiences and views are treated with equal
respect and value in relation to their gender, sexual orientation, and racial or ethnic
background.
Please note that the use of any electronic device in examination situations is strictly
prohibited. The use of calculators is only allowed when specifically stated for a particular
exam. If a cellular phone is required for urgent messages, it must be left with an examination
proctor for the duration of the examination.
Professional Behavior Related to Lab Use
No sharps are to be removed from any lab area by students or faculty at any time due to
issues surrounding transportation of biohazardous materials, which is in accordance with
RDC policy and the Human Pathogens and Toxins Act. In addition, products in the lab
should not be used for human consumption at any time and students should not practice any
of the Restricted Activities such as administering injections, initiating intravenous lines, and
inserting nasogastric tubes on each other.
Changes to the Course Outline
Changes to the course outline will only be made with the mutual consent of the course
tutors and students involved. Changes will be reviewed by the Associate Dean of Nursing
for consistency with policy.
It is students’ responsibility to be familiar with the information contained in the course
outline and to clarify any areas of concern with the instructor.
REQUIRED EVALUATION
In order to pass Nursing 491, the student must achieve a passing grade of 60% or more
(30/50) on the Evaluation of Nursing Practice (ENP) and complete academic requirements
as outlined in this course outline. Instructors will provide students with a formative
evaluation at midterm of the course and a summative report at the end of the course. All
assignments must be completed and submitted to complete the course successfully.
N491 Assignment Weighting
Weighting
Safe Medication
Administration Test
Focused Assessment
Pass> 85%
10 points
Pass/Fail
Proposal Assignment
Written
33 points
Oral Presentation
7 points
Evaluation of Nursing
Practice (ENP)
50 points
Due Date
Spring 2015
May 19, 2015
Due Date Due Date
Fall I
Fall II
September November
28, 2015
16, 2015
Week 5 or as negotiated with the
instructor
Week 6 or as negotiated with the
instructor
Week 7 or as negotiated with the
instructor
At the end of each clinical week or as
negotiated with the instructor, students
will submit the ENP
At the end of term or as negotiated with
the instructor, students will submit a
self-reflective summary of the ENP.
Total
100 points
Grading Policy
Grading System: The grades will be assigned using the University of Alberta Grade Point
Conversion System:
Descriptor
Poor
Minimal Pass
Letter Grade
A+
A
AB+
B
BC+
C
CD+
D
Grade Point Value
4.0
4.0
3.7
3.3
3.0
2.7
2.3
2.0
1.7
1.3
1.0
Failure
F
0.0
Excellent
Good
Satisfactory
ASSIGNMENT OF FINAL GRADE
The assignments are marked as raw scores according to the percentage weight assigned to
each. At the end of the course, all scores are totalled for a term summary mark in the course.
The FINAL COURSE GRADE is based on a combination of absolute academic
achievement (an individual student’s term summary mark) and relative performance (a
comparison of a student’s term summary mark to all students’ term summary marks). Due
attention is paid to descriptions of grade points according to the 2015-2016 University of
Alberta Calendar [Section 23.4].
Assignments and Evaluation
In order to pass NURS 491, students must demonstrate safe ethical nursing practice,
professional behaviour, and complete the assignments listed below.
Late assignments will be penalized 10% of the value for each day, or portion thereof that the
assignment is late; for example, the written portion of the proposal assignment valued at 33
marks will lose 3.3 marks each day it is late.
1. Safe Medication Administration Test
The purpose of this assignment is to ensure the student is meeting course objectives 1, 2, 3,
4, 5, and 6. It is a written (fill in the blank and calculations) assignment designed to
numerically measure (10/100) if the student can accurately
a.
b.
c.
d.
e.
Analyze physicians’ medication orders
Analyze treatment protocols used in nursing practice
Analyze intravenous therapy documents used in nursing practice
Analyze procedural policies used in nursing practice
Perform medication dosage calculations
2. Focused Assessment.
The purpose of this assignment is to ensure that the student is meeting course outcomes 1,
2, 4, and 6 when working with patients. It is a Pass/Fail practical assignment designed to
evaluate if the student can
a. Demonstrate an accurate individualized assessment of a patient guided by a
patient’s and/or patient’s family’s verbal, physical, and environmental cues
3. Proposal. The purpose of this assignment is to ensure that the student is meeting
course outcomes 1 and 6. It is a written assignment designed to numerically measure
(40/100) the student’s ability to:
a. Create a scholarly document about a current nursing issue or need in the
format of a:
i. Proposal for change; OR
ii. Research Proposal
b. Demonstrate university-level scholarly writing
c. Teach others about the aforementioned current nursing issue or need
d. Demonstrate university-level presentation of information
4. Evaluation of Nursing Practice (ENP). The purpose of this assignment is to
ensure that the student is meeting course outcomes 1, 2, 3, 4, 5, and 6. It is an
ongoing self-reflective journal designed to numerically measure, in conjunction with
the instructor’s observations (50/100), the student’s ability to:
a. Generate, implement, and evaluate two personal overarching measurable
learning goals
b. Demonstrate and appraise 4th year level of competence in terms of:
i. Professional responsibility & accountability
ii. Knowledge level
iii. Ethical practices
iv. Service to the public
v. Self-regulation
vi. Context based learning
*See Blackboard for additional details about assignments and marking guides
Textbooks and Resources for N491
Required
Academic Integrity. Available at
(http://www.osja.ualberta.ca/en/Students/UndergraduateHandbook.aspx)
American Psychological Association. (2009). Publication manual of the American Psychological
Association (6th ed.). Washington, DC: Author.
Canadian Nurses Association. (2008). Code of ethics for registered nurses. Ottawa, ON: Author.
(Available @ www.cna-nurses.ca.)
Canadian Nurse’s Association & Canadian Association of Schools of Nursing (2004). Joint
position statement: Promoting continuing competence for Registered Nurses. Ottawa: Author.
Available @ http://www.cnaaiic.ca/CNA/documents/pdf/publications/PS77_promoting_competence_e.pdf
College and Association of Registered Nurses of Alberta. (2005). Professional boundaries for
registered nurses: Guidelines for the nurse-client relationship. Edmonton, AB: Author.
(Available @
www.nurses.ab.ca/Carna-admin/Uploads/Professional%20Boundaries%20Guidelines.pdf.)
College & Association of Registered Nurses of Alberta. (2006). Entry-to-practice competencies for
the registered nurses profession. Edmonton, AB: Author. (Available @
www.nurses.ab.ca/Carna-Admin/Uploads/Entry-to-Practice%20Competencies.pdf.)
College & Association of Registered Nurses of Alberta. (2013). Nursing practice standards.
Edmonton, AB: Author. (Available @
www.nurses.ab.ca/Carna-Admin/Uploads/Nursing%20Practice%20Standards.pdf.)
Elsevier Online Review Course/HESI Exam (purchased through the book store)
~ note: This resource may not be available in the book store for Fast Track students until
the first week of the course.
Recommended
Community Health Nursing Textbook (previously required) for students in Community
Placements
Pediatrics Textbook (previously required) for students on Peds & NICU.
Dorman Wagner, K., & Hardin-Pierce, M. (2014). High acuity nursing (6th ed.). Upper
Saddle River, NJ: Prentice-Hall. (previously required) for students in Rural Acute
Care.
In addition to the recommended texts, students will find it helpful to refer to texts that have
previously been required.