Docstoc

The University of Texas at Austin - DOC

Document Sample
The University of Texas at Austin - DOC Powered By Docstoc
					N377P                                                                               Fall 2009


                               The University of Texas at Austin
                                       School of Nursing
                           N377P Clinical Care Management Practicum
                                           Fall 2009
Prerequisites
      Prerequisites for N377P include the successful completion of N127P, N157P, N224,
      N226, N227, N265, N266, N325, N325P, N355P, N356, N356P, N365P, N366P, N455.
      The student is also required to be enrolled in N377 concurrently, or has successfully
      completed N377.

Course Hours
      This course will meet for a total of 135 hours over 10 weeks. Time will be spent as
      follows:

        Orientation to Clinical Facility                             8 Hours
        Weekly Clinical/Post-Clinical                              100 Hours
        Weekly Conference (Thursday 1:00-3:00 PM)                   20 Hours
        Preclinical Prep                                             7 Hours
                                                                   135 Hours
        Additional study time is required of the student for satisfactory clinical performance.

Faculty and Office Hours
       The Co-Facilitators for N377P are Janis L. Carelock, RN, MSN, CCRN, CNS; NUR
       4.131; 471-7937; jcarelock@mail.utexas.edu and Martha Meraviglia, RN, CNS, PhD;
       NUR 5.151, 471-6118; mmeraviglia@mail.utexas.edu. Individual faculty will post their
       office hours, office numbers, and e-mails.

Course Description
      The Senior 2 Practicum in the nursing major is the laboratory application of selected
      concepts, and theories of management in the planning and delivery of health care.
      Experiences include management of groups of patients in selected health care settings.

Course Objectives
At the conclusion of this course the learner will be able to:

1.      Demonstrate increasing competency in organizing, managing, and delivering complex
        nursing care.
2.      Apply concepts and theories learned in prerequisite courses in planning, implementing,
        and evaluating care of individuals, families, and groups.
3.      Provide continuity of care through collaboration with other health care providers, health
        care agencies, patients, and families.
4.      Analyze patient care delivery systems (work to be done, integration of people and
        organization, structure and coordination).
5.      Based on analysis, develop strategies for change in patient care delivery system.
6.      Utilize current research findings in the practice setting.
7.      Practice nursing according to legal, ethical, and professional standards.

                                                  1
N377P                                                                                Fall 2009


Teaching/Learning Methods

        Teaching/learning is accomplished in numerous ways. Methods utilized include, but are
        not limited to, simulations, actual experiences, case studies, lecture, group discussion, and
        completion of written assignments.

        The student will develop clinical holistic, critical thinking skills congruent with
        baccalaureate education. This is facilitated through discussions, Socratic questioning,
        case scenario presentations and grand rounds.

References

        Students are required to use textbooks, research and other journal articles, and other
        references as appropriate to prepare for and to evaluate experiences in clinical laboratory.
        In addition, each clinical laboratory faculty member may require special readings
        appropriate to the clinical setting in which the student is practicing.

Optional Textbook
Silvestri, L. A. (2008). Saunders comprehensive review for the NCLEX-RN examination (4th
        ed.). Philadelphia: Saunders.

Methods of Evaluation and Grading Policy

        The total grade for N377P is determined by:

        Clinical Practice in Assigned Agency               80%

        Assignments: Case Studies                          20%

        Completion of HESI Exam                 Mandatory Requirement

Explanation of Total Clinical Grade

Faculty will determine clinical practice grades using a variety of sources. These include, but are
not limited to, instructor observation, evaluation from teaching assistants/staff, input from
clients/family, and student self-evaluation. Clinical grades are based on a scale of 60-100%. The
final grade will include the clinical practice grade averaged with the written assignment grades
specified above, and is as follows:

                               100-90     =     A
                               89-80      =     B
                               79-70      =     C
                               69-60      =     D
                               <60        =     F

                                                  2
N377P                                                                              Fall 2009


                                   HESI Exam Requirements

To assist BSN students to systematically prepare for the NCLEX, N377P includes the
requirement that students complete the HESI Exam. This exam is considered to be preparation
for the NCLEX and is a mandatory requirement for completion of this course. Students will not
be allowed to proceed to Capstone until the exam is completed. Although no score
requirement is mandated prior to proceeding to Capstone, an acceptable score is 850. Findings
indicate that 98% of students taking the HESI who scored 900 passed the NCLEX.

You have been assigned to take the exam in the Learning Center, 5th floor, Computer Lab
(5.102G) on the following date according to your clinical instructor:

 Instructor/ Group         Date                      Day                      Time

 Flanagan Monday           September 30              Wednesday                4-7pm
 Flanagan Tuesday          October 2                 Friday                   1-4pm
 Nurmi Monday              October 7                 Wednesday                4-7pm
 Nurmi Tuesday             October 8                 Thursday                 3-6pm
 Meraviglia                October 9                 Friday                   1-4pm
 Belcik                    October 14                Wednesday                4-7pm
 Kumagai                   October 15                Thursday                 3-6pm
 Cross                     October 16                Friday                   1-4pm

Before taking the HESI exam, it is strongly recommended that students purchase the Saunders
comprehensive review for the NCLEX-RN examination (2008), to assist in reviewing NCLEX
content areas so that the HESI results will be a more accurate reflection of preparation for the
NCLEX. In addition, specific study guides for the HESI are available for checkout in the
Learning Center, entitled HESI NCLEX –RN Review Manual. The text should be supplemented
with previous course textbooks and notes as needed by students.

After completing the HESI Exit Exam, each student can print a copy of test results.

                          Procedure and Guidelines for HESI Exam

1.      The testing time frame allows for 3 hours on the established day the student is scheduled,
        although some students have finished in less time. Be sure to arrive at least 10 minutes
        prior to your scheduled exam time to allow adequate time for check-in and instructions.
2.      Students with documented special learning needs MUST contact Nancy Hall and their
        clinical instructor.
3.      Students will not be allowed to have books, notes, book bags, purses, telephones or any
        other materials in the testing area while taking the exam.

Students who perform poorly on HESI can receive on-line remediation for identified deficits.




                                                 3
N377P                                                                                 Fall 2009


           EXPECTATIONS IN CLINICAL LABORATORY FOR PRACTICUM

Students are expected to:

1.      Dress in accordance with The University of Texas at Austin School of Nursing dress code
        policy or dress policy of hospital if assigned to a special unit.

2.      Wear name tags and appropriate identification.

3.      Arrive on time for clinical lab and clinical conferences.

4.      Notify agency and instructor in the case of illness, late arrival, or anticipated absence.

5.      Turn all assignments in to instructor on time.

6.      Keep all appointments with clients, instructors, etc.

7.      Demonstrate non-judgmental verbal and nonverbal behavior toward an individual’s
        philosophy, culture, religion, socioeconomic background, moral code and life style.

8.      Notify instructor if the student is to be in other than the assigned area.

9.      All medications must be checked against the MAR with a licensed nurse prior to
        administration. This is a mandatory policy.

10.     Attendance is mandatory at all Thursday seminars. All excused and unexcused absences
        will require makeup at the faculty's discretion.


If there is a serious infraction of any of the above, the student’s grade may be lowered one letter
grade. If there are serious infractions of more than one of these, the student may receive a
failing grade.

If there is a pattern of infractions, such as repeated lateness, the clinical grade may be lowered
one grade and/or there is potential for failure of this course.


Preclinical Preparation

Preclinical preparation will be determined by each individual faculty member based on the units
to be used, and the type of patients typically seen in that clinical area. Please check with your
clinical instructor to get a copy of the form to be used by your clinical group.




                                                   4
N377P                                                                                  Fall 2009


          THE UNIVERSITY OF TEXAS AT AUSTIN POLICY STATEMENTS

Honor Code:
The profession of nursing has a legacy of public respect and trust. We provide specialized care
for the health needs of individuals and the community with integrity, honesty, compassion, and
state of the art knowledge and skills. Learning and practicing responsible and ethical professional
behavior is a vital part of professional education. The Institutional Rules on Student Services and
Activities given in the General Information Catalog (Chapter 11) and The University of Texas at
Austin’s Honor Code apply to all nursing students:

The core values of The University of Texas at Austin are learning, discovery, freedom,
leadership, individual opportunity, and responsibility. Each member of the University is expected
to uphold these values through integrity, honesty, trust, fairness, and respect toward peers and
community.

Additionally, the School of Nursing has its own honor code:

As a student in The University of Texas at Austin’s School of Nursing, I pledge myself to be
honest in all of my student activities including, but not limited to, all of my scholastic work and
interactions with patients, members of the community, faculty, and peers. Furthermore, I will not
use any substance prior to or during my interaction with patients that could alter my judgment or
ability to render safe care: this includes but is not limited to any use of alcohol, illegal drugs, and
prescription or over-the counter drugs that may impair my mental and/or physical abilities
required to perform safe patient care. I will disclose to my instructor any violations of the above
standards of conduct.

Medications Policy: As a requirement for clinical courses N425P, N455P, N465/466P, and
N377P, each student must pass a medication calculation/conversion and abbreviation test with a
grade of at least 90% on each section, each semester. Each student is expected to utilize assigned
and recommended learning resources to prepare for taking the test. The medication test will be
scheduled by the instructor within the first one to two weeks of each semester. Calculators may
be used for testing, but no programmable calculators are allowed. No formulas, conversion
tables, or personal data assistants (palm pilots or pocket PCs) will be allowed. If a score of 90%
is not achieved on the first test, the student must meet with the instructor to develop a learning
contract. The agreed upon learning activities in the contract must be completed prior to re-
testing. Re-testing will be scheduled by the instructor. If a score of 90% is not achieved after the
first re-test, additional learning activities and testing will be required until competency is
achieved. Because accurate calculation of drugs is essential to patient safety, students will not be
allowed to give medications in clinical settings until the medication test has been successfully
passed. Insufficient experience in medication administration in the clinical setting may affect the
achievement of clinical objectives and result in failure of the course.




                                                   5
N377P                                                                                Fall 2009


Course Repeat Policy: A student must earn a grade of at least "C" in each nursing course. A
student may repeat a nursing course only one time. No more than two nursing courses may be
repeated. If the student does not earn a grade of "C" or better the second time he or she takes the
course, the student cannot continue in the School of Nursing. If, while repeating the course, the
student drops the course or withdraws from the university at a time when the student’s
performance in the course is considered to be inferior to that required for a grade of "C", the
student may not re-enroll in the course or continue in the School of Nursing.

Infectious Disease Policy: (Clinical courses only). Students in all clinical courses are asked, not
required, to report any infectious diseases they are carrying at the time of the clinical placement
to supervising faculty and the clinical agency. The purpose of this request is to give faculty and
agencies an opportunity to make reasonable accommodations for student, staff, and patient needs.
Students must be in compliance with the School of Nursing policy regarding TB testing.

Academic and Program Accommodations for Students with Disabilities:
Refer to the General Information for information on Academic and Program Accommodations
for Students with Disabilities or contact the Services for Students with Disabilities office in the
Office of the Dean of Students at 471-6259. The School of Nursing works to ensure that students
who have disabilities have equal access to the University’s programs and services.

If you have any questions about services or accommodations for students with disabilities, please
talk with the faculty member, the Assistant Dean for Undergraduate Programs, or the Assistant
Dean for Student and Clinical Affairs or directly call the Office of the Dean of Students, Services
for Students with Disabilities, 471-6259.

Attendance Policy: Regular attendance at all class meetings is expected. Faculty are
responsible for implementing an attendance policy and must notify students of any special
attendance requirements. A student who is absent from a class or examination for the
observance of a religious holy day may complete the work missed within a reasonable time after
the absence, if proper notice has been given. Notice must be given at least fourteen (14) days
prior to the classes scheduled on dates the student will be absent. For religious holy days that fall
within the first two weeks of the semester, notice should be given on the first day of the semester.
It must be personally delivered to the instructor and signed and dated by the instructor, or sent
certified mail, return receipt requested. A student who fails to complete missed work within the
time allowed will be subject to the normal academic penalties. Special regulations of colleges
and schools, required by the unique nature of their programs of study, may be enacted through
the normal legislative process and printed in The Undergraduate Catalog. These special
regulations may not conflict with University regulations on class attendance and absence.

Punctuality & Late or Missed Work Policy:
Faculty are responsible for implementing a Punctuality & Late or Missed Work Policy.




                                                  6
N377P                                                                                Fall 2009


Student Conduct Policy: Students and faculty in The School of Nursing each have
responsibility for maintaining an appropriate learning environment. Faculty have the professional
responsibility to treat students with understanding, dignity and respect and to guide the
teaching/learning process. Students are expected to refrain from verbal and nonverbal behaviors
in the classroom and clinical that may be distracting to others, such as, but not limited to:
arriving late or leaving early, side conversations, text messaging, note passing, surfing the
internet or answering e-mail on laptops, and answering cell phone or pager. Students who
persistently engage in behaviors that are disruptive to the teaching/learning process may be
required to leave the setting. For further information refer to General Information, Institutional
Rules on Student Services and Activities, Chapter 11: Student Discipline and Conduct.

Scholastic Dishonesty Policy and Professional Integrity:
Refer to the General Information for information on the Scholastic Dishonesty Policy Sec. 11-
802. Scholastic dishonesty includes, but is not limited to cheating, plagiarism, collusion,
falsifying academic records, and misrepresenting facts. The Dean of Students Office records acts
of dishonesty and notifies the School of Nursing of each incident. In addition to all of the
University statements and policies relative to academic dishonesty, the School of Nursing
recognizes the strong link between honesty in academic work and professional integrity. Any act
of academic dishonesty, including fabrication of reports or records of interactions with clients, is
considered incompatible with ethical standards of nursing practice. The School of Nursing does
not admit students who have a record of violations to the professional sequence. Students who
engage in scholastic dishonesty may be subject to dismissal and may jeopardize their eligibility
for licensure as a registered nurse.

Uniform Policy:
A new uniform is being phased in fall 2007 for J1 students. J1 students will have white uniform
tops with the burnt orange piping on the collar, longhorn logo on the front and the School of
Nursing patch on the left shoulder sleeve. The pants will be burnt orange scrub bottoms with an
elasticized waist. All other UT Nursing students will be required to wear Longhorn burnt orange
scrubs for clinical experiences, except in those areas (such as the operating room and psych
settings) where other attire is required. UT uniforms are available at Co-op East. You can order
the uniform tops, Nursing Scrub Top (with three pockets) and Nursing Scrub Bottom. White
uniform pants are also allowed in place of scrub bottoms.

Other notes about uniforms and professional appearance:

1.      T-shirts worn under the scrub tops must be plain white: long sleeves for cooler winter
        months is OK, as long as they can be pushed up out of the way during certain procedures
        and gloving.

2.      Public Health and Psychiatric settings usually do not require the standard uniform, but
        suggest professional street clothes. Students should consult professors in those courses for
        specific requirements.




                                                 7
N377P                                                                                 Fall 2009


3.      Longhorn scrubs and Lab coats must have the School of Nursing patch sewn on the right
        upper side, and name tags are always required. Patches can be purchased at Co-Op East
        and photo identification nametags will be available though the Learning Center.
        Replacements or additional nametags will cost $5.00 each.

4.      A lab coat may be worn instead of the uniform in some situations. A three-quarter length
        or full-length lab coat is required with the School of Nursing patch. When a lab coat is
        worn, appropriate professional clothing should be worn underneath. Shorts, low cut tops,
        or t-shirts with slogans and jeans are NOT considered appropriate. In all clinical settings,
        students must project a professional image and clearly be identified as a University of
        Texas student nurse.

5.      Shoes must be all white (white leather athletic shoes are OK as long as they are clean and
        all white). Heels of shoes are not to exceed 2 inches in height. Socks must be white. Hose
        must be worn if wearing a dress or skirt and support hosiery is recommended. Clogs and
        cloth/canvas shoes are unacceptable.

6.      Hair must be worn above the collar at all times when in uniform. If hair is long, it must be
        tied back securely or put up in a manner that prevents it from falling below the collar.
        Hair must be a natural color (i.e., a shade of black, brown, red, gray, or blonde). You may
        need to fasten hair back so that it will not drag over open wounds or get in the way of
        sterile fields.

7.      Nails must be short enough to allow for deep palpation of the abdomen without leaving
        fingernail marks in the client’s skin. Artificial nails and nail polish are not permitted in
        clinical settings.

8.      Jewelry must be kept to a minimum. A watch with second hand is necessary. Limit rings
        to one and it must not have large stones. Remember that hands will be going into gloves,
        sliding under mattresses and giving care. Small stud-type or small hoop earrings are
        acceptable in clinical. Large or dangling earrings may get in the way and often attract
        small children and disoriented clients to catch hold and pull them through the earlobe.

9.      Body piercings, other than earlobe, must not be visible while in clinical settings.

10.     Tattoos must not be visible as they detract from a professional image.

11.     No perfume, cologne, or heavily scented hair spray may be used.




                                                  8
N377P                                                                                 Fall 2009


                               The University of Texas at Austin
                                       School of Nursing
                           N377P Clinical Care Management Practicum
                                           Fall 2009

                                        Course Assignments

1.      Case Studies

        As designated by the instructor, students will be expected to write two case studies using
        the Case Study Format given in the syllabus. The purpose of this assignment is to
        demonstrate critical thinking related to your patient’s health status and hospital
        experience by applying, analyzing, and evaluating data and associated nursing care.
        Applicable readings from professional journals are to be incorporated into the case study.
        Due dates for the case studies will be set by the individual faculty members. Three
        articles, one of which is research, will be applied to each case study. APA format will be
        used to list the article. Articles from the internet must be full text articles. Summaries or
        abstracts are not acceptable. The purpose is to reflect on the article and it’s application to
        the case study. (This is a total of 6 articles with the 2 case studies, two of which are
        research.)

2.      Self-Evaluation

        Written self-evaluations are due at the discretion of the individual instructor. The format
        for the self-evaluation will be given by the individual instructor. The self-evaluations
        allow the student an opportunity to communicate progress and performance to their
        faculty. In turn, faculty will have the opportunity to review perceptions, validate progress,
        give feedback and assist students in areas needing additional practice and experience. Due
        dates for the self-evaluations will be specified by the instructor.

3.      Weekly Seminars

        Weekly seminars will be held on Thursdays from 1:00-3:00 PM. Students are required to
        attend all seminars. If the student cannot attend, he/she must notify the instructor prior to
        class and make arrangements for class make-up. Failure to notify the instructor will result
        in the student’s grade being lowered by one letter grade.




                                                  9
N377P                                                                                                      Fall 2009


                                 The University of Texas at Austin
                                         School of Nursing
                             N377P Clinical Care Management Practicum
                                             Fall 2009

                                         Case Study Format

Patient's Initials:                 Room #:                                       Age/Gender:

Admission Date:                  Date of Care:                     Allergies:

Admitting Diagnosis:                                  Today’s Diagnosis:

Diet:                        Code Status:                 IV Solution & Rate/Saline Lock:

Activity Level:
1.      Description of why the patient was admitted and the events from admission to day of
        care. Include a summary of the overall collaborative plan of care. List surgical
        procedures and related complications that occurred during this admission.

2.      Significant past history: (include previous medical diagnosis(es), surgeries and dates, and
        medications the client usually takes at home.

3.      Family/social support.

4.      Concept map of primary diagnosis. The concept map must have the etiology, risk factors,
        pathophysiology, clinical manifestations (signs and symptoms), collaborative care
        (treatments, diagnostic tests, meds, surgery, etc), and complications. (Please site
        references, page number of reference.)

5.      List usual nursing interventions and related rationale for the pathophysiological condition
        (medical diagnosis) described in #4 above.

6.      Analyze trends of pertinent laboratory and other diagnostic findings. (Include nursing
        implications (How the results will impact your nursing care for this patient, what you will
        do considering any abnormal findings?) Be sure to consider EKG, x-ray, and other
        diagnostic methods.

7.      List all medications you administered per the following format. List any routine prn or
        stat meds you did not administer and the rationale for use.

          Medication/   Dosage   Class/MAO   Major Side     General Indications     Rationale for Use in         Nursing
            Route                             Effects                                   This Patient           Implications
                                                                                                               Assessment
                                                                                                              Administration
                                                                                                              Patient/Family
                                                                                                                Education




                                                     10
N377P                                                                                 Fall 2009


8.      List treatments and skills ordered and/or performed such as PT, RT, O2, blood glucose
        monitoring, IV site change, and rationale for treatment.

9.      List 3 main nursing diagnosis in order of priority that were appropriate for your day of
        care.

10.     Describe the following: 1) in-hospital referrals; 2) discharge planning concerns; and 3)
        community resources for patient/family. List specific Austin community, state and/or
        national referrals.

11.     a) Briefly summarize the professional nursing care you delivered on the date given above
        that is reflective of baccalaureate nursing practice. b) If you could relive the day, how
        would you improve the care you gave?

12.     Apply three nursing articles that relate to this patient. One of the articles must be research
        (ideally nursing research). Include the following:

        a.     Full article citation in APA format; only full-text articles can be used
        b.     Why I selected this article for this case study
        c.     What I learned from this article
        d.     How I will apply this information to my future nursing care




                                                  11
N377P                                                                              Fall 2009


                                POTENT MEDICATION LIST

POLICY: Students may be assigned to patients who are receiving continuous infusions of
vasoactive and antiarrhythmic medications. However, students cannot regulate vasoactive or
antiarrhythmic medications or give medications during a cardiac arrest. In addition, students may
not administer intravenous paralyzing agents or drugs for conscious sedation or IV sedative
agents. Fibrinolytic therapy may not be administered by a student. Students are responsible
for doing related calculations, and knowing drug facts on all medications the patient
receives. Chemotherapeutic drugs will only be administered by Registered Nurses who are
certified in the administration of chemotherapy. STUDENTS MAY NOT HANG BLOOD
OR BLOOD PRODUCTS.

Vasoactive Drugs (Partial List)
These are drugs that are given intravenously and are potent vasoconstrictors or vasodilators.
Students may not regulate continuous infusion rates (i.e. may not titrate dosage).

        Dobutamine
        Dopamine
        Epinephrine
        Milrinone
        Nitroglycerine
        Nitroprusside
        Norepinephrine
        Vasopressin

Antiarrhythmic medications (partial list). Student may give only under direct supervision.
Student may not regulate continuous infusion rates.

        Intravenous Medications:
        Adenosine
        Amiodarone
        Atropine
        Calcium Chloride
        Cardizem
        Digoxin
        Isoproterenol
        Lidocaine
        Magnesium sulfate
        Procainamide
        Verapamil
        Tikosyn (oral medication); may not administer




                                                12
N377P                                                                                Fall 2009


Other potent medications (various groups). Student may give only under direct supervision:

        3% Saline
        Aminophylline (intravenous medications)
        Amphotericin
        Coumadin (oral)
        Heparin (must double check dose prior to giving)
        Insulin—IV or subcutaneous (must double check dose prior to giving SQ)
        IV Dilantin
        KCl concentration of 40 mg/1000 cc or greater
        Mannitol
        Narcan

IV medications that the student must not administer:

Paralyzing agents (partial list)
       Atracurium
       Pancuronium
       Succinylcholine
       Vecuronium

Intravenous sedatives, continuous infusion (partial list)
       Ativan
       Benzodiazepines- diazepam, lorazepam, midazolam
       Propofol

Fibrinolytics (Thrombolytics) (partial list)
       Eminase
       TNKase
       tPA

All medications administered by the student will be checked with regard to the following: correct
medication and characteristics of medication (clarity, color, viscosity) and Five Rights-Route.
The last check of the five rights must be with the patient's armband. For IV medications, the
concentration, correct diluent and the time interval over which medication is to be given must
be checked. Assessments are to be initiated under the supervision of the instructor or supervising
nurse, i.e., lab tests, blood pressure, pulse respirations, monitor for dysrhythmias, etc. Additional
medications may be added to this list at the discretion of individual faculty members or staff.




                                                 13
N377P                                                                                  Fall 2009


                               CLINICAL EVALUATION TOOL



Student Name:

Hospital:                                                              Floor:

        Faculty will use the Clinical Evaluation Tool to evaluate students after their clinical
experiences. Behaviors are rated to correspond to percentages in the final clinical grade of 60-
100%. The faculty will review clinical evaluation behaviors with the students at mid-term and
final evaluation times. Faculty will meet more often with students who are having difficulty in
clinical. The student also has to meet the basic behaviors listed below to satisfactorily complete
the course.

        The following three criteria are critical elements in the student's evaluation. If the clinical
instructor observes behaviors, which in her/his judgment indicate that the student is not meeting
any one of these three criteria at a passing level, the student will not receive a passing grade,
regardless of the behaviors assessed in the remainder of the tool.

                                                                             YES                   NO

1.      (Safety) Delivers nursing care which prevents real
        or potential personal harm to clients and their families.

2.      (Knowledge) Demonstrates having a theoretical
        knowledge base necessary for clinical practice.

3.      (Communication) Demonstrates the use of
        communication skills appropriate for the situation.


Comments:




                                                  14
N377P                                                                                                    Fall 2009



                          CLINICAL BEHAVIORS                                       SCORE     COMMENTS:
                                                                                    (6-10)
TECHNICAL COMPETENCE
   N425P, J1
   1. Implements basic nursing skills with reasonable dexterity within
      performance criteria.
   2. States principles and implications for basic nursing actions.

    N455P, J2
    1. Performs nursing skills with reasonable dexterity and organization.
    2. Uses principles as basis for nursing actions.

   N377P, S2
   1. Performs advanced nursing skills with dexterity and efficiency.
   2. Incorporates standards of care in performance of nursing actions.
CRITICAL THINKING/KNOWLEDGE INTEGRATION                                                      COMMENTS:
   N425P, J1
   1. States scientific rationale when performing beginning nursing care.
   2. Uses appropriate resources in providing safe nursing care.

    N455P, J2
    1. Correlates scientific and nursing knowledge to enhance nursing care.
    2. Uses intragency resources independently to enhance nursing care.

    N377P, S2
    1. Validates rationale as a basis for providing nursing care.
    2. Integrates community resources and research findings to enhance nursing
       care.
    3 Based on knowledge of situation, anticipates problems or needs of the
       patient/family.
    4. Analyzes health data from a variety of sources and modifies care based on
       nursing implications.




                                                                              15
N377P                                                                                                       Fall 2009



                           CLINICAL BEHAVIORS                                         SCORE     COMMENTS:
                                                                                       (6-10)
ACCOUNTABILITY
   N425P, J1
   1. Accepts responsibility for fulfilling learning and performance criteria.
   2. Recognizes own limitations and seeks assistance as necessary.
   3. Practices in an ethical/legal manner.
   N455P, J2
   1. Demonstrates initiative for own performance and learning.
   2. Assumes responsibility for own nursing actions.
   3. Recognizes/identifies ethical dilemmas and responds appropriately.

  N377P, S2
  1. Self-directive in assuming responsibility for continuous professional
     growth.
  2. Uses professional standards to evaluate and revise nursing actions.
  3. Analyzes impact of ethical dilemmas to patient, family and health care
     delivery system.
MANAGEMENT                                                                                      COMMENTS:
  N425P, J1
  1. Participates as a team member.
  2. Organizes own nursing care activity efficiently.
  3. Verbalizes recognition of patient advocacy role of professional nurse.

    N455P, J2
    1. Takes initiative with team members in managing patient care.
    2. Organizes own nursing care activities for 2-3 patients efficiently.
    3. Acts as an patient advocate in managing patient care.

    N377P, S2
    1. Assumes increasing independence and responsibility for patient care.
    2. Effectively manages increasing numbers of complex patients.
    3. Integrates patient advocacy in managing care for patients and their
       families.
    4. Identifies need/makes inter/intra referrals as needed.




                                                                                 16
N377P                                                                                                     Fall 2009



                          CLINICAL BEHAVIORS                                        SCORE     COMMENTS:
                                                                                     (6-10)
NURSING PROCESS
   N425P, J1
   1. Accurately collects data, as directed, in a systematic manner.
   2. Makes nursing diagnoses based on apparent data.
   3. Plans and delivers individualized care with assistance.
   4. Evaluates outcomes of care with assistance.
   N455P, J2
   1. Accurately collects appropriate data in a systematic manner.
   2. Makes nursing diagnoses based on objective and subjective data.
   3. Independently plans and delivers individualized nursing care.
   4. Revises care plan based on evaluation process.
   N377P, S2
   1. Prioritizes collected data in relation to patient needs.
   2. Recognizes nursing implications of assessment data.
   3. Prioritizes nursing diagnosis based on implication from assessment data.
   4. Based on ongoing evaluation, contributes to patient discharge.
INTERPERSONAL SKILLS/CARING/COMMUNICATION                                                     COMMENTS:
   N425P, J1
   1. Communicates accurately and in a timely fashion.
   2. Demonstrates caring behaviors through nursing practice.

    N455P, J2
    1. Aware of effects of own communication on others.
    2 Recognizes ways culture and values influence patients’ needs.
    N377P, S2
    1. Incorporates therapeutic and professional communication in delivering
       and managing nursing care.
    2. Demonstrates empathy, sensitivity, responsiveness in a caring manner
       while meeting the needs of multicultural patients.
    3. Communicates plan of care with multidisciplinary groups of healthcare
       providers verbally and in writing.




                                                                               17
N377P                                                                                                      Fall 2009


                                              Clinical Competency Criteria

  Competency             Standard                         Quality of Performance                    Level of Mastery

               Safe                              Proficient; coordinated, confident           No supporting cues needed
Independent    Accurate                          Occasional expenditure of excess energy
               Effect/Affect – Each time         Within an expedient time period


               Safe                              Efficient; coordinated; confident            Occasional supportive cues
Supervised     Accurate                          Some expenditure of excess energy
               Effect/Affect – Each time         Within a reasonable time period


               Safe                              Skillful in parts of behavior                Frequent verbal and
Assisted       Accurate – Each time              Inefficiency and uncoordination              occasional physical directive
               Effect/Affect – Most of the       Expends excess energy                        cues in addition to supportive
               time                              Within a delayed time period                 ones


               Safe but not alone                Unskilled; inefficient                       Continuous verbal and
Marginal       Performs at risk                  Considerable expenditure of excess energy    frequent physical cues
               Accurate – Not always             Prolonged time period
               Effect/Affect – Occasionally


Dependent      Unsafe                            Unable to demonstrate procedure/behavior     Continuous verbal and
               Unable to demonstrate             Lacks confidence, coordination, efficiency   physical cues
               behavior




                                                           18
N377P                                                                                           Fall 2009


                                      N377P Clinical Care Management Practicum
                                             Calculation of Course Grade
                                                       Fall 2009

CLINICAL COMPONENT:                         MID-TERM                                 FINAL
                                           CONFERENCE                             CONFERENCE

TECHNICAL COMPETENCE

APPLICATION OF KNOWLEDGE

ACCOUNTABILITY

MANAGEMENT

NURSING PROCESS

INTERPERSONAL SKILLS/CARING

MID-TERM CLINICAL GRADE

ASSIGNMENTS                                                   / 20% TOTAL                       / 80%
HESI EXAM Completed Yes/No

             FINAL NUMERICAL GRADE                                 LETTER GRADE

MID-TERM
                                     STUDENT NAME                                        DATE

MID-TERM
                                     FACULTY NAME                                        DATE

FINAL
                                     STUDENT NAME                                        DATE

FINAL
                                     FACULTY NAME                                        DATE


                                                         19
N377P                                                                                    Fall 2009


                                  IN CASE OF EMERGENCY

IF YOU SEE SMOKE, SEE FLAMES, SMELL SOMETHING BURNING, OR BECOME
AWARE OF ANOTHER EMERGENCY THAT MAY REQUIRE EVACUATION OF THE
BUILDING, IMMEDIATELY:

1.   If possible, ISOLATE the fire or other emergency by closing the door.
2.   ACTIVATE the nearest FIRE ALARM PULL STATION.
3.   EVACUATE to the PRIMARY or ALTERNATE ASSEMBLY AREA.
4.   Dial University Police at 911 or Dispatch 471-4441.

DO NOT CALL 911 UNTIL YOU ARE OUTSIDE THE BUILDING.

IF A FIRE ALARM IS ACTIVATED:

    In a calm and orderly manner, proceed to evacuate the area and follow the instructions of the
     Fire Wardens or emergency response personnel. Each floor has two designated wardens.
     Their role is to ensure that everyone on their floor has proceeded to the fire exit stairs.
    Do not rush, push or panic.
    Close your office, classroom, or lab door behind you.
    EVACUATE to the designated ASSEMBLY AREAS. If your progress to the PRIMARY
     assembly area is impeded, proceed to the ALTERNATE assembly area.
    DO NOT USE ELEVATORS TO EVACUATE. Descend the nearest fire exit stairs in single
     file down to the GROUND LEVEL (first floor) and exit the building. Fire exit stairs are
     located on the southwest and northwest ends of the building.
    If there is someone who requires assistance, please provide it.
    Do not reenter the building unless directed by UTPD or an Austin Fire Department Officer
     in charge.

DO NOT BLOCK ACCESS TO BUILDING FOR EMERGENCY PERSONNEL. Do not exit
through the front door of the building. If you are on the second floor near the lobby, exit through
the glass doors to the patio, then out to one of the designated assembly areas.

ASSEMBLY AREAS:

From NORTHWEST FIRE STAIR EXIT—proceed to first floor stairwell exit door to outside of
building. DO NOT ENTER FIRST FLOOR HALLWAY AND EXIT THROUGH GLASS
DOORS. Primary assembly area is across north bridge toward tennis courts. Alternate assembly
area is east end of F23 parking lot near Red River St.

From SOUTHWEST FIRE STAIR EXIT— proceed to first floor stairwell exit door to outside of
building. DO NOT ENTER FIRST FLOOR HALLWAY AND EXIT THROUGH GLASS
DOORS. Primary assembly area is south to Centennial Park. Alternate assembly area is across
south bridge toward tennis courts.



                                                 20
N377P        Fall 2009




        21