Spring 2014
Angelina College
Health Careers I
VNSG 1362 Clinical Nursing
General Syllabus
I.
BASIC COURSE INFORMATION:
A. Course Description: VOCATIONAL NURSING – VNSG 1362 – CLINICAL NURSING. Three hours credit.
A health related work-based learning experience that enables the student to apply specialized
occupational theory, skills, and concepts. Direct supervision is provided by the clinical
professional. Placement in third semester. 288 clinical hours. Prerequisites: VNSG 1226, 1304, 1361,
1405, 1423. Co-requisites: VNSG 1219, 1238, 1307, and 1432.
B. Intended Audience: Freshmen working toward a VN certificate.
C. Instructor: Elizabeth Powell, MEd, BSN, RN
Office Location: Hudson HS
Office Hours: By appointment
Phone: 936-633-5265
E-mail Address: epowell@angelina.edu
II. INTENDED STUDENT OUTCOMES:
A. Core Objectives Required for this Course (tentative)
1. Critical Thinking: to include creative thinking, innovation, inquiry, and analysis, evaluation
and synthesis of information
2. Communication: to include effective development, interpretation and expression of ideas
through written, oral and visual communication
3. Empirical and Quantitative Skills: to include the manipulation and analysis of numerical data
or observable facts resulting in informed conclusions
4. Teamwork: to include the ability to consider different points of view and to work effectively
with others to support a shared purpose or goal
5. Social Responsibility: to include the ability to connect choices, actions and consequences to
ethical decision-making
6. Personal Responsibility: to include intercultural competence, knowledge of civic
responsibility, and the ability to engage effectively in regional, national, and global
communities
B. Course Learning Outcomes for all Sections
* Perform as an intermediate member of the health care team in compliance with the ethical and legal
responsibilities of the vocational nurse.
* Demonstrate the use of physiological assessment skills in the care of the medical-surgical clients and
.
maternal-newborn clients.
* Apply the nursing in the delivery of care to clients with medical-surgical health problems and to maternalnewborn clients with needs or problems.
* Safely perform selected skills on designated clients
* Complete lab check-offs successfully within three attempts.
III. ASSESSMENT MEASURES
A. Assessments for the Core Objectives:
1. Critical Thinking: Care planning
2. Communication: Giving and receiving report on patients using SBAR technique
3. Empirical and Quantitative Skills: Dosage calculations
Revised: 12/9/13
4. Teamwork: Working as part of the patient’s care team with other health care workers, the instructor,
and other students.
5. Social Responsibility: Being accountable for ethical treatment of patients.
6. Personal Responsibility: Acting as a culturally competent nurse.
B. Assessments for Course Learning Outcomes
DECs Objectives:
Member of the Profession
A1) Function within a directed scope of practice of the vocational nurse with appropriate supervision.
3a) Practice according to facility policies and procedures and provide input in the development of facility policies
and procedures.
3b) Question orders, policies, and procedures that may not be in patient’s best interest.
B2a) Provide nursing within the parameters of vocational nursing knowledge, scope of practice, education,
experience, and ethical/legal standards of care.
2b) Participate in evaluation of care administered by the interdisciplinary health care team
3a) Practice nursing in a caring, nonjudgmental, nondiscriminatory manner.
3b) Provide culturally sensitive health care to patients and their families.
5a) Assume accountability for individual nursing practice.
5b) Follow established evidence-based clinical practice guidelines.
6.a) Follow established policies and procedures.
6b) Questions orders, policies, and procedures that may not be in the patient’s best interest.
7) Use communication techniques to maintain professional boundaries in the nurse/patient relationship.
8) Comply with professional appearance requirements according to organizational standards and policies.
C2) Work collegially with members of the interdisciplinary health care team.
Provider of Patient-Centered Care
A. 1) Use problem-solving approach to make decisions regarding care of assigned patients.
2a) Organize care for assigned patients based upon problem-solving and identified priorities.
2b) Proactively manage priorities in patient care and follow-up on clinical problems that warrant investigation with
consideration of anticipated risks.
3. Identify and communicate patient physical and mental health problems encountered in practice.
4. Apply relevant, current nursing practice journal articles to practice and clinical decisions.
4. Apply relevant, current nursing practice journal articles to practice and clinical decisions.
B. 1)Use structured assessment tool to obtain patient history.
2) Perform focused assessment to assist in identifying health status and monitoring change in patients.
3) Report and document focused patient assessment data.
4) Identify predictable and multiple health needs of patients and recognize signs of decompensation.
5) Share observations that assist members of the health care team in meeting patient needs.
6) Assist with health screening.
7) Differentiate abnormal from normal health data of patients.
8) Recognize health care outcomes and report patient status.
C. 1) Integrate concepts from basic sciences and humanities to deliver safe and compassionate care in delivery of
patient care.
2) Identify short-term goals and outcomes, select interventions considering cultural aspects, and establish priorities
for care in collaboration with patients, their families, and the interdisciplinary team.
3) Participate in the development and modification of the nursing plan of care across the lifespan, including end-oflife care.
4) Contribute to the plan of care by collaborating with interdisciplinary team members.
7) Demonstrate basic knowledge of disease prevention and health promotion in delivery of care to patients and
their families.
D. 1) Assume accountability and responsibility for nursing care through a directed scope of practice under the
supervision of a registered nurse, advanced practice registered nurse, physician assistant, physician, podiatrist, or
dentist using standards of care and professional values.
2a) Identify priorities and make judgments concerning basic needs of multiple patients with predictable health care
needs in order to organize care.
2b) Manage multiple responsibilities.
Revised: 12/9/13
2c) Recognize changes in patient status.
2d) Communicate changes in patient status to other providers.
3a) Implement plans of care for multiple patients.
3b) Collaborate with others to ensure that healthcare needs are met.
E1) Implement individualized plan of care to assist patient to meet basic physical and psychosocial needs.
2) Implement nursing interventions to promote health, rehabilitation, and implement nursing care for patients with
chronic physical and mental health problems and disabilities.
3) Initiate interventions in rapidly-changing and emergency patient situations.
4) Communicate accurately and completely and document responses of patients to prescription and
nonprescription medications, treatments, and procedures to other health care professionals in a timely manner.
5) Foster coping mechanisms of patients and their families during alterations of health status and end-of-life.
6a) Assist interdisciplinary team members with examinations and procedures.
6b) Seek clarification as needed.
6c) Provide accurate and pertinent communication when transferring patient to another provider.
7a) Inform patients of Patient Bill of Rights.
7b) Encourage active engagement of patients and their families in care.
8) Communicate ethical and legal concerns through established channels of communication.
9) Use basic therapeutic communication skills when interacting with patients, their families, and other
professionals.
10) Apply current technology and informatics to enhance direct patient care while maintaining patient confidentiality
and promoting safety.
11) Facilitate maintenance of patient confidentiality.
12a) Demonstrate accountability by providing nursing interventions safely and effectively using a directed scope of
practice.
12b) Provide nursing interventions safely and effectively using established evidence-based practice guidelines.
13) Provide direct patient care in disease prevention and health promotion and/or restoration.
F1) Report changes in the assessment data.
2) Use standard references to compare expected and achieved outcomes of nursing care.
3) Communicate reasons for deviations from plan of care to supervisory health care team member.
4) Assist in modifying plan of care.
5) Report and document patient’s responses to nursing interventions.
6) Assist in evaluating patient care delivery based on expected outcomes in plan of care and participate in revision
of plan of care.
G.1) Identify health-related learning needs of patients and their families.
2) Contribute to the development of an individualized teaching plan.
3) Implement aspects of an established teaching plan for patients and their families.
4) Assist in evaluation of learning outcomes using structured evaluation tools.
5) Teach health promotion and maintenance and self-care to individuals from a designated teaching plan.
6) Provide the patient with the information needed to make choices regarding health.
7) Provide patients and families with basic sources of health information.
H. 2) Report unsafe patient care environment and equipment.
3) Implement established cost containment measures in direct patient care.
6) Assist with maintenance of standards of care.
Patient Safety Advocate
A.4) Use standards of nursing practice to provide and evaluate patient care.
B. 1) Promote a safe, effective care environment conducive to the optimal health and dignity of the patients and
their families.
2) Accurately identify patients.
3a) Safely perform preventative and therapeutic procedures and nursing measures including safe patient handling.
3b) Safely administer medications and treatments.
4) Clarify any order or treatment regimen believed to be inaccurate, non-efficacious, contraindicated, or otherwise
harmful to the patient
5) Document and report reactions and untoward effects to medications, treatments, and procedures and clearly and
accurately communicate the same to other health care professionals.
6) Report environmental and systems incidents and issues that affect safety.
Revised: 12/9/13
7) Use evidence-based information to contribute to development of interdisciplinary policies and procedures related
to a safe environment including safe disposal of medications and hazardous materials.
8) Implement measures to prevent risk of patient harm resulting from errors and preventable occurrences.
9) Inform patients regarding their plans of care and encourage participation to ensure consistency and accuracy in
their care.
C.1) Assist in the formulation of goals and outcomes to reduce patient risk of health care-associated infections.
2a) Implement measures to prevent exposure to infectious pathogens and communicate conditions.
2b) Anticipate risk for the patient.
3) Implement established policies related to disease prevention and control.
D1) Evaluate individual scope of practice and competency related to assigned task.
2) Seek orientation/training for competency when encountering unfamiliar patient care situations.
3) Seek orientation/training for competency when encountering new equipment and technology.
E1) Report unsafe practices of healthcare providers using appropriate channels of communication.
3) Report safety incidents and issues through the appropriate channels.
4). Implement established safety and risk management measures.
Member of the Health Care Team
A1) Involve patients and their families with other interdisciplinary health care team members in patient care across
the lifespan.
2) Cooperate and communicate to assist in planning and delivering interdisciplinary health care.
3) Participate in evidence-based practice in development of patient care policy with the interdisciplinary team to
promote care of patients and their families.
B1) Respect the privacy and dignity of the patient.
2) Identify unmet health needs of patients.
3) Act as an advocate for patient’s basic, needs including following established procedures for reporting and solving
institutional care problems and chain of command.
5) Refer patients and their families to community resources.
C1a) Identify support systems of patients and their families.
1b) Identify major community resources that can assist in meeting needs.
2a) Communicate patient needs to the family and members of the health care team.
2b. Maintain confidentiality according to HIPPA guidelines.
2c) Promote system-wide verbal, written, and electronic confidentiality.
D1a) Communicate changes in patients status and/or negative outcomes in patient responses to care with
members of the interdisciplinary health care team.
1b) Follow legal guidelines in communicating changes in patient status, including chain of command and Texas
Nursing Practice Act.
2) Identify health care providers and other who can assist in patient care.
3) Contribute to positive professional working relationships.
4) Use evidence-based clinical practice guidelines to guide critical team communications during transition in care
between providers.
5) Recognize and manage conflict through the chain of command.
6b) Participate in interdisciplinary team meetings.
7) Respond to situational changes in the work environment to facilitate optimum patient care.
E2a) Apply knowledge of facility regulations when accessing client records.
2b) Protect confidentiality when using technology.
2c) Intervene to protect patient confidentiality when violations occur.
3a) Use current technology and informatics to enhance communication, support decision making, and promote
improvement of patient care.
4) Document electronic information accurately, completely, and in a timely manner.
F3a) Document and/or report responses to care or untoward effects.
D.
Course Objectives - Unit Objectives for Dosage Calculations
Students will, with at least 85% accuracy, complete the following objectives:
Chapter 12
Revised: 12/9/13
1.
Solve problems containing oral, parenteral, intravenous dosages correctly.
Chapter 16
1.
Calculate drops per minute when given the total volume and time over which an IV solution or IV
piggyback is to be infused.
2. Calculate milliliters per hour when given the total volume and time over which an IV solution or IV
piggyback is to be infused.
Chapter 17
1.
2.
3.
4.
5.
6.
7.
8.
9.
Calculate the IV flow rate of medications in units per hour or international units per hour.
Calculate the units per hour of medications from the IV flow rate.
Calculate the IV flow rate of medications in units per kilogram per hour (weight-based heparin).
Calculate the IV flow rate of medications in milligrams per minute.
Calculate the IV flow rate of medications in micrograms per minute.
Calculate the IV flow rate of medications in micrograms per kilogram per minute.
Calculate the milligrams per minute of medications from the IV flow rate.
Calculate the micrograms per minute of medications from the IV flow rate.
Calculate the micrograms per kilogram per minute of medications from the IV flow rate.
Chapter 18
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Convert the weight of a child from pounds to kilograms.
Convert the neonate and infant weight from grams to kilograms.
Perform pediatric dosage calculations.
Calculate the single or individual dose of medications.
Determine whether the prescribed dose is safe and therapeutic.
Calculate a safe and therapeutic 24-hour dosage range.
Calculate the single dose range from an 24-hour dosage range.
Determine whether the actual dose (in milligrams per kilograms per 24 hours) is safe to administer.
Calculate pediatric IV solutions.
Administer medications to pediatric patients.
Calculate the daily fluid requirements for infants and young children.
Calculate the body surface area (BSA) for medication administration.
Chapter 19
1. Calculate the IV rate of oxytocin (Pitocin) ordered in milliunit per minute.
2. Calculate the IV rate of magnesium sulfate ordered in milligrams per minute.
Chapter 20
1. Recognize an automated medication dispensing system.
2. Identify the advantages of using an automated medication dispensing system.
SCANS Skills
Workplace competencies
Assessments
Required reading of clinical charts
Oral report to staff, peers, and instructors
Critical thinking assignments
Computer skills
Administer medications
Prepare written care maps, care plans, & windows
Interpret physician orders
Communicate with clients
Communicate with interdisciplinary health team,
Revised: 12/9/13
Teach clients as indicated
Use of the computer in the work setting
IV. INSTRUCTIONAL PROCEDURES:
Methodologies utilized in this course include classroom teaching in the lab setting, use of instructional lab
equipment, presentations assigned by the instructor, written assignments assigned by the instructor, computer
assignments, and instructor directed clinical experiences. Computerized clinical and theory enhancers and
other CAI's may also be utilized.
V. COURSE REQUIREMENTS AND POLICIES:
A. Required Textbooks and Recommended Readings, Materials and Equipment
Ackley, B.J. & Ladwig, G. B. (2011). Nursing diagnosis handbook: A guide to planning care (9th ed.). St. Louis,
MO: Elsevier/Mosby.
deWit, S. (2009). Fundamental concepts and skills for nursing (4th ed.). St. Louis, MO: Saunders/Elsevier.
deWit, S. & Kumagai C. (2013) Medical-surgical nursing: Concepts and practice (2nd ed.) St. Louis MO. Elsevier.
Eyles, M.O. (2011). Mosby’s comprehensive review of practical nursing for the NCLEX-PN (16th edition). St.
Louis, MO: Elsevier/Mosby.
Karch, Amy. (2013). 2013 Lippincott’s nursing drug guide. Ambler, PA: Lippincott, Williams, & Wilkins.
Langford, R.W. (2005). Nursing PDQ for LPN (2nd ed.). St. Louis, MO: Elsevier/Mosby.
Leifer, G. (2011). Introduction to maternity and pediatric nursing (6th ed) St. Louis, MO: Elsevier.
Leonard, P.C. (2011). Quick & easy medical terminology. (6th ed.). St. Louis, MO: Elsevier/Mosby.
Mosby’s dictionary of medicine, nursing, and allied health professions (8th ed.). (2006). St. Louis, MO: Mosby.
Ogden, S. & Fluharty, L. (2012). Calculation of drug dosages: A work text (9th ed.). St. Louis, MO:
Elsevier/Mosby.
B. Course Policies – This course conforms to the policies of Angelina College as stated in the
Angelina College Handbook.
1. Academic Assistance – If you have a disability (as cited in Section 504 of the Rehabilitation Act of
1973 or Title II of the Americans with Disabilities Act of 1990) that may affect your participation in this
class, you should see Karen Bowser, Room 208 of the Student Center. At a post-secondary institution,
you must self-identify as a person with a disability; Ms. Bowser will assist you with the necessary
information to do so. To report any complaints of discrimination related to disability, you should contact
Dr. Patricia McKenzie, Administration Building, Room 105 or 936-633-5201.
2. Attendance – Attendance is required as per Angelina College Policy and will be recorded
every day. Any student with three (3) consecutive absences of four (4) cumulative
absences may be dropped from the class. Records will be turned in to the academic dean
at the end of the semester. Do not assume that non-attendance in class will always result
Revised: 12/9/13
in an instructor drop. You must officially drop a class or risk receiving an F. This is
official Angelina College Policy.
3. Additional Policies Established by the Instructor
VI. COURSE OUTLINE:
VII. EVALUATION AND GRADING:
A. Grading Criteria
By passing all assignments through completion of said assignments and any assigments made during
clinical rotations. The student may receive a failure for omission of one or more assignments in the lab
or during clinical rotation. Failure to submit assignments without following written criteria, or failure to
follow agency policies or the policies of Angelina College may also constitute a failure in the course.
The course grade is either "Pass" or "Fail," and is computed on the basis of satisfactory completion of
written clinical assignments, critical skills criteria, and clinical evaluation criteria. Students must demonstrate
clinical competency by satisfactorily meeting all criteria described in the Student Evaluation Form, see appendix.
Repeated violations of criteria may be considered unsafe conduct. In the event of unsafe conduct, a student will be
dismissed from the course with a grade of "F."
B. Determination of Grade
"Pass is defined as achievement of all the following:
1. Completion of 100% of course requirements.
2. Adherence to all policies.
3. Timely submittal of all paperwork.
4. Completion of patient-care assignments in a safe and timely manner.
5. 85% or greater on each dosage calculation final exam with two attempts.
6. Pass all care plans assigned this semester with a 75 or above. Refer to the AC VN Program Criteria for
Grading Nursing Process Critical Thinking Rubric.
7. Perform at a satisfactory level on all DECS objectives by the end of the semester (see Student Clinical
Evaluation form in appendix).
"Fail" is defined as failure to achieve any or all of the following:
Less than 100% completion of course requirements.
Non-adherence to all policies.
Untimely submittal of paperwork.
Inability to complete patient assignments in a safe manner.
Inability to resolve probationary status.
Progression in the VN Track requires successful completion of co-requisite courses with a minimum grade of
"C."
7. Achieve less than an 85% on dosage calculations final exam on 2 nd attempt after remediation.
8. Achieve less than a 75% on any care plan during the semester.
9. Failure to satisfy DECS objective(s).
1.
2.
3.
4.
5.
6.
In order to successfully complete this course, the student will:
1. Attend all assigned laboratory and clinical days. Laboratory days/conferences are considered clinical days.
2. Pass all skills in the laboratory setting. Three attempts are allowed to pass each skill in the laboratory. If the
student is unable to complete a skill within three attempts, the student automatically receives a "Fail" for VNSG
1363. The student must then withdraw from all other nursing co-requisite courses.
C. Dosage Calculations:
Practice Exam 1- Chapters 1-15
Revised: 12/9/13
Practice Exam 2- Chapters 1-20
Comprehensive Final Exam (Chapters 1-20).
The instructor may modify the provisions of the syllabus to meet individual class needs by informing the class in
advance as to the changes being made.
Revised: 12/9/13