Syllabus UNRS 314 Expanded Syllabus Nursing Care of Children and Young Adults UNRS 314 Nursing Faculty: Jan Bazner-Chandler RN, MSN, CNS, CPNP Sherry Nolan RN, MSN, CNS Ruth Paul RN, MSN Lori Silao RN, MSN, CNNP 1 Syllabus UNRS 314 AZUSA PACIFIC UNIVERSITY School of Nursing UNRS314 COURSE: UNRS 314 COURSE TITLE: Nursing Care of Children and Young Adults PLACEMENT IN CURRICULUM: Junior Level COURSE CREDIT AND CLOCK HOURS: 6 units, 28 hours, lecture / discussion / 156 hours clinical Faculty: Jan Chandler RN, MSN, CNS, PNP: Lead Instructor Pager (818) 421-6327 Office: West campus room # 339, extension 5390 Email: jchandler@apu.edu Clinical Instructor: Sherry Nolan RN, MSN, Clinical Instructor Office: 323-361-2868 Page: 213-209-1539 Email: snolan@chla.usc.edu or snolan@apu.edu Ruth Paul RN MSN, Clinical Instructor Office: 323-660-2450 ext 12630 Email: rpaul@chla.usc.edu or rpaul@apu.edu Lori Silao RN, MSN, CNNP, Clinical Instructor Page: 818-425-8486 Email: mikias@aol.com or lsilao@apu.edu CLINICAL AGENCIES: Huntington Memorial Hospital 100 W. Colorado Blvd Pasadena, California 90027 (626) 397-5000 ext: 5144 2 Syllabus UNRS 314 Childrens Hospital Los Angeles 4650 Sunset Blvd Los Angeles, California 90027 (323) 660-2450 MISSION STATEMENT: Azusa Pacific University is an evangelical Christian community of disciples and scholars who seek to advance the work of God in the world through academic excellence in liberal arts and professional programs of higher education that encourage students to develop a Christian perspective of truth and life. SCHOOL OF NURSING MISSION STATEMENT: Consistent with the mission and purpose of the University, the School of Nursing is a Christian community of discipleship, scholarship, and practice. Its purpose is to advance the work of God in the world through nursing education, collaborative projects, and Church and community service that encourages those affiliated with the School of Nursing (whether faculty, staff, student, graduate, or colleague) to grow in faith and in the exercise of their gifts for service to God and humanity. SCHOOL OF NURSING PROGRAM LEARNER OUTCOME: The graduate of Azusa Pacific University’s baccalaureate nursing program integrates faith and ethics as a skilled and knowledgeable practitioner, accountable professional, health care educator and advocate, and coordinator of care. CATALOG DESCRIPTION: This theoretical and clinical course focuses on the care of children from birth through adolescence. The effects of acute and chronic illness on growth and development are studied in the acute and community care setting. Education of the child and family on health promotion, disease prevention, and safety issues are addressed. Ethical issues are discussed regarding the relationship to the child and family, including issues such as child abuse, informed consent, and the impact of diverse cultural and spiritual beliefs on health care decisions in the family. Prerequisites: Bio 220; Psych 290; UNRS 105 or UNRS 270; UNRS 210; UNRS 212; UNRS 220: UNRS 260; corequisite: UNRS 367. Student must be of junior standing. 3 Syllabus UNRS 314 COURSE GOALS AND OBJECTIVES Program Competency 1: Utilize Christian worldview to integrate beliefs, values, ethics and service in personal and professional life. The student will explore the Christian World View regarding the care of children. o Read and discuss two assigned articles on ethics in caring for children. One page reaction paper to be written during post conference o Explore concept of discipline and the implications for child abuse. o Utilize spiritual assessment tool provided to determine spiritual needs and initiates nursing interventions for the child and family experiencing spiritual distress. Adheres to facility HIPAA guidelines concerning confidentiality in caring for clients. Incorporates the Code of Nurses in administering care to patients as adapted by the ANA in June 2001. http://www.nursingworld.org/ethics/ecode.html Program Competency 2: Provides nursing care utilizing professional knowledge and core competencies (critical thinking, communication, assessment, and technical skills) derived from a foundation of nursing science, general education, and religious studies. Utilize assessment findings to plan care and implement appropriate interventions to assist the child / families achieve the desired health care outcomes. o Performs nursing assessments of clients/patients within the family context. o Establishes nursing diagnoses from a comprehensive client/patient subsystems database, recognizing the influences of the family. o Develops a nursing care plan to meet collaborative objectives of the client/patient and the health care team. o Demonstrate the above in written format. Incorporate concepts / skills learned in previous nursing courses: pharmacology, nutrition, growth and development, and previous nursing clinical course. Perform a physical assessment on various age children using developmentally appropriate approach and distinguish between the normal and abnormal physical and psychological manifestations in the pediatric population Evaluate the growth and developmental milestones of the well child in the required developmental assessment of the infant, toddler, school age and adolescent. Develop competency in performing the clinical skill expected of a junior level student as outlined in the UNRS 314 syllabus and skills check-off list. o Perform junior level clinical skills in a safe manner. o Utilize hospital procedure manual to provide safe care o Implement appropriate steps to prepare a child for procedures, surgery, and hospitalization. o Utilize the nursing skills center, computer center, and hospital procedure manuals as needed to review and practice procedures expected to be performed in the clinical area. o Skills check off list to be reviewed with clinical instructor at final evaluation session with clinical instructor. Actively participate in the learning process with enthusiasm, and a positive attitude. Apply research finding to planning and implementing the interdisciplinary plan of care. 4 Syllabus UNRS 314 o o Utilize Internet and library resources to support seminar and clinical activities and assignments. Participate in clinical and course evaluation in SON. Program Competency 3: growth and development. Demonstrates initiative for continual personal and professional Incorporate knowledge of legal issues into nursing practice in the clinical setting. Implement the ANA standards of pediatric nursing practice and legal implications of child rights laws as outlined in: http://www.nursingworld.org/ethics/ecode.htm Demonstrate professionalism in appearance and speech when representing APU SON in the role of student nurse. Treat faculty and students with respect in the classroom and clinical areas. Select personal and professional experiences for learning and growth. Demonstrate professional accountability by: o Attendance at all lectures and clinical days and arrival at clinical with required equipment. o Notification of faculty of absence from class or clinical according to SON handbook. o Submitting papers in on time. o Participating in class discussion Recognize own learning style and incorporates appropriate methods of study to assure success in the course. Consult with the lead faculty or clinical instructor about individual needs or unique learning styles. Program Competency 4: Acts as a patient and family educator and advocate to promote optimal health and well-being. Demonstrate understanding of the cultural, social, and spiritual issues unique to the developing child. o Examine how the child’s growth and development age affects: faith and moral development, language and communication, injury and illness prevention. o Act as an advocate for the child and family. o Assess cultural difference of the child / family using the Cultural Assessment Tool provided. o Demonstrate sensitivity to cultural differences in caring for clients and personal in the clinical setting. o Provide assistance or referral as needed. Program Competency 5: Functions independently and collaboratively, both as a leader and/or member of a health care team to manage and coordinate care. Demonstrate preparedness for clinical experience by completion of Nurse Report Form as instructed. Collaborate as a member of the health care team with RN partner as demonstrated by accurate report giving during and at completion of clinical experience. 5 Syllabus UNRS 314 Prioritize clinical decisions in the clinical setting based on scientific rationale. Communicate with the health care team utilizing proper written and oral communication. Complete self-evaluation questions in the clinical evaluation form to be reviewed with clinical instructor at the final evaluation. TOPIC OUTLINE: Conscious sedation, pain management, pediatric pharmacology, and pediatric procedures. IV therapy: technical skills, management, and maintenance Alteration in fluid and electrolytes Well child care: immunizations, growth and development, milestones Alteration in skin integrity, burns, HIV, and pediatric infections Emergency care: PALS, poisoning, and child abuse Cardiovascular with emphasis on congenital and acquired heart problems in the pediatric population. Respiratory system: assessment, clinical manifestation and interventions in managing children with respiratory problems: upper airway, pneumonia, cystic fibrosis, asthma, and broncho pulmonary dysplasia Hematology: assessment, clinical manifestations and interventions in managing children with Hematologic disorders: managing blood infusions, care of child with sickle cell anemia, hemophilia, ITP, DIC, and iron deficiency anemia. Gastrointestinal and genitourinary with a focus on congenital anomalies, infectious process and auto-immune diseases. Musculoskeletal system: Managing the child in traction, assessment of orthopedic patient and identification of common complications, congenital defects, fractures, infectious process and autoimmune disorders. Neurology: Management of the child with ICP, congenital defects, infectious process and trauma. Pediatric malignancies: focus on management of the child receiving chemotherapy, longterm physiologic and psychological impact of cancer in the pediatric population. Cancers specific to pediatrics: leukemia, neuroblastoma, osteosarcoma, Hodgkins disease, Wilm’s tumor, brain tumors, and retinoblastoma. Inborn error in metabolism and endocrine disorders: Diabetes, hypo and hyperthyroid, PKU, celiac disease, and growth disturbances. HESI test is mandatory standardized test to be taken at the end of the semester FAITH INTEGRATION: Selected topics related to the Christian faith will be integrated into the course content. These concepts will include: 1) child abuse, 2) children’s rights, 3) end-of-life issues, 4) concept of healing, 5) and concept of health, 6) the doctrine of creation as it applies to genetic factors. One page paper to be submitted incorporating Biblical references for one of above topics as it relates to clinical practice in the pediatric setting. Three hour post-conference discussion regarding ethical and spiritual issues encountered during clinical practice. 6 Syllabus UNRS 314 TEACHING STRATEGIES Lecture, discussion, on-line internet resources, audio visuals (videos), computer assist programs, library, computer searches, demonstration, role playing, clinical practice, post conference, seminar, interdisciplinary conferences, and hospital grand rounds. Additional pediatric resources available on instructor web sit http://home.apu.edu/~jchandler/ or www.pedstudent.com Clinical nursing experience focuses on management of pediatric clients in the acute care hospital, and sub acute clinic settings. Written assignments: o o o o o o o One data form following the format as outlined. Paper format to be APA. Client from acute care setting or outpatient clinic Grading rubric and grading criteria poster online under clinical papers One research paper based on data form patient Criteria posted on-line Grading criteria posted on-line Developmental assessment of: infant or toddler and school-age or adolescent (2 due) - Credit for Service Learning Daily nursing clinical report forms A medication quiz to be passed with 80% before administering medications in the clinical setting. Bi-weekly quizzes based on objectives from weekly lectures. Faith integration paper Grading Criteria: A grade of C minus or better is required to pass the course. Grading criteria is: A = 100% A- = 92.9% 93 – 90 – B+ = B = 87 – 89.9% 83 – 86.9% B- = 80 – 82.9% C+ = C = C- = 77 – 79.9% 73 – 77% 70-72% Clinical Papers Theory Points: Medication quiz Bi-weekly quizzes Final Exam 75% of grade Clinical Points: (1) Data form 25 points 1 paper (analysis of medical diagnosis with actual patient) 25 points 2 Developmental 10 points each Faith Integration Paper 5 points 25% of grade Rubric and grading forms can be accessed under clinical assignments online. HESI Testing 5 points for meeting national standards 0 points if national standard not met 7 Syllabus UNRS 314 Clinical Policies: Unsafe nursing practice will result in clinical warning / probation. A grade of 70% in the clinical and in the theory portion of the course is required to pass the course. Review SON handbook for specific criteria outlining warnings, probation, and clinical failure. All 156 hours of clinical hours need to be completed to pass the clinical portion Medication quiz must be passed with 80% to pass meds in the clinical Late papers will be subject to a 10% reduction in grade for each late day. All assignment must be completed in order to pass the course. There is a no make-up policy for quizzes. A 30 point nursing data form will be required to make-up for the missed points on the quiz. Extension on clinical papers must be discussed with the clinical instructor All written assignments must be completed to pass the course: 2 data, 3 developmental, and 1 faith integration Clinical logs must be submitted to the instructor to document clinical hours Skills check off list must be maintained by the student and submitted at final evaluation Evaluation questions must be completed and brought to the final evaluation meeting with the clinical instructor CLINICAL AND CLASS PREPARATION: In order for you to learn the most possible, you will need to come to class and clinical prepared. This helps all of us receive the most from our time together. (The School of Nursing expects at least three hours preparation for each hour class time, and one hour of preparation for clinical time.) Clinical assignment forms are to be filled out for all assigned patients. Students are expected to attend post-conference discussions. COURSE POLICIES Dress Code: No open toed or open-back shoes, clogs or slip on shoes are to worn in the clinical area. For the clinical area, blue scrub, nursing shoes and an APU patch is required. When representing the SON in the community, professional attire will include a white lab coat with the APU patch and business casual. During the clinical, simple studs in the ears is the only acceptable jewelry. NO tongue rings or acrylic nails. NO jeans or jean jackets to be warn on the hospital campus at any time. See the APU nursing handbook for additional criteria. Attendance and Punctuality is required at all classes. If and unexpected emergency does occur please notify the lead teacher the day of the absence from the lecture or lab. If an illness or emergency prohibits you from attending clinical, notify your clinical instructor at least one hour before the clinical day. Clinical and or post-conference absences will need to be made up by completing an equal amount of hours in a community care activity. 8 Syllabus UNRS 314 HIPAA Compliance In order to avoid violations of HIPAA, you must not collect in your notes or include in any reports (e.g., patient care plans) any information that would permit a third party to identify a specific patient. Such information includes, but is not limited to, a patient’s name, address, social security number, or the name of the hospital or clinic where you observed the patient. For example, the diagnosis alone or situation may be such as to permit others to identify the patient. If other information permit a third party to identify the patient, you should consult with your faculty member regarding the appropriate way to comply with your course assignment prior to preparing a report about that patient. Paper Format: All papers, except data forms and clinical observations, are to be typewritten, doublespaced, with pages numbered and placed in a folder or fastened securely together. Please write your name clearly on materials submitted. Please use American Psychological Association (APA) Bibliographic Style for all style and references. Points will be deducted for papers with multiple spelling, typing or grammar errors. HESI Testing: Students are required to complete the HESI test for the clinical course. HESI must be completed in the semester the course is taken. HESI testing is scheduled during required laboratory hours and is mandatory attendance. Meeting the national standards is worth 5 points added to your cumulative points for the course. SPECIAL NEEDS LEARNER Any student in this course who has a disability that might prevent him or her from fully demonstrating his or her abilities should meet with an advisor in the Learning Enrichment center as soon as possible to initiate disability verification and discuss accommodations that may be necessary to ensure your full participation in the successful completion of course requirements. (University Handbook) SUPPORT SERVICES Azusa Pacific has 2 libraries that may assist the student in achieving the requirements of this course. The William V. Marshburn (located on East Campus) and the Hugh and Hazel Darling Library (located on West Campus). The materials placed on reserve for this course are located in the Darling Library. Azusa Pacific has 20 computer centers located on their campuses. The School of Nursing Computer Center has CD Rom’s required for courses available for student use. Hours are posted each semester. The Learning Enrichment Center (LE) is dedicated to helping student’s experience maximum intellectual development and personal growth. It is located on East 9 Syllabus UNRS 314 Campus in the Village Court. Students are encouraged to call and make an appointment as needed for tutoring. The writing center is available to assist with writing papers, APA format and literature reviews. Special Needs Learners (students having special needs due to learning disabilities, language or other factors that may affect achievement) should make any learning needs known to the instructor the first week of the course, so accommodation can be made. Academic Integrity: The mission of Azusa Pacific University includes cultivating in each student not only the academic skills that are required for a university degree, but also the characteristics of academic integrity that are integral to a sound Christian education. It is therefore part of the mission of the university to nurture in each student a sense of moral responsibility consistent with the biblical teachings of honesty and accountability. Furthermore, a breach of academic integrity is viewed not merely as a private matter between the student and an instructor but rather as an act which is fundamentally inconsistent with the purpose and mission of the entire university. A complete copy of the Academic Integrity Policy is available in the Office of Student Life, the Office of the Vice Provost for Undergraduate Programs, and online. Academic dishonesty includes: 1. Cheating – intentionally using or attempting to use, unauthorized materials, information, or study aids in any academic exercise. a. Students completing any examination should assume that external assistance (e.g., books, notes, calculators, conversations with others) is prohibited unless specifically authorized by the instructor. b. Students may not allow others to conduct research or prepare any work for them without advance authorization from the instructor. c. Substantial portions of the same academic work may not be submitted for credit in more than one course without authorization. 2. Fabrication – Intentional falsification or invention of any information or citation in an academic exercise. 3. Facilitating Academic Dishonesty – Intentionally or knowingly helping or attempting to help another commit an act of academic dishonesty. 4. Plagiarism – Intentionally or knowingly representing the words, ideas, or work of another as one’s own in any academic exercise. From the School on Nursing UG Student Handbook Ethical Practices/Academic Integrity Ethical practices include values/beliefs, and principles that influence decision-making, personal conduct, and relationships. A highly developed sense of integrity is basic 10 Syllabus UNRS 314 characteristic required of professional nurses. Students are expected to maintain ethical standards while in the nursing program. Behaviors identified as violating ethical standards include, but are not limited to: a. Plagiarism b. Cheating c. Lying d. Stealing e. Failing to report nursing errors f. Misrepresenting or misstating events regarding professional conduct g. Breach of professional confidentiality h. Lack of accountability for one’s own action i. Patient/Client abandonment j. Fabrication of data Repeated offense shall result in dismissal from SON. Penalty for any offense will include: 1. Involved student(s) is subject to receiving a 0 (zero) on the assignment and/or ‘F’ in course. 2. Involved student(s) will be placed on permanent probation Definitions In general, academic misconduct is defined as any act that gains, or is intended to gain, unfair academic advantage for a student. When a student is implicated in plagiarism, the minimum penalty is: 1. Permanent probation in the School on Nursing. 2. A zero on the assignment in question. 3. Any further discipline will be given individual consideration and be administered according to university guidelines. 4. The incident will be reported to the Dean of Students. REQUIRED TEXTS: Bowden V., Dickey S, & Greenberg C. (1998). Children and their families: The continuum of care. W.B. Saunders Medication manual or PDA program of choice Perrin, R. (2007). Pocket guide to APA style. Haughton Mifflin Company. Taylor, J.T. (2002). Spiritual care: Nursing theory, research, and practice. Upper Saddle River, NJ: Prentice Hall. Note: You may use support nursing text books that have been purchased for previous courses as reference. 11 Syllabus UNRS 314 Required Internet Articles: Center for Disease Control, Universal Precautions. www.cdc.gov JCAHO, Pain Standards and Hot Line. (2001). www.jcaho.org Scope and Standards of Pediatric Oncology Nursing Practice, (2000). http://www.apon.org/ Statement on the Scope and Standards of Genetics Clinical Nursing Practice, 2001 http://www.nursingworld.org/ethics/ecode.htm Statement on the Scope and Standards of Pediatric Clinical Nursing Practice, (1996). http://www.pedsnurses.org/ RECOMMENDED: Health assessment text book McEvoy, M. (2000). An added dimension to the pediatric health maintenance visit. The spiritual history. Journal of Pediatric Health Care. September/October, 217- 220. Nazareno, G. & Narareno A. (2008). 2008 Intravenous medications: A handbook for health professionals. O’Brien, M. (1999). Spirituality in nursing: Standing on holy ground. Jones and Bartlett. Clinical Drug Therapy Text and Medication Calculations Additional Resource Articles: Child Abuse: www.findarticles.com Campbell, E. (2005) Child abuse recognition, reporting, and prevention: A cultural congruent approach. Journal of Multicultural Nursing. Summer 2005. Conscious Sedation Guidelines http://www.aap.org/policy/04789.html (you will need to type in Guidelines for Monitoring and management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures: An Update (2006). Key word: Conscious sedation Trouble Shooting IVs: http://community.nursingspectrum.com/MagazineArticles/article.cfm?A ID= 12273 Troubleshooting Pediatric Peripheral IVs: Phlebitis and infiltration. 12 Syllabus UNRS 314 PALS Article http://www.aafp.org/afp/991015ap/1743.html: Pediatric Advanced Life Support Kawasaki Disease http://www.aafp.org/afp/990600ap/3093.html Kawasaki Article Immunization Schedule http://www.cispimmunize.org/ Current Immunization Schedule Spiritual Care http://pediatrics.aappublications.org/ You need to type in Spiritual and it will take you directly to the article: o Barnes, L. (2000). Spirituality, Religion, and Pediatrics: Intersecting Worlds of Healing. Pediatrics. p:899-908 Ethical Issues http://aappolicy.aappublications.org/cgi/reprint/pediatrics;106/5/1151 .pdf o Foregoing Life-Sustaining Medical Treatment in Abused Children o Committee on Bioethics. (1996). Ethics and the care of critically ill infants and children. Pediatrics. Vol. 98, No 1. o Campbell, E., (2005) Child abuse recognition, reporting and prevention: a culturally congruent approach. Cultural Competency http://aap.org Type in Cultural Effectiveness for article: Ensuring culturally effective pediatric care: Implications for education and health policy. Committee on Pediatric Workforce. (2004) Internet Resources: Available through web site http://pedstudent.com 13 Syllabus UNRS 314 Clinical Skills for Pediatric Rotation Physical assessment: able to perform and document a physical assessment on the: Infant Toddler School age Adolescent Pain management: Administer narcotics according to hospital policy. Administer and record findings of pain assessment tools used. PCA pump. Patient response to intervention Developmental assessment: able to perform and document findings for appropriate age group. Discharge Planning: Care plan reflects discharge needs. Child and family teaching. Follow up care. Home medications and treatments. Growth: able to chart on CDC growth form and calculate BMI on a child. Administration of medications and IVs: Mg per kg calculations. Proper labeling of medication. Physician orders Observing 5 patient rights. Proper identification of patient. Proper administration of medication Correct IV fluid and drip calculation. Hourly recording of IV fluids. Labs: Review daily for current values. Identify abnormal values. Facilitate collection of specimens. Play Therapy / School: Assess activity level based on condition. Identify and facilitate play activities Communicate with school regarding tutoring. Procedures: Observe sterile technique. Apply sterile gloves. Change dressings as ordered. Colostomy care Apply urine collection devices. Weigh diapers for accurate output. Weigh infant /child using appropriate scale. Central line dressing change. Monitor blood administration with nurse. Monitor patient under conscious sedation with registered nurse. Urine catheterization as ordered. IV insertion and blood drawing Nutrition: Record daily fluid and food intake. Calculate caloric needs of child. Insertion of feeding tubes. Nasogastric tube feeding. Gastrostomy tube feeding. Monitor TPN infusion. Safety Issues: Identification band on all children. Hand washing for child / family / nurse. Side rails up at all times. Restraints as per hospital policy. Needle and pin precautions. Safety needs according to developmental level. Vital Signs: Assess vital signs according to hospital Identify base line norms according to text. Report abnormal findings. Record vital signs on proper hospital form Initiate interventions based on findings. Monitors: Pulse oximetry Intravenous infusion pump. Apnea monitor policy. Self Care: Assess child’s ability to perform ADL. Daily bath. Oral care. Oxygen therapy: Oxygen therapy per nasal cannula or mask. Suction: bulb syringe, oral, nasal, endotracheal, and tracheostomy Regulate and monitor oxygen therapy. Apply ambu bag to infant / child as needed. 14 Syllabus UNRS 314 I have received a copy of the syllabus for UNRS 314, Nursing Care of Children and Young Adults. I have read the syllabus and have been offered an opportunity to ask questions and make comments about it. I understand and agree to the requirements outlined in this syllabus. Print Name: ________________________ Signature: __________________________ Date: ___________________________ If you have any questions, please see Jan Chandler. Thanks! 15