Certified Nursing Assistant Proficiency Skills Checklist Please Check the Appropriate - DOC

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					  DEVELOPING COMPETENCY
    IN NURSING PRACTICE
SKILLS LABORATORY SYLLABUS

        CONTRA COSTA COLLEGE
       LIBRARY, ALLIED HEALTH,
   VOCATIONAL AND ATHLETICS DIVISION
             NURSING 211
               FALL 2008
     CONTRA COSTA COLLEGE
        L.A.V.A DIVISION --
    LIBRARY, APPLIED HEALTH
VOCATIONAL and ATHLETICS DIVISION
             FALL 2008




      NURSING 211 SYLLABUS




    DEVELOPING COMPETENCY
      IN NURSING PRACTICE
CONTRA COSTA COLLEGE                                                                                                                                        NURSING 211
L.A.V.A. DIVISION




                                                                           INDEX

                                                                                                                                                                    Page
SKILLS LABORATORY
   Course Description .......................................................................................................................................................... 3
   Course Objectives ............................................................................................................................................................ 4
   Student Information ......................................................................................................................................................... 5
   Absence Policy ................................................................................................................................................................ 9
   Nursing Skills Laboratory Schedule (grid) .................................................................................................................... 11
   Nursing Student Agreement .......................................................................................................................................... 13
   Skills Laboratory Schedule ............................................................................................................................................ 15
   Skills Check-off Period Calendar .................................................................................................................................. 16
   Textbook List ................................................................................................................................................................ 17



   LABORATORY SKILLS
   Information Sheet .......................................................................................................................................................... 21
   Skills Checklists ............................................................................................................................................................ 23



   COURSE EVALUATION
   Evaluation Form ............................................................................................................................................................ 55
SKILLS LABORATORY INFORMATION
   THIS COURSE COMPLIES WITH THE
      AMERICAN DISABILITIES ACT.
IF YOU HAVE ANY SPECIAL NEED, PLEASE
              INFORM
    THE FACULTY AND EVERY EFFORT
 WILL BE MADE TO ACCOMMODATE YOU




   “The Rehabilitation Act of 1973, Section 504, requires Contra Costa College to make all
     programs accessible to qualified individuals with learning, physical, or psychological
disabilities. Students who would like to receive accommodations for their learning, physical, or
  psychological disabilities should contact the Disabled Student Programs & Services (DSPS)
             office (H-19) and schedule an appointment: (510 235-7800, ext. 7220.”
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211



                      CATALOG DESCRIPTION:
    NURSING 211 - DEVELOPING COMPETENCY IN NURSING PRACTICE


Co-requisite:
Nursing 210


Course Description:
This course is an adjunct to Nursing 210. It provides instruction related to specific fundamental
medical-surgical nursing skills, as well as an opportunity for individual and small group practice
of those skills in the laboratory.


Credit:
Three (3) laboratory hours. / Point six (0.6) unit.


Nursing Skills Lab Faculty:
Sean E. McNeal, RN, MSN, CNS

Nursing Skills Lab Assistant:
Joan Batiste, RN

Faculty Director of Nursing:
Maryanne Werner-McCullough, RN, MS, MNP

Secretary, Nursing Department:
Diana Hall
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211



                          TERMINAL COURSE OBJECTIVES


Upon successful completion of Nursing 211, the student will:

 1. Discuss the steps necessary for safe performance of following fundamental nursing
procedures:
    a) Wound care including
        Sterile Dressing Change
        Wound Irrigation
        Drainage Tubes-Devices
        Suture Removal / Staple Removal
    b) Bladder Procedures including
        Catheterization-Straight and Foley
        Care of Foley
        Catheter Removal
        Bladder Irrigation
    c) Bowel Procedures:
        Enemas
        Rectal Tubes
        Harris Flush
    d) Administration of Oral, Rectal and Topical Medications
    e) Administration of Parenteral Medications: IM, Sub-Q, Z-Track, and Intradermal
    f) Ostomy Management: Changing and Emptying ostomy pouch, colostomy irrigation.
    g) Insulin Administration / Mixing Insulin and Blood Glucose Monitoring


 2. Demonstrate proficiency in fundamental nursing skills in the laboratory setting.
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211
                              STUDENT INFORMATION SHEET
                                  Welcome to Nursing 211

Instructor:
Sean E. McNeal, RN, MSN, CNS

Office:
Health Sciences Building: Room HS-106B.

Office Hours:
To Be Announced

Messages:
To Be Announced

Course Objectives:
At the completion of the course the student will be able to: 1) discuss the steps necessary for safe
performance of selected fundamental nursing skills; and 2) demonstrate proficiency in fundamental
nursing skills in the simulated laboratory setting..

Methods of Learning:
 1. Skills demonstration
 2. Small group discussion
 3. Audio-visual aids
 4. Computer assisted instruction

Individual Conference:
Conferences may be initiated either by request of the student or upon recommendation of the
instructor. Appointments at the College must be scheduled through the Nursing Department Secretary.

Grading:
Credit/No Credit

Credit:
Three laboratory hours / Zero-point six (0.6) units.

Skills Testing:
Ten (10) fundamental nursing skill complexes will be presented and demonstrated by the Nursing Skills
Laboratory Instructor. Five (5) of the fundamental nursing skill complexes have been identified by the
nursing faculty as critical skills. In order to receive “CR”(Credit) for the course, minimally, the student
must demonstrate competency in performing each critical skill before the Nursing Skills Laboratory
Instructor. In addition, successful completion of the course is dependent upon satisfactory progress in the
course and adherence to the Policies and Procedures in the Associate Degree Nursing Program Student
Handbook.

A student who has not demonstrated skills competency as measured by the skills checklists and the
Nursing Skills Laboratory Instructor and/or is not in compliance with College and Nursing Program
Policies will receive “NC” (No Credit) or an “I” (Incomplete) as a grade for the course based on academic
standing.
Student Information Sheet
Page 2


Skills Check Off:
 1. Ten (10) Fundamental nursing skill complexes will be presented and demonstrated by the
Nursing Skills Laboratory Instructor in the Nursing Skills Laboratory.
 2. After each skill presentation by the Instructor, the student will then have two (2) weeks to
prac tice the skill and demonstrate proficiency before a peer evaluator. The peer evaluator will
sign the student's check-off sheet to verify that this was done.
 3. Each student will have a peer evaluator/practice partner assigned to them by the Nursing
Skills Laboratory Instructor at the beginning of the semester.
 4. It is the responsibility of the individual student to maintain completed skill check-off sheets.

Critical Skills Check Off:
 1. Five (5) critical fundamental nursing skill complexes will be presented and demonstrated by
the Nursing Skills Laboratory Instructor in the Nursing Skills Laboratory.
 2. After the each critical skill presentation by the Instructor, the student will have two (2)
weeks to practice the critical skill and demonstrate proficiency before the student's assigned peer
evaluator.
 3. After being checked off on the critical skill by the peer evaluator, the student will then
demonstrate skill proficiency before the Nursing Skills Laboratory Instructor within the two (2)
week skill check-off period.
 4. It is the responsibility of the individual student to maintain completed check-off sheets.
 5. All students are required to complete the critical skill check off within the two week skill
check-off period.
 6. Failure to successfully complete an assigned critical skill within the two (2) week check-off
period will result in the student not advancing in the student's clinical rotation.
 7. Failure to successfully complete the five (5) critical skill complexes during the course will
result in the student receiving “NC” (No Credit) or an “I” (Incomplete) as the final grade for the
course based on academic standing.
 8. Students who have not demonstrated critical skill competency before the Nursing Skills
Laboratory Instructor during the two week check-off period will be reevaluated.

Policies and Procedures:
The current Policies and Procedures are included in the Associate Degree Nursing Student
Handbook. These policies and procedures will apply for the current school year. Please read
them carefully. Questions regarding policies and procedures should be directed to the Nursing
Skills Laboratory Instructor

Student Conduct In Nursing Skills Laboratory:
The student should be aware that Contra Costa College is guided by the California Education
Code for standards of student conduct. This code states that (1) disorderly, unethical, vicious, or
immoral conduct and/or (2) misuse, abuse, theft, or destruction of state property are grounds for
a student to be placed on probation, suspended, or expelled from the college.

Attendance:
 1. Weekly skills presentation and demonstration will be presented on Thursdays as per class
schedule.
 2. Weekly skill practice sessions will be held on Thursdays as per class schedule.
Student Information Sheet
Page 3


Attendance, continued
 3. Attendance at the weekly skill demonstration and student practice sessions parallels College
policy. Attendance will be taken at each class. It is the student’s responsibility to sign the roll
when present. The faculty considers it unethical for a student to sign for another student. (Refer
to Attendance Policies in the College Catalog.)
 4. A student whose absences exceed current College policy will be dropped from the course by
the Instructor and receives an “I” (Incomplete) for the course.
 5. It is the student's responsibility to obtain Instructor-provided materials or information for the
course when absent.
 6. No one will be permitted to enter the Nursing Skills Laboratory once class has begun.

Miscellaneous Information:
 l. Any problem in the Nursing Skills Laboratory should be addressed to the Skills Laboratory
Instructor. If no resolution is reached the problem may be brought to the Student Issues
Committee.
 2. Student’s questions should be addressed to the Instructor for clarification. Never assume.
 3. Unsafe or broken equipment in the Skills Laboratory should be reported by the student to the
instructor immediately.
 4. Student name and peer evaluator sections on the critical skill checklist sheet are to be filled
in by the aforementioned parties prior to handing to Skills Laboratory Instructor for signoff.
Skills Laboratory Instructor will not record critical skill as being done until this is completed.
 5. Taping is not permitted without the express permission of the Instructor.
 6. Student's announcements should be made at the end of class time.
 7. Food and beverages may not be brought into the Nursing Skills Laboratory at any time.
 8. The student will be asked to complete a course evaluation at the end of the semester. The
faculty appreciates the suggestions (and uses these) as a basis for change.
 9. The contents of this syllabus is subject to change at the discretion of the Instructor. Students
will be advised of any changes in the syllabus by the Instructor.
CONTRA COSTA COLLEGE
LAVA DIVISION
ASSOCIATE DEGREE NURSING PROGRAM



                              SKILLS LAB COURSE ABSENCE POLICY


POLICY:
The Nursing Skills Lab provides the student with an opportunity to practice clinical skills in a
laboratory setting prior to performing the skill with actual patients. The practice of skills is
essential to safe clinical practice.

Each student is expected to be on time and to participate in ALL Skills Lab classes.

Only four (4) hours of absence are allowed each semester from the Skills Lab course. Being late
to class four times equals one hour of Skills Lab absence.



PROCEDURE:
No make-up time will be allowed.

A student will be dismissed from the nursing program when absences exceed four (4) hours
within a semester, unless an emergency absence request is approved.

(See Emergency Absence Policy.)




Adopted: 12/97
Reviewed: 5/98, 5/01, 5/06, 5/07
Revised: 5/99, 5/00, 5/02, 5/03, 5/04, 5/05/ 5/08
CONTRA COSTA COLLEGE
LAVA DIVISION
ASSOCIATE DEGREE NURSING PROGRAM


             CRITICAL SKILLS IN THE NURSING SKILLS LAB COURSES


POLICY:
Nursing skills lab courses are designed to complement nursing theory classes. Critical skills are
identified for each nursing skills lab course and are an essential component of the student's
clinical learning. Students are expected to complete all of the critical skills in a timely manner.

Students who do not satisfactorily demonstrate basic nursing skills in the first four weeks of the
Nursing 210 (Fundamentals of Nursing) course may not start in the clinical setting and may not
continue in the course.


PROCEDURE:
Students who do not satisfactorily complete check-offs on the critical skills of a nursing course
will not be allowed to progress to the next nursing theory course and will be assigned a grade of
Incomplete ("I") in the nursing skills lab course. (See College Policy about grade of
Incomplete.)

A Clinical Practice Committee meeting will be held for any student who does not satisfactorily
demonstrate basic nursing skills in the first four weeks of the Nursing 210 (Fundamentals of
Nursing) course.




Adopted: 5/97
Revised: 5/98, 5/05, 5/07
Reviewed: 5/99, 5/00, 5/01, 5/02, 4/03, 5/04, 5/06, 5/08
 Nurs 211 – Fall Semester 2008
Week / Date               Skills Lab Activity                             References
Week 1           No Class                                            
Aug 21
Week 2           No Class                                            
Aug 28
Week 3           No Class                                            
Sept 4
Week 4           No Class                                            
Sept 11
Week 5           Management of Enteral Tubes                         
Sept 18
Week 6           Wound Care I*                                       
Sept 25          Sterile Dressing Change
Week 7           Bladder Procedures*                                 
Oct 2
Week 8           Administration of Non-parenteral Medications*
Oct 9
Week 9           Administration of Parenteral Medications            
Oct 16            (Intramuscular & Intradermal Injections)*
Week 10          Blood Glucose Monitoring                            
Oct 23        
Week 11          Insulin Administration (Subcutaneous Injections)*   
Oct 30
Week 12          Bowel Procedures                                    
Nov 6
Week 13          Ostomy Management*                                  
Nov 13
Week 14          Wound Assessment                                    
Nov 20           Wound Care II

Week Off
Nov 27
                                            Thanksgiving Holiday
Week 15          Drains                                              
Dec 4            Removal of Staples and Sutures
Week 16          Skills Review                                       
Dec 11
Week 17
                 Finals Week – No Class
Dec 18
     Nursing Skills Lab Courses – Fall 2008 (70 students)   6/08
                   N 236        Simulation Simulation                N 211                  N 256
             Maternal-Child                                 Fundamentals of         Intermediate M-S /
             Nursing Skills                                 Nursing Skills Lab      Psych Nursing
             Lab (1 unit)                                   (0.6 units)             Skills Lab (1 unit)
Day &Time         Monday         Tuesday      Wednesday           Thursday                 Friday
8-9 AM       N 236 Skills       Certified     Certified     N 211 Skills            N 236 Skills Practice
             Presentation       Nursing       Nursing       Presentation            Groups 2 & 3
             Groups 1, 2 & 3    Assistants    Assistants    Groups 1, 2 & 3         2 faculty : 20
             1 faculty : 30                                 1 faculty : 35
9-10 AM      N 236 Skills       Certified     Certified     N 211 Skills            N 236 Skills Check-
             Practice           Nursing       Nursing       Presentation            off
             Group 1            Assistants    Assistants    Groups 4 & 5 & 6        Groups 2 & 3
             1 faculty : 10                                 1 faculty : 35          2 faculty : 20
10-11 AM                        Certified     Certified     N 211 Skills Practice
                                Nursing       Nursing       Groups 1 & 2
                                Assistants    Assistants    2 faculty : 24
11-12 PM                        Simulation Simulation       N 211 Skills            LUNCH
                                                            Check-off               11:30 – 12:30 pm
                                                            Groups 1 & 2            N 256 Skills
                                                            2 faculty : 24          Presentation
                                                                                    Groups 1, 2 & 3
                                                                                    1 faculty : 40
12-1 PM                         Simulation   Simulation     LUNCH                   -----------------
                                                            -----------------       12:30 – 1:30 pm
                                                            12:30 – 1:30 pm         N 256 Skills Practice
                                                            N 211 Skills Practice   Groups 1 & 2
                                                            Groups 3 & 4            2 faculty : 20
                                                            2 faculty : 24
1 -2 PM                         Simulation   Simulation
                                                            ------------------      -----------------
                                                            1:30 – 2:30 pm          1:30 – 2:30 pm
                                                            N 211 Skills            N 256 Skills
                                                            Check-off               Check-off
                                                            Groups 3 & 4            Groups 1 & 2
                                                            2 faculty : 24          2 faculty : 20
2-3 PM                          Simulation   Simulation
                                                            --------------------    -------------------
                                                            2:30 – 3:30 pm          2:30 – 3:30 pm
                                                            N 211 Skills            N 256 Skills Practice
                                                            Practice                Groups 3 & 4
                                                            Groups 5 & 6            2 faculty : 20
                                                            2 faculty : 24
3-4 PM       N 236 Skills       Simulation   Simulation
             Check-off                                      -------------------     --------------------
             Group 1                                        3:30 – 4:30 pm          3:30 – 4:30 pm
             1 faculty : 10                                 N 211 Skills            N 256 Skills
                                                            Check-off               Check-off
                                                            Groups 5 & 6            Group 3 & 4
                                                            2 faculty : 24          2 faculty : 20
4-5 PM                          Simulation   Simulation
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
ASSOCIATE DEGREE NURSING PROGRAM


                             CONTRA COSTA COLLEGE
                           NURSING STUDENT AGREEMENT

   Statement of Understanding                                                                Student Initials

    I understand the general standards of this course                                        _________

    I understand the class, clinical, and Skills Labs schedule                               _________

    I understand that I will be held responsible for my own preparation for class, clinical,
      and skills lab                                                                          _________
   
    I understand that I am responsible for my own learning                                   _________

    I understand the policies of the Nursing Department and have received the
     Course Syllabus which includes the Student Handbook                                      _________

    I understand the course learning objectives, including theory and clinical objectives    _________

    I understand the process by which my final grade will be determined                      _________

    I understand that consistent attendance at all classes, Skills Labs, and
     Clinical Rotation sites is required                                                      _________

    I understand the process by which concerns, complaints, and questions by me
     should be addressed                                                                      _________

    I understand the policy re: taping in the classroom                                      _________

    I understand that my active participation in class, Skills Lab, and at the clinical
     site is important to my learning                                                         _________

    I understand that I will be responsible for the paper work as stated by the
     Instructor(s), and outlined in the Syllabus                                              _________

    I understand that my Instructor(s) will informally and formally evaluate my clinical
     and classroom performance and that if I have concerns re: my progress in the
     Course, I should make immediate plans to discuss this with my Instructor(s)              _________



  _________________________________________                                     __________________
   Signature of Student                                                          Date


   ________________________________________                                     ______________________
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211


                                      TEXTBOOK LIST

Required for Nursing 211:

Nursing 210 Syllabus

Nursing 211 Syllabus

Associate Degree Program Nursing Student Handbook

Elkin, Perry & Potter (2007) Nursing Interventions & Clinical Skills, (4th Ed.) and Skills
Performance Checklists for Nursing Interventions & Clinical Skills, (4th Ed.) package.
(Note: Textbook and checklists are packaged together)

Potter & Perry (2006) Mosby’s Nursing Skills CD-ROM 2.0, Student Version
(Note: Textbook, checklists, and CD-Roms are packaged together with Nursing 210 textbooks)

It is encouraged that students subscribe to ONE of the following journals of nursing:

American Journal of Nursing, Nursing 2006, or RN Magazine


It is required that the student purchase a Nursing Skills Lab Kit.
More information will be provided during Fall orientation.
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211



     STANDARD PROTOCOLS FOR ALL NURSING INTERVENTIONS

Assessment – Before the Skill
1.     Verify the nursing intervention using the physician’s order and the nursing care plan.
2.     Identify the client.
3.     Assess the Client for possible contraindications to the specific intervention.


Diagnosis:
1.     Develop an appropriate nursing diagnosis based on the assessment.


Planning:
1.     Identify goals and expected outcomes.
2.     Introduce yourself to the client.
3.     Explain the procedure and rationale.
4.     Gather appropriate equipment.
5.     Wash your hands.
6.     Adjust the bed to the appropriate height and lower the side rail nearest you.
7.     Provide privacy for the client.


Intervention – During the Skill:
1.     Promote client involvement prn.
2.     Assess the client’s tolerance.


Intervention – Completion:
1.     Ensure the client’s comfort and safety.
2.     Raise the side rails and lower the bed.
3.     Clean up bedside area and dispose of equipment properly.
4.     Wash hands.


Evaluation:
1.     Document the procedure and clients response on the appropriate hospital record(s).
2.     Revise the nursing care plan as necessary.
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211


                          STERILE DRESSING CHANGE
                                WOUND CARE
                       MANAGEMENT OF DRAINAGE TUBES
                         SUTURE AND STAPLE REMOVAL
Directions:
1.      Prior to Skills Lab session on Sterile Dressing Change, review Skills 5.2, 5.3 & 21.1 in Nursing
        Interventions & Clinical Skills”

2.     Prior to Skills Lab session on Chronic Wounds/wound Assessment/Wound Care, review Skills
       22.1, 22.2, & 23.1, 23.2, 23.3, & 23.4 in Skills Lab textbook.

3.     Prior to Skills Lab session on Drains/Staple and Suture Removal, review Skills 21.2 & 21.3 in
       Skills Lab textbook

Class Components:
1.     Presentation/Demonstration
2.     Video
3.     Discussion
4.     Small Group Practice
5.     Skill Check-Off

Skill Performance Checklists:
1.      Skill 5.2    Preparing a Sterile Field
              5.3    Sterile Gloving
              21.1   Providing Surgical Wound Care

2.     Skill   22.1    Pressure Ulcer Risk Assessment and Prevention Strategies
               22.2    Treatment of Pressure Ulcers and Wound Management
               23.1    Applying Dressings
               23.2    Changing Transparent Dressings
               23.3    Applying Binders and Bandages
               23.4    Wound Vacuum Assisted Closure

3.     Skill   21.2    Monitoring and Measuring Drainage Devices
               21.3    Removing Staples and Sutures (Including applying SteriStrips)


*Nursing Interventions & Clinical Skills textbook with packaged performance checklists will be referred
to as skills lab textbook throughout the remainder of the syllabus. YOU MUST BRING THE TEXTBOOK
AND CHECKLISTS TO ALL SKILLS LAB SESSIONS
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211



                                   BLADDER PROCEDURES
Directions:
Prior to Skills Lab session, review skills 33.1, 33.2, 33.3, 33.4, & 9.4in Skills Lab textbook.


Class Components:
1.     Presentation/Demonstration
2.     Video—"Basic Clinical Skills: Urethral Catheterization‖
3.     Discussion
4.     Small Group Practice
5.     Skill Check-Off


Skill Performance Checklists:
33.1    Urinary Catheterization with Straight or Indwelling (Retention) Catheter: Female and
        Male
33.2    Removal of an Indwelling Catheter
33.3    Inserting straight catheter for specimen collection or post-void residual
33.4    Closed and Open intermittent catheter irrigation
 9.4    Catheter care
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211




                                     BOWEL PROCEDURES
                                         ENEMAS
                                       RECTAL TUBES
                                       HARRIS FLUSH

Directions:
Prior to Skills Lab session, review Skill 9.5 in Skills Lab textbook.

Class Components:
1.     Presentation / Demonstration
2.     Discussion
3.     Small Group Practice
4.     Skill Check-Off

Skill Checklists:
9.5     Administering an enema
        Administering an oil Retention Enema
        Administering a Harris Flush Enema
        Inserting a Rectal Tube
Contra Costa College                                                               Student Name:
L.A.V.A.                                                                           Evaluator:
Nursing 211                                                                        Date:

                                 ADMINISTERING AN OIL RETENTION ENEMA

Performance Checklist:                                                                                                                           Yes No
 1. Checked physician’s orders and client care plan ......................................................................                       
 2. Gathered appropriate equipment ...............................................................................................               
 3. Identified client and explained procedure. ..................................................................................                
 4. Washed hands ............................................................................................................................    

Procedure:
 1. Provided privacy .........................................................................................................................   
 2. Donned clean gloves ..................................................................................................................       
 3. Exposed anal opening, and gently inserted rectal tube tip of container 3-4 inches. ..................                                        
 4. Squeezed contents slowly, and emptied entire amount into rectum.. ........................................                                   
 5. Removed rectal tube gently.. ......................................................................................................          
 6. Discarded equipment, following universal precautions. .............................................................                          
 7. Explained to client that oil should be retained for 1-3 hours before it was expelled.. ................                                      
 8. Cleaned up area and supplies ....................................................................................................            
 9. Helped client assume comfortable position. ...............................................................................                   
10. Removed gloves and wash. .......................................................................................................             
11. Documented on appropriate hospital record(s). .........................................................................                      

Comments: __________________________________________________________________________
 ___________________________________________________________________________________
 ___________________________________________________________________________________
Contra Costa College                                                                 Student Name:
L.A.V.A.                                                                             Evaluator:
Nursing 211                                                                          Date:

                                    ADMINISTERING A HARRIS FLUSH ENEMA


Performance Checklist:                                                                                                                             Yes No
 1. Checked physician’s orders and client care plan ......................................................................                         
 2. Gathered appropriate equipment ...............................................................................................                 
 3. Identified client and explained procedure. ..................................................................................                  
 4. Washed hands ............................................................................................................................      
Procedure:
 1. Filled fluid container with 100-200 mL of ordered solution; checked that temperature was
    between 105º - 110º F. ..............................................................................................................          
 2. Allowed solution to run through tubing so that air was removed. ...............................................                                
 3. Hung solution on IV pole. ...........................................................................................................          
 4. Raised bed to HIGH position, and lowered side rails.. ...............................................................                          
 5. Donned clean gloves ..................................................................................................................         
 6. Placed bed protector under client. ..............................................................................................              
 7. Placed client on left side in Sims’s position ................................................................................                 
 8. Lubricated tip of tubing with water-soluble lubricant ..................................................................                       
 9. Gently spread buttocks, and inserted tubing 3-4 inches into client’s rectum, past external
    and internal sphincters. Avoided traumatizing hemorrhoids during insertion ............................                                        
10. Raised water container to maximum height of 128 inches above bed .......................................                                       
11. Allowed solution to flow slowly into rectum and sigmoid colon. If cramping occurred,
    clamped tube for few minutes and then continued infusion .......................................................                               
12. Lowered container below level of rectum and allowed all fluid to flow back into container........                                              
13. Raised container 18 inches above rectum and allowed solution to flow back into rectum ........                                                 
14. Repeated inflow-outflow process 5-6 times, changing solution when it became thick with feces.                                                  
15. Provided privacy until client had expelled total volume of instilled solution following
    last inflow-outflow series. ...........................................................................................................        
16. Assisted client with perineal care, and helped client assume conformable position. .................                                           
17. If client was on strict I&O measured returns to make sure total volume of solution
    was expelled ...............................................................................................................................   
Administering a Harris Flush Enema
Page 2


18 Cleaned all equipment, and replaced in bathroom or appropriate location. ...............................                     

19. Removed gloves and washed hands. ........................................................................................   
20. Documented on appropriate hospital record (s) .........................................................................     

Comments: __________________________________________________________________________
 ___________________________________________________________________________________
 ___________________________________________________________________________________
Contra Costa College                                                      Student Name:
L.A.V.A.                                                                  Evaluator:
Nursing 211                                                               Date:

                                            INSERTING A RECTAL TUBE


Performance Checklist:                                                                                                           Yes   No
 1. Checked physician’s orders and client care plan .......................................................                          
 2. Gathered appropriate equipment ................................................................................                  
 3. Identified client and explained procedure. ..................................................................                    
 4. Washed hands ...........................................................................................................         

Procedure:
 1. Provided privacy .........................................................................................................    
 2. Placed client on left side in recumbent position and draped. ......................................                           
 3. Placed bed protector under client. ..............................................................................             
 4. Taped plastic bag around distal end of rectal tube or inserted tube into stool
    specimen container.. ..................................................................................................       
 5. Vented upper side of plastic bag to prevent inflation...................................................                      
 6. Donned clean gloves. .................................................................................................        
 7. Lubricated proximal end of rectal tube and with water-soluble lubricant .....................                                 
 8. Gently spread buttocks, and asked client to take a deep breath. Gently inserted tube
    into client’s rectum, past external and internal sphincters, (1-4 inches in adults, 1-2 inches
    in children) .................................................................................................................  
 9. With an adult, gently tape tube into place using hypoallergenic paper tape. With a child,
    held tube in place manually ........................................................................................  
10. Took client’s pulse ......................................................................................................    
11. Left tube in place no longer than 20 minutes ..............................................................                   
12. Removed tube, and provided perianal care as needed ...............................................                            
13. Helped client assume comfortable position ................................................................                    
14. Cleaned tubing, and replaced in bathroom if to be reused. Removed and
      discarded plastic bag..................................................................................................     
15. Cleaned up area and remaining supplies. .................................................................                     
16. Removed gloves and washed hands. .........................................................................                    
17. Documented on appropriate hospital record(s) ...........................................................                      


Comments: __________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211




         ADMINISTRATION OF NON PARENTERAL MEDICATIONS

Directions:
Prior to Skills Lab session, review Skills 16.1, 16.3, 16.4, 16.5, 16.6, & 16.7 in Skills Lab textbook.

Class Components:
1.     Presentation / Demonstration
2.     Video – ―Administering Oral, Topical, Suppository and Inhalant Medications‖
2.     Discussion
3.     Small Group Practice
4.     Skill Check-Off

Skill Checklists:
16.1    Administering Oral Medications
16.3    Applying Topical Medications
16.4    Instilling eye and Ear Medications
16.5    Using Metered-Dose Inhalers (MDI)
16.6    Using Small-volume Nebulizers
16.7    Inserting Rectal and Vaginal Medications
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211




                         Administration of Parenteral Medications
                           IM, Subcutaneous and Intradermal

Directions:
Prior to Skills Lab session, review Skills 17.1, 17.2, & 17.3 in skills lab textbook.

Class Components:
1.     Presentation / Demonstration
2.     Video – ―Intramuscular Injections‖, VHS `1651
                  ―Subcutaneous Injections‖, VHKS 1652
                  ―Intradermal Injections‖, VHS 1653
                        All three videos are in CCC Library Media Lab
3.     Discussion
4.     Small Group Practice
5.     Skill Check-Off

Skill Checklists:
17.1    Subcutaneous injections (Includes insulin)
17.2    Intramuscular Injections
17.3    Intradermal injections
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211




                            ENTERAL TUBE MANAGEMENT

Directions:
Prior to Skills Lab session on Enteral Tube Management, review Skills 31.1, 31.2, 31.3 and 16.2 in skills
lab textbook.

Class Components:
1.     Presentation / Demonstration
2.     Videos -- ‖Nasogastric Intubation and Nutrition Management‖, VHS 1780, #1, #2, #3 & #4 in
       CCC Library Media Lab
3.     Discussion
4.     Small Group Practice
5.     Skill Check-Off

Skill Checklists:
31.1    Intubating the client with a small-bore Nasogastric or Nasointestinal Feeding Tube
31.2    Verifying Tube Placement for a Large-Bore or Small-Bore Feeding Tube
31.3    Administering Tube Feedings for Nasogastric, Gastrostomy, and Jejumostomy Tubing
16.2    Administering medications through a feeding tube.
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211


                            INSULIN ADMINISTRATION
                                MIXING INSULINS
                          BLOOD GLUCOSE MONITORING
Directions:
Prior to Skills Lab session, review PG 17-2 and skills 17.1 and 13.3 in skills lab textbook.


Class Components:
1.    Presentation / Demonstration
2.    Discussion
3.    Small Group Practice
4.    Skill Check-Off


Skill Performance Checklists:
PG 17-2       Mixing medications from vials

Skill 13.3     Blood Glucose Monitoring

               Insulin Administration
Contra Costa College                                                      Student Name:
L.A.V.A.                                                                  Evaluator:
Nursing 211                                                               Date:

                                             INSULIN ADMINISTRATION


Performance Checklist:                                                                                                           Yes No
 1. Checked medication orders, injection site, and rotation chart .....................................                            
 2. Gathered appropriate equipment ................................................................................               
 3. Washed hands ...........................................................................................................      
 4. Rotated intermediate or long acting insulin bottle before drawing up ordered amount                                           
 5. Validated medication record, insulin bottle, and syringe with an RN for accuracy .......                                      


Procedure:
 1. Used the “six rights” before administering the drug.....................................................                      
 2. Explained action of medication and procedure of administration. ...............................                               
 3. Provided privacy. ........................................................................................................    
 4. Washed hands and donned gloves.. ..........................................................................                   
 5. Selected site for injection............................................................................................       
 6. Cleansed area with alcohol wipe using circular motion. Cleansed from inside outwards  
 7. Took off needle guard ................................................................................................        
 8. Expressed any air bubbles from syringe .....................................................................                  
 9. Grasped subcutaneous tissue between thumb and forefinger pump ..........................                                      
10. Inserted needle at 45º degree or 90º degree angle ....................................................                        
11. Released subcutaneous tissue ...................................................................................              
12. Held syringe barrel with one hand ..............................................................................              
13. Injected medication slowly ..........................................................................................         
14. Withdrew needle quickly and held wipe over injection site for several seconds. .........                                      
15. Did not recap needle. Discarded needle/syringe unit in puncture proof container. ....                                         
16. Cleaned up area and supplies ....................................................................................             
17. Washed hands ...........................................................................................................      
17. Documented procedure on appropriate hospital record(s) ..........................................                             


Comments: __________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
CONTRA COSTA COLLEGE
L.A.V.A. DIVISION
NURSING 211


                                 OSTOMY MANAGEMENT
Directions:
Prior to Skills Lab session, review Skills 32.2 in skills lab textbook.


Class Components:
1.    Presentation / Demonstration
2.    Video – “Caring for the Stoma, Caring for the Patient: Enterostomal Therapy Nursing”
3.    Discussion
4.    Small Group Practice
5.    Skill Check-Off


Skill Performance Checklists:
Skill 32.2    Pouching an Enterostomy
              Emptying a Colostomy Bag
Contra Costa College                                              Student Name:
L.A.V.A.                                                              Evaluator:
Nursing 211                                                           Date:

                                       EMPTYING A COLOSTOMY BAG


Performance Checklist:                                                                                                        Yes No
 1. Checked physician’s orders and client care plan ........................................................                    
 2. Gathered appropriate equipment ................................................................................            
 3. Identified client and explained procedure ...................................................................              
 4. Washed hands ..........................................................................................................    


Procedure:
 1. Provided privacy for client ..........................................................................................     
 2. Donned clean gloves ..................................................................................................     
 3. Raised bed to HIGH position, and lowered side rails on working side of bed. .............                                  
 4. Placed bath blanket over client, and folded top linen to bottom of bed........................                             
 5. Exposed colostomy bag and placed bed protector under bag ....................................                              
 6. Placed bedpan under colostomy bag .........................................................................                
 7. Removed clamp at distal portion of colostomy bag. ....................................................                     
 8. Made a cuff of 1-2 inches at distal portion of colostomy bag .......................................                       
 9. Emptied content from colostomy bag into bedpan ......................................................                      
10. Removed and covered bedpan ..................................................................................              
11. Cleansed any residue from cuff, first using moist paper towel or alcohol wipe,
    then using a dry paper towel ......................................................................................        
12. Rolled down cuff made on distal end of colostomy bag. .............................................                        
13. Replaced clamp on last 1 inch distal portion of colostomy bag ...................................                          
14. Positioned client for comfort. ......................................................................................      
15. Cleaned up area and supplies. ..................................................................................           


Comments: __________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
COURSE EVALUATION
Contra Costa College
L.A.V.A. Division
Associate Degree Nursing Program

                                   COURSE EVALUATION

Course being evaluated:         NURSING 211                 ______ Date: _________________________

                  Please indicate how much you agree or disagree with the following
                      statements concerning the course you have just completed:

     1 = Strongly Agree            2 = Agree              3 = Disagree            4 = Strongly Disagree

       Rank                                                COMMENTS
 1     2  3      4
                     Course Objectives …
                          1. are clear and concise
                          2. were useful in guiding learning course content
                     Course Content…
                          3. seemed relevant and useful
                          4. builds on my previous knowledge
                          5. is not a duplication of previous material syllabus
                     Syllabus was valuable in preparing for class in regards to:
                          6. class objectives
                          7. related learning materials
                          8. vocabulary
                     Textbook format was clear and understandable:
                          9. Skills Lab textbook
                          10. Skills Performance Checklists
                          11. Nursing Skills CD-Rom Set
                     Skills Testing:
                          12. were representative of skills laboratory content
                          13. were effective as a learning device
                          14. feedback/review was satisfactory
                     Overall:
                          15. amount of work required for course seemed appropriate
                          16. in general, I am satisfied with this course

What improvement would you suggest for this course?        (you may use the back of the page, if necessary).




Optional:   Name:______________________________________
rse seemed appropriate
                          16. in general, I am satisfied with this course

What improvement would you suggest for this course? (you may use the back of the page, if necessary).




Optional:   Name:______________________________________

				
DOCUMENT INFO
Description: Certified Nursing Assistant Proficiency Skills Checklist Please Check the Appropriate document sample