Spring 2014
Angelina College
Health Careers Division
VNSG 1362 Clinical Nursing II
General Syllabus
I. COURSE DESCRIPTION: (as stated in the bulletin, including necessary pre-requisite courses, credit hours)
VNSG 1362- Clinical Nursing . Three hours credit. A method of instruction providing detailed education, training,
and work-based experience and direct patient/ client care generally at a clinical site. Specific detailed learning
objectives developed for this course by the faculty. On-site clinical instruction, supervision, evaluation, and
placement are the responsibility of the college faculty. Clinical experiences are unpaid, external learning
experiences. Courses may be repeated if topics and learning outcomes vary. Placement in second semester. 288
Clinical hours. Prerequisites: VNSG 1304, 1361, 1405, 1423. Co-requisites: VNSG 1133, 1136, 1330, 1331, 1429
INTENDED AUDIENCE:
Freshman working toward educational requirements for a Vocational Nursing Certificate.
INSTRUCTOR
Name:
Office Location:
Office Hours:
Phone:
E-mail Address:
Amy Williams, RN
MMC-L 5th Floor Tower
Tuesday 0800-1200
936-329-8490
amywilliams@angelina.edu
II. INTENDED STUDENT OUTCOMES
A. Core Objectives Required for this course.
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 Qualitative 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
B.
Exemplary Objectives – (Found in the Texas Higher Education Coordinating Board Document. Titled:
CORE CURRICULUM: ASSUMPTIONS AND DEFINING CHARACTERISTICS Dated: April 1998)
(Not applicable for Nursing Program)
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B.
Course Objectives – (common to all sections))
After completing this course the student should be able to perform the
following DECs
MEMBER OF THE PROFESSION
A.
Function within the nurse’s legal scope of practice and in
accordance with the policies and procedures of the employing
health care institution or practice setting.
1. Function within a directed scope of practice of the vocational nurse
with appropriate supervision.
2. Assist in determination of predictable health care needs of patients to
provide individualized, goal-directed nursing care.
B.
Assume responsibility and accountability for the quality of
nursing care provided to patients and their families.
2. b.
Participate in evaluation of care administered by the
interdisciplinary health care team
5. a.
Assume accountability for individual nursing practice.
5. b.
Follow established evidence-based clinical practice guidelines.
MEMBER OF THE PROFESSION
6. a.
Follow established policies and procedures.
6. b.
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.
C.
Contribute to activities that promote the development and
practice of vocational nursing.
2. Work collegially with members of the interdisciplinary health care
team.
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D.
Demonstrate responsibility for continued competence in
nursing practice, and develop insight through reflection, selfanalysis, self-care, and lifelong learning.
PROVIDER OF PATIENT-CENTERED CARE
A. Use clinical reasoning and established evidence-based
policies as the basis for decision making in nursing practice.
1. Use problem-solving approach to make decisions regarding care of
assigned patients.
2. a.
Organize care for assigned patients based upon problemsolving and identified priorities.
2. b.
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 care
problems encountered in practice.
B. Assist in determining the physical and mental health status,
needs, and preferences of culturally, ethnically, and socially
diverse patients and their families based on interpretation of
health-related data.
1. Used 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
patient needs.
6. Assist with health screening.
7. Differentiate abnormal from normal health data of patients.
8. Recognize healthcare outcomes and report patients’ status.
PROVIDER OF PATIENT-CENTERED CARE
FINAL
A. Report data to assist in the identification of problems and
formulation of goals/outcomes and patient-centered plans of
care in collaboration with patients, their families, and the
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interdisciplinary health care team.
1. Integrate concepts from basic sciences and humanities to deliver
safe and compassionate care in delivery of patient care.
1362
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.
1362 1429
3. Participate in the development and modification of the nursing plan
of care across the lifespan, including end-of-life care.
1226 1362
4. Contribute to the plan of care by collaborating with interdisciplinary
team members.
1362
5. Assist in the discharge planning of selected patients.
1352
6. Demonstrate fiscal accountability in providing patient care.
1362
B. Provide safe, compassionate, basic nursing care to
assigned patients with predictable health care needs
through a supervised, directed scope of practice.
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.
1423
2. a.
Identify priorities and make judgments concerning basic needs
of multiple patients with predictable health care needs in order to
organize care.
2. b.
Manage multiple responsibilities.
2. c.
Recognize changes in patients status.
2. d.
Communicate changes in patient status to other providers.
1362
3. a.
3. b.
met.
1362
Implement plans of care for multiple patients.
Collaborate with others to ensure that healthcare needs are
4. Participate in management activities.
1362
PROVIDER OF PATIENT-CENTERED CARE
SELF
A. Implement aspects of the plan of care within legal, ethical,
and regulatory parameters and in consideration of patient
factors.
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1. Implement individualized plan of care to assist patient to meet basic
physical and psychosocial needs.
1423
2. Implement nursing interventions to promote health, rehabilitation, and
implement nursing care for clients with chronic physical and mental
health problems and disabilities.
1429 1362
4. Communicate accurately and completely and document responses of
patients to prescription and nonprescription medications, treatments, and
procedures to other health care professionals clearly and in a timely
manner.
1362
5. Foster coping mechanisms of patients and their families during
alterations in health status and end of life.
1362 1429
6. a.
Assist interdisciplinary health care team members with
examinations and procedures.
1362
6. b.
Seek clarification as needed.
6. c.
Provide accurate and pertinent communication when transferring
patient care to another provider.
1429 1362
7. b.
care.
Encourage active engagement of patients and their families in
8. Communicate ethical and legal concerns through established
channels of communication.
1429 1362
9. Use basic therapeutic communication skills when interacting with
patients, their families, and other professionals.
1362 1429
10. Apply current technology and informatics to enhance direct patient
care while maintaining patient confidentiality and promoting safety.
1362 1423
11. Facilitate maintenance of patient confidentiality.
1362 1429
12. a. Demonstrate accountability by providing nursing interventions
safely and effectively using a directed scope of practice.
12. b. Provide nursing interventions safely and effectively using
established evidence-based practice guidelines.
1423 1362
1228
13. Provide direct patient care in disease prevention and health
promotion and/or restoration.
1423 1362
1429 1228
PROVIDER OF PATIENT-CENTERED CARE
SELF
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B. Identify and report alterations in patient responses to
therapeutic interventions in comparison to expected
outcomes.
1. Report changes in assessment data.
1362 1423
1429
2. Use standard references to compare expected and achieved
outcomes of nursing care.
1423 1362
1228 1429
3. Communicate reasons for deviations from plan of care to supervisory
health care team member.
1362
4. Assist in modifying plan of care.
1423 1362
1429
5. Report and document patient’s responses to nursing interventions.
1362
6. Assist in evaluating patient care delivery based on expected
outcomes in plan of care and participate in revision of plan of care.
C. Implement teaching plans for patients and their families with
common health problems and well-defined health learning
needs.
1. Identify health-related learning needs of patients and their families.
1362
1423 1429
1228 1362
2. Contribute to the development of an individualized teaching plan.
1423 1362
1429
3. Implement aspects of an established teaching plan for patients and
their families.
1423 1362
4. Assist in evaluation of learning outcomes using structured evaluation
tools.
1362 1423
5. Teach health promotion and maintenance and self care to individuals
from a designated teaching plan.
1423 1362
6. Provide the patient with the information needed to make choices
regarding health.
1362
7. Provide patients and families with basic sources of health
information.
1362
D. Assist in coordinating of human, information, and material
resources in providing care for assigned patients and their
families.
2. Report unsafe patient care environment and equipment.
3. Implement established cost containment measures in direct patient
care.
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1423 1362
1362
6. Assist with maintenance of standards of care.
1362
Unit Objectives for Dosage Calculations
On completion of the materials provided in this chapter, the student will be able to perform
Computations accurately by mastering the following concepts:
D. Course Objectives -
Ch. 12
Using the dimensional analysis format to solve oral dosage problems
Using the dimensional analysis format to solve parenteral dosage problems
Using the dimensional analysis format to solve problems of intravenous flow rate in drops per minute
Using the dimensional analysis format to solve problems involving administration of medications in units
per hour
Using the dimensional analysis format to solve problems involving administration of medications on
milligrams per minute, micrograms per minute, and micrograms per kilograms per minute
Using the dimensional analysis format to solve pediatric and obstetrical dosage problems
Ch. 16
Calculating drops per minute (gtt. /min) when given the total volume and time over which an IV solution
or intravenous piggyback is to be infused.
Intravenous piggyback is to be infused.
Ch. 17
Calculating the IV flow rate of medications in units per hour or international units per hour
Calculating the units per hour of medications from the IV flow rate
Calculating the IV flow rate of medications in units per kilogram per hour (weight –based heparin)
Calculating the IV flow rate if medications in milligrams per minute
Calculating the IV flow rate if medications in micrograms per minute
Calculating the IV flow rate if medications in micrograms per kilograms per minute
Calculating the milligrams per minute of medications from the IV flow rate
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Calculating the micrograms per minute of medications from the IV flow rate
Calculating the micrograms per kilogram per minute of medications from the IV flow rate
Ch. 18
Converting the weight of a child from pounds to kilogram
Converting the neonate and infant weight from grams to kilograms
Performing the pediatric dosage calculations
Calculating the single or individual dose of medications
Determining whether the prescribed dose is safe and therapeutic
Calculating a safe and therapeutic 24 –hour dosage range
Calculating the single dose range from a 24- hour dosage range
Determining whether the actual dosage (in milligrams per kilogram per 24 hours) is safe to administer
Calculating pediatric IV solutions
Administering IV medications to pediatric patients
Calculating the daily fluid requirements for infants and young children
Calculating the body surface area (BSA) for medication administration
Ch. 19
Calculating the IV rate of Oxytocin (Pitocin)
Calculating the IV rate of magnesium sulfate ordered in milligrams per minute
Ch. 20
Recognize an automated medication dispensing system
Identify the advantages of using an automated medication dispensing system
III. ASSESSMENT MEASURES OF STUDENT LEARNING OUTCOMES:
A. Assessments for the Core Intellectual Competencies –
1. Reading – Competency in reading will be assessed through student's reading and understanding of
course material, patient charts, hospital policies, patient care references and participation in conference
and patient care discussion..
2. Writing –
Competency in writing is assessed through the development of Nursing Care Plans and
other clinical paperwork due on a weekly basis..
3. Speaking – Competency in speaking is assessed through oral contribution in small-group activities and
interpersonal communication with patients, staff, instructors and peers.
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4. Listening – Competency in listening is assessed through the student's response to questions,
demonstration of ability to follow instructions, and ability to participate in small-group activities..
5. Critical Thinking – Competency in critical thinking is assessed through student's ability to discuss
patient care, identify patient care needs and complete care plans and other written clinical
assignments.
6. Computer Literacy – Competency in computer literacy will be assessed by the student's ability to
complete assigned computer assisted instruction, on line testing, and blackboard course
materials.
B. Assessments for the Exemplary Objectives Specific to the Course –
Non-applicable for the Nursing Program.
C. Assessments for Objectives Specific to the Course –
SCANS Skills
Assessments
Foundation Skills
Written assignments
Critical Thinking Case Studies
Oral presentations
Required reading
Demonstrated competency in clinical
Workplace Competencies:
Administer medications
Prepare written care maps, care plans, & windows
Interpret physician orders
Communicate with clients
Communicate with interdisciplinary health team.
Demonstrate competency in clinical
Use the computer in the work setting
Computer assisted instruction
D. Assessments for the Objectives of the Course as determined by the Instructor –
Non-applicable.
IV. INSTRUCTIONAL PROCEDURES:
Methodologies utilized in this course include skills laboratory experience, preparation and research
for patient care, care planning, direct patient care, preparation and presentation of group assignments
and computer assisted instruction.
Computerized clinical enhancers and other C.A.I.'s may also be utilized.
V. COURSE REQUIREMENTS AND POLICIES:
A. Required Textbooks, Materials and Equipment –
Ackley, B. J. & Ladwig, G. B. (2011) Nursing Diagnosis Handbook; A Guide to Planning Care (8th ed.) St.
Louis, Mo. Elsevier - Mosby.
DeWitt, Susan C. (2008) Fundamental Concepts and Skills for Nursing (3 rd Ed.) St. Louis Mo. Elsevier Mosby.
DeWitt, Susan C. (2008) Student Learning Guide to Accompany Fundamental Concepts and Skills in
Nursing (3rd Ed.). St. Louis Mo. Elsevier- Mosby.
DeWitt, S. C. & Kumagai, C. K., (2013) Medical- Surgical Nursing Concepts & Practice (2 nd Ed.). St. Louis
MO. Elsevier-Saunders
Dewitt, Susan C. & Kumagai, Candice K., (2013) Student Learning Guide to Accompany Medical- Surgical
Nursing Concepts & Practice (2nd Ed.).
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Eyles, M. O. (2011) Mosby's NCLEX-PN examination (16th Ed.)
Herilhy, B. (2011) The Human Body in Health and Illness, (4th Ed) St. Louis Mo. Elsevier – Mosby.
Karch, Amy M. (2010) Lippincott’s Drug Guide 2011 Lippincott Williams and Wilkins
Langford, R.W. (2008). Nursing PDQ for LPN (2ND Ed.). St. Louis Mo. Elsevier- Mosby.
Leonard, Peggy C. (2011) Quick and Easy Medical Terminology, (6th Ed.). St. Louis Mo. Elsevier-Mosby.
Leifer, G. (2011) Introduction to Maternity & pediatric nursing (6th Ed) St. Louis, Mo. Elsevier
Leifer, G. (2011) Introduction to Maternity & pediatric nursing Study Guide (6th Ed) St. Louis, Mo. Elsevier
Mosby’s Medical Nursing and Allied Health Dictionary, (8th Ed.) (2009) St. Louis Mo. Elsevier- Mosby.
Neeb, K. (2006) Fundamentals of Mental Health nursing (3rd edition) Philadelphia: F.A. Davis
Ogden, S.J. & Fluharty L.K., (2011) Calculation of Drug Dosages, (9th Ed.). Mosby’s
Polan, E. & Taylor, D. (2011) Journey Across the Life Span: Human Development and Health Promotion,
(4th Ed) Philadelphia, PA. F.A.Davis
Roach, S. M. (2010) Introductory to Pharmacology
Roach, S. M. (2010) Introductory to Pharmacology Study Guide
Wold, G.H., (2011) Basic Geriatric Nursing Z95th ed.). Elsevier- Mosby.
Students may use basic function calculator.
B. Assignments – (Appropriate due dates, schedules, deadlines)
Clinical assignments are aligned with VNSG 1362: Clinical Nursing II. See course calendar for assigned
times.
Using the nursing process, identify several nursing diagnosis's for the client. Develop a care window and
careplan for the client. Each week the student will be assigned a new client to process
the assigned clinical paper work with. At the discretion of the instructor, the student may be given two to
three clients per week during second semester. The student will be expected to be prepared to discuss
the clients diagnosis using critical thinking skills during postconference.
C. Course Policies – (This course conforms to the policies of Angelina College as
stated in the Angelina College Handbook.)
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 selfidentify 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 McKenzieAdministration Building, Room 105 or 936-633-5201
Attendance – See the AC VN Handbook
Additional Specific Requirements for this Course – (Withdrawal and Dismissal) Students considering
withdrawal from the program should talk to the Nursing Program Coordinator for withdrawal and re-entry
information. When a student does not officially withdraw in the Office of Admissions, an "F" will appear
on the transcript for the courses in progress at the time.
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All exams (and written assignments) become the property of the Nursing Program. To report any
complaints of discrimination related to disability, you should contact Dr. Patricia McKenzie, Administration Building,
Room 105 or 936-633-5201.
VI. COURSE CONTENT:
A. Content/ Topics - (as required by the individual Instructor)
Application of the theory, concepts, and skills through clinical assignments aligned with VNSG 1362,
Clinical Nursing II.
B. Additional Content
Appendix A: Skills Check Off List
Appendix B: Window, Care Map, and Care Plan w/Grading Criteria Form
Appendix C: Short Drug Sheets
Appendix D: Dosage Calculation
Appendix E: Physical Assessment Form
Appendix F: Portfolio
Appendix G: Intrapartal Assessment
Appendix H: Newborn Assessment
Appendix I: Obstetrical Nursing Diagnoses
Appendix J: Postpartum Assessment
VII. EVALUATION AND GRADING:
A. Grading Criteria
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 Clinical Evaluation
Form for the VN Program. 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".
"Pass" is defined as achievement of all of 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 dosage calculation exam with two attempts.
6. Pass at least two (2) care plans this semester with a 75 or above. Refer to the Angelina College
Vocational Nursing Program Criteria for Grading Nursing Process Critical Thinking Rubric.
7. Satisfactorily meet competencies designated as first and second semester level as stated in the Clinical
Evaluation Form by the end of the semester.
"Fail" is defined as failure to achieve any or all of the following:
1. Less than 100% completion of course requirements.
2. Non-adherence to all policies.
3. Untimely submittal of paperwork.
4. Inability to complete patient assignments in a safe manner.
5. Inability to resolve probationary status.
6. 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 exam on 2nd attempt after remediation.
8. Achieve less than 75% on at least two care plans during the semester.
9. Successfully meet clinical competencies designated for first and second semester on the VN Clinical
Evaluation Form by the end of the semester.
In order to successfully complete this course, the student will:
1. Attend all assigned laboratory and clinical days. Laboratory days are considered clinical days.
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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 1362. The student must then withdraw from all other nursing co-requisite courses.
3. Adhere to the above described policy on skills performed in the laboratory and clinical setting.
4. Pass the dosage calculations final exam with 85% or above within two attempts prior to entering the
clinical setting.
5. Pass at least two care plans during the semester with a 75% or above.
6. Satisfactorily meet clinical competencies designated for first or second semester level on the VN Clinical
Evaluation Form by the end of the semester.
B. Determination of Grade
Grading Scale:
PASS =P
FAIL= F
Grade distribution:
Written clinical assignments
Critical skills
Clinical evaluation criteria (clinical performance)
Dosage Calculations:
Review of Ch. 1-15
Ch. 16- 20
Exam Ch. 1-20 (with a score of 85 or better)
VIII. SYLLABUS MODIFICATION:
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.
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