nurse-p/course_packs/meg93_205_NUR205LTUC… · Web viewJournal to be submitted in .doc (WORD) format or other format as directed by your Clinical Instructor. Developing and maintaining

NUR 205L

Transition into Nursing

TUCSON Clinical Course Pack

FALL 2010

Clinical Instructors:

Bobbi Forsch (Tucson)

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Northern Arizona UniversitySchool of Nursing

NUR 205LTUCSON Clinical Course Pack

Clinical Description: NUR 205L

NUR 205, Transition into Nursing, has a 2-credit/6.5 contact hour Skills Lab/Clinical component, NUR 205L, required as an integral part of the course. This Skills Lab/Clinical consists of both laboratory and clinical experiences at area health care facilities. Students will be assigned to a clinical group, which is scheduled to meet weekly for 6.5 hours throughout the semester:

Tucson Skills Lab Clinical InstructorSection A: Wednesday 8:30 am – 3:00 pm Bobbi ForschSection B: Thursday 8:30 am – 3:00 pm Bobbi Forsch

The time frame for the Skills Lab/Clinical sessions for each Section of the NUR 205 L course will be reconfirmed by your Clinical Instructor at the beginning of the semester.

Students are expected to participate in all Skills Lab and Clinical experiences. Arrangements for make-up assignments for illness or approved personal emergencies are at the discretion of your Clinical Instructor.

Required Textbooks and Materials: See NUR 205 Lecture Syllabus.

Required Tools:A quality stethoscope. You should expect to spend at least $50.00 on one.A Kelly clamp (hemostat)A pair of bandage scissorsA penlightA pen (black ink)A blood pressure cuff (manual)A watch with a second handNAU SON Name Badge (first and last name)NAU SON Uniform

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Clinical Strands and Clinical CompetenciesUpon completion of NUR 205L, the successful student will be prepared to:

Accountability:1. Demonstrate the ability to take responsibility for own words and actions.2. Demonstrate responsibility for own development and maintenance of current nursing

knowledge.3. Adhere to ethical, legal, professional responsibilities within the student role.4. Preserve the confidentiality of patients.5. Engage in self-reflection and professional dialogue with faculty about developing

professional practice.Caring:

6. Identify caring behaviors applied to nursing care delivery.7. Protect patient privacy.8. Plan and deliver care with sensitivity to individual patient needs.9. Discuss awareness and respect for the uniqueness of patients and their situation.10. Demonstrate awareness of own needs, strengths and limitations.

Clinical Competence:11. Demonstrate beginning basic competence and application of knowledge in the performance

of basic nursing skills in laboratory and structured clinical settings.12. Develop practice skills based on current knowledge, theory, and research.

Communication:13. Establish and maintain effective working relationships with peers and faculty.14. Demonstrate appropriate and accurate written and verbal communication.15. Accurately observe and report the status of patients with extensive guidance.16. Apply therapeutic communication skills in selected situations with extensive guidance.17. Demonstrate awareness of self and effect on others when communicating.

Critical Thinking:18. Demonstrate beginning skills in the organization of patient data, identification of nursing

diagnoses, and identification of priorities in the planning and delivery of care, and evaluation of care with extensive guidance.

19. Identify sources of professional information and how to access information to guide beginning practice.

20. Begin to incorporate knowledge from the behavioral, biological and natural sciences to patient assessment and the planning and evaluation of nursing care.

Culture:21. Verbalize cultural values and biases.22. Demonstrate sensitivity to personal and cultural definitions of health.23. Demonstrate flexibility and openness to continued learning about culture and diversity.24. Begin to integrate concepts from liberal studies foundation in order to understand self and

others.Learning-Teaching:

25. Identify own learning needs and styles.26. Develop and implement a simple teaching plan, and evaluate learning with peers.27. Incorporate recent research findings into simple teaching plan.

Management/Leadership:28. Seek relevant direction from faculty in the implementation of basic nursing skills.29. Demonstrate beginning skills in management of time, materials, and self.30. Organize and coordinate self to demonstrate beginning clinical competencies and

successful transition into the role of student nurse.

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While faculty members are looking for growth throughout the semester, students must demonstrate minimal competency within each experience. Sustained repetitive patterns of greater than two instances of unsafe or unprofessional conduct as defined in the ANA Ethical Code of Conduct and/or the Arizona Nurse Practice Act as interpreted by the faculty may constitute immediate failure of the course (see NUR 205 didactic syllabus). Any breach in confidentiality will also constitute failure of this course.

A student may be removed from a clinical experience for unsafe clinical practice as determined by your Clinical Instructor. The Undergraduate Student Handbook defines “nursing behavior which jeopardizes the rights of others and/or the health and welfare of patients” as unprofessional. Any removal from clinical for unsafe/unprofessional conduct may result in a referral to the Student Affairs Committee for review, and may constitute grounds for dismissal of the student from the program.

Grading:The Skills Lab/Clinical component of this course is graded on a Pass/Fail basis, and a Pass in the Skills Lab/Clinical component is required to be able to successfully complete the overall course. Evaluation of the student’s competency is based on objectives (clinical competencies) derived from the clinical strands and will be based on several measures of student skill and ability. While the overall Skills Lab/Clinical component is graded as Pass/Fail, individual assignments will be assigned points relative to the completeness and level of mastery demonstrated in particular assignments.

In order to earn a Pass in NUR 205L, a minimum overall average of 75% is required.

In addition:

Students are expected to attend every skills lab and clinical session. Students must be on time for skills lab and clinical sessions. If a student is sick or expects to be late to the skills lab or clinical session, the student is expected to contact his/her Clinical Instructor before the skills lab or clinical session begins.

Students may have one excused absence from a Skills Lab/Clinical session with prior approval of your Clinical Instructor; however there may be a requirement that the time be made up at your Clinical Instructor’s discretion. Please NOTE: Absence from more than one Skills Lab session or Clinical session or clinical session will result in a failing grade in NUR 205L.

A student must earn 75% or higher on the Final Skills Check-Off in order to demonstrate minimal competency, and to earn a passing grade for this course and be able to proceed to the next nursing course. The student will be offered one additional opportunity to demonstrate clinical mastery in the Final Skills Check-Off, and must complete it with a minimum score of 75%.

A student must earn a performance rating of 3 or above in all clinical competencies on the NUR 205 L Student Final Clinical Evaluation to receive a passing grade for the course.

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Success in the Skills Lab/Clinical component of NUR 205 will be based on the following:

1. Coming to the Skills Lab/Clinical Facility on time and in full uniform, including name badge. Please NOTE: Full uniform (including NAU name badge) is to be worn by all students during every Skills Lab/Clinical session as early in the semester as possible, and beginning at least by Week 4 of the semester.

2. Clinical Health Requirements and Documentation must be completed and copies submitted to the School of Nursing (SON) to the appropriate department (e.g., Student Services Department). Deadline: The deadline is 5:00 pm Friday of Week 5.

3. Coming to the Skills Lab/Clinical Facility prepared and with required books and course materials: Fundamentals of Nursing, Nursing Diagnoses (NANDA-I), Nursing Care Plans, Skills/Procedures Check-Lists, and other resources located on the NUR 205 Vista Shell, as requested by your Clinical Instructor.

4. Coming to the Skills Lab/Clinical Facility with stethoscope, Kelly clamp (hemostat), bandage scissors, penlight, pen with black ink, manual blood pressure (BP) cuff, watch with second hand, and your NAU Nursing Therapeutics Skills List, as requested by your Clinical Instructor.

5. Completing a weekly journal and submitting it each week within required time frame, as requested by your Clinical Instructor. Journal to be submitted in .doc (WORD) format or other format as directed by your Clinical Instructor.

6. Developing and maintaining a Student Clinical Portfolio.

7. Coming to the Clinical Facility each week and completing the Patient Information Sheet, as requested by your Clinical Instructor, and bringing your NAU Nursing Therapeutics Skills List.

8. Appropriate readings and other assignments completed for Skills Lab/Clinical sessions.

9. Successful return demonstration of therapeutic nursing skills.

10. Safe demonstration of selected skills in Skills Lab/Clinical experience.

11. Satisfactory completion of Final Skills Check-Off (75% or higher).

12. Satisfactory completion of Mid-Term and Final Self-Evaluations and meetings with your Clinical Instructor.

13. Satisfactory completion of other Skills Lab/Clinical assignments.

14. Satisfactory completion of NUR 205 L Student Final Clinical Evaluation (rate of 3 or higher in all competencies).

15. Completion of Evaluation of Clinical Learning Experience (Clinical Facility).

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Important Notes:Each student is expected to review the medical record/chart of his/her assigned patient before providing direct patient care. How this is accomplished will be determined by your Clinical Instructor at the Clinical Facility. This preparation is necessary so that the student will be able to provide safe and appropriate care for his/her patient. Any student who comes unprepared to Skills Lab or to the Clinical Facility, will be sent home and counted as absent.

Successful Completion of Clinical Portion of NUR 205L:Successful completion of the clinical portion of NUR 205L will consist of completion of all course requirements, achieving a minimum overall average of 75% in each individual area, and turning in the required evaluations:

Skills Lab/Clinical Facility Assignments Points

Clinical Health Requirements & Documentation completed and copies submitted to the SON to the appropriate department (e.g., Student Services Department). Deadline: 5:00 pm Friday of Week 5 of the semester.

required

Coming to Skills Lab/Clinical Facility on-time, in full uniform, prepared with equipment, paper work, and with required textbooks (10 points/weekly session; 13 sessions = Skills Lab [7 sessions]; Skills Check-Off [1 session]; Orientation to Clinical Facility [1 session]); Direct care at Clinical Facility [4 sessions].

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Weekly Journals (15 points/weekly journal; 12 journals = Skills Lab [7 weekly journals]; Orientation to Clinical Facility [1 weekly journal]; Direct care at Clinical Facility [4 weekly journals]. The due dates and the method of submitting the weekly journals are determined by your Clinical Instructor.

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Final Skills Check-Off (earned 75% or higher) 25

Items #1 - #15 on page 5—see previous page—(requirements of Skills Lab/Clinical component of NUR 205)

required

Student Clinical Portfolio required

Mid-Term Self-Evaluation requiredFinal Self-Evaluation requiredMid-Term Evaluation Meeting with Clinical Instructor requiredEnd-of-Semester Evaluation Meeting with Clinical Instructor requiredEvaluation of Clinical Learning Experience (Evaluation of Clinical Facility at the end of the semester)

required

Total 33575% = 252 points

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Clinical ExperiencesWhile the majority of this Skills Lab/Clinical Facility experience will take place in the Nursing Skills Lab, additional clinical experiences will be required in area health care facilities and/or simulated activities. Scheduling of these experiences may involve schedule adjustments to meet the needs of the agencies. Necessary changes will be communicated to students in advance. Adherence to NAU Nursing and health care agency policies for these clinical experiences is imperative.

Open Lab (Optional):It is recommended that each NUR 205/NUR 205L student sign up and attend (participate) in one 1-hour Open Skills Lab session.

Tucson: TBA

Clinical Health Requirements and Documentation:It is your responsibility to submit all required documentation (immunizations, CPR, liability insurance, fingerprinting, Tb test, etc.) to the SON to the appropriate Department (e.g., Student Services Department) by the deadline (5:00 pm Friday of Week 5). Do NOT give this information to your Clinical Instructor. You will not be asked for this.

Student Clinical Portfolio:Developing, maintaining, and updating your Student Clinical Portfolio is a clinical requirement in NUR 205, and a clinical requirement that will continue each semester throughout the Nursing Program. Your Student Clinical Portfolio contains, at a minimum, your: (a) NAU Nursing Therapeutics Skills List, (b) a copy of all of your Clinical Health Requirements with Documentation of completion, and (c) other Clinical Documents.

Proposed Skills Lab/Clinical Schedule:The following schedule of Skills Lab/Clinical Facility experiences is proposed; however, adjustments may be made at the discretion of your Clinical Instructor. Any changes will be announced in advance.

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Proposed Skills Lab/Clinical Schedule

Week Topic Learning Outcomes: The student will be prepared

to:

Therapeutic Skills Introduced

Lippincott SkillsTo be viewed

PRIOR to Skills Lab session

(beginning Week 2)

Readings & Activities

Readings to be completedPRIOR to Skills Lab session

(beginning Week 2)

Week One

Week of 8/30/10

Orientation

Infection Prevention

and Control,

& Patient Safety

Body Mechanics

Bed Making

1. Describe expectations of NUR 205L

1. Identify actions to ensure patient safety in hospital setting.

2. Perform selected skills correctly.

3. Demonstrate proper body mechanics.

4. Verbalize rationale for procedures.

5. Differentiate between surgical and medical asepsis.

6. Explain rationale for standard precautions.

7. Differentiate types of isolation and indications for use.

Patient identification Side rails/bed

positions Call light Handwashing Universal/standard

precautions Airborne precautions Droplet precautions Contact precautions Blood borne

precautions Gown/gloves/mask

application & removal Aseptic techniques Sterile technique

(gloves & sterile field) Disposal of

contaminated wastes Body Mechanics Bed Making:

unoccupied

Lippincott Skills—directions will be given in lab during Week 1

Lippincott Skills—Module 2 Asepsis will be completed in lab during Week 1

DVD: Infection Control & Standard Precautions (Medcom; CDC) w/post-test (in Skills Lab during Week 1)

Review NUR 205L syllabus

Discuss Weekly Journal Assignment (Due date and method of submission is determined by Clinical Instructor.)

Required ReadingPotter & Perry (P&P):Ch 8: CaringCh 34: Infection Prevention and Control

Discuss Chabner Assignment—Self-Study

http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html http://www.cdc.gov/ncidod/dhqp/ar_mrsa_healthcareFS.htmlhttp://www.cdc.gov/ncidod/dhqp/ar_VRE_publicFAQ.html http://www.cdc.gov/handhygiene/index.html

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http://www.cdc.gov/handhygiene/index.html

http://www.cdc.gov/handhygiene/index.html

http://www.cdc.gov/ncidod/dhqp/ar_VRE_publicFAQ.html



http://www.cdc.gov/ncidod/dhqp/ar_mrsa_healthcareFS.html



http://www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html




to:




(beginning Week 2)


Readings to be completedPRIOR to Skills Lab session

(beginning Week 2)

Week Two

Week of 9/6/10

Hygiene

Bed Bath

Bed Making:

Occupied

Preventing Pressure

Ulcers

1. Perform basic hygiene skills correctly on a partner.

2. Perform selected skills correctly.


4. Explain scientific rationale for correct practice of skills

5. Document care given and patient response to care.

Bathing (partial bed bath on each other)

Back rub Oral/denture care Perineal care (demo) Scalp/hair care Shaving (demo) Hand/Foot care Change IV gown BedMaking: occupied

& unoccupied Applying anti-embolic

stockings (TEDS) Applying SCD (on

mannequin) Body Mechanics

Module 7–Hygiene Required ReadingPotter & Perry:Ch 39: Hygiene

Practice NCLEX Quiz on Week 1 content (in lab; paper & pencil quiz; open book)

Weekly Journal (Due date and method of submission is determined by Clinical Instructor.)

______________________Monday (9/6/10): Labor Day

(Holiday)

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to:


Lippincott Skills

To be viewed PRIOR to Skills

Lab session (beginning Week 2)


Readings to be completed PRIOR to Skills Lab session

(beginning Week 2)

Week Three

Week of 9/13/10

Activity and Exercise

Mobility and Immobility

Patient Safety

Vital Signs & Pulse Oximetry

O2 Therapy (e.g., nasal cannula, mask, non-rebreather mask)

1. Perform basic skills related to activity and exercise correctly.

2. Explain rationale for correct practice of skills related to mobility & protecting skin integrity.


4. Assess & demonstrate interventions for patients w/ impaired mobility and activity intolerance.

5. Perform vital signs and O2 sat correctly on lab partner; interpret & analyze data obtained.

6. Perform basic skills and explain rationale for use of various oxygen delivery systems.

Body mechanics Turning & positioning

patient in bed Moving patient up in bed Protecting skin integrity Ambulation/Transfer belt Range of motion (ROM) Hydraulic lift Restraints Seizure precautions Assistive devices:

canes, crutches, walkers, etc.

Transfers: Bed to chair; Chair to bed; etc.

Safe lifting & Safe falling Blood pressure (2-step

method; manual) Temperatures: oral,

rectal (describe), axillary, tympanic, temporal

Pulse: apical, radial, brachial, pedal

Respirations Pain assessment Pulse Oximetry; O2

delivery systems

Module 1–Vital Signs

Module 9–Activity

Module 14–Oxygenation

Required ReadingPotter & Perry:Ch 37: Activity & ExerciseCh. 38: Patient SafetyCh 47: Mobility & ImmobilityCh 32: Vital SignsCh 40: pp. 956 – 960 (Oxygenation Therapy)



10


to:


Lippincott Skills

To be viewed PRIOR to Skills

Lab session (beginning Week 2)



(beginning Week 2)

Week Four

Week of 9/20/10

Preventing pressure ulcers

Skin Integrity

Wound Care

1. Complete an assessment for a patient with impaired skin integrity and list appropriate interventions

2. Demonstrate assessment and skills related to wound care/dressings

3. Document care and patient response.

4. Explain rationale for correct practice of skills.

Preventing pressure ulcers

Skin care Sterile Technique Wound care (e.g., dry

dressing)/ Dressings/ Drains/ Tape/Wraps

Staple/suture removal; steri-strip application

Pain assessment Vital Signs & Pulse

Oximetry (revisit) Cardiovascular &

Respiratory Systems LOC

Module 8 – Skin Integrity and Wound Care

Required ReadingPotter & Perry:Ch 48: Skin Integrity and Wound Care



11


to:




(beginning Week 2)



(beginning Week 2)

Week Five

Week of 9/27/10

Documen-tation

Nutrition

Fluid Balance

Vital Signs & Pulse Oximetry (Check-Off)

Skin Integrity and Wound Care (Con’t)

Practice Scenarios

1. Perform basic skills related to nutrition (including fluids).

2. Explain scientific rationale for correct practice of skills.

3. Document patient care and patient response.

4. Demonstrate assessment and skills related to wound care/ dressings

Fluid balance I & O Feeding patients (lab

partner) Aspiration

Precautions Therapeutic diets;

use of thickeners Blood glucose

monitoring/ Accucheck (self)

Weights Vital Signs & Pulse

Oximetry (revisit) Skin Integrity (revisit) Wound Assessment

and Wound Care (revisit) (e.g., irrigation & wound packing)

Review Modules assigned in Weeks 1 - 4

Required ReadingPotter & Perry:Ch 15 – 20: Critical Thinking and Nursing ProcessCh 26: DocumentationCh 41: pp. 981-991: Fluid Balance and I & O



Chart Smart II Documentation Tutorial (in computer lab)

Scenario work (in Skills Lab)--PRACTICE

12


to:




(beginning Week 2)



(beginning Week 2)

Weeks Six and Seven

Week of10/4/10

Week of10/11/10

Elimination Urinary &

Bowel(Part 1: Urinary)

Elimination Urinary &

Bowel (Part 2: Bowel)

PracticeScenarios

1. Perform basic skills related to urinary elimination.

2. Perform basic skills related to bowel elimination

3. Explain rationale for correct practice of skills.

4. Document care and patient response.

5. Identify common diagnostic studies and verbalize rationale for procedures.

Urine specimens (non-invasive)

Indwelling Foley catheter care

Condom catheter I & O measurement Common diagnostic

tests (urine, stool) Use of bedpan,

commode, and urinal Ostomy care:

pouching, emptying, and irrigating

Peristomal skin care Collecting stool

specimen for occult blood (guaiac)

Module 11–Urinary Elimination

Module 13–Bowel Elimination

Required ReadingPotter & Perry:Ch 41: Fluid Balance (OMIT Electrolytes, Acid-Base Balance, & IVs) Ch 45: Urinary Elimination (OMIT insertion of a straight or indwelling urinary catheter)Ch 46: Bowel Elimination (OMIT insertion of a naso-gastric tube, & enema)

Week 7: Practice NCLEX Quiz on Oxygenation (in lab; paper & pencil quiz; open book)


Scenario work (in Skills Lab)--PRACTICE

13


to:

Week Eight

Week of10/18/10

Final Skills Check-Off

in Skills Lab on campus

(scenarios)

No Weekly Journal

Mid-Term Evaluation with Skills

Lab/ Clinical

Instructor

There will be a sign up sheet so that 2 students sign up together for the Final Skills Check-Off. Each pair of students will have about 1 hour to complete a given scenario covering skills the students have learned this semester. The Final Skills Check-Off Sheet is located in the appendices of the NUR 205 L Syllabus.

NO Weekly Journal due for this week (Week 8 session).

There will be a sign up sheet for each student to sign up for a Mid-Term Evaluation Meeting with his/her Skills Lab/Clinical Instructor.

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Week Topic Learning Outcomes: The student will be

prepared to:

WeeksNineThru

Thirteen/Fourteen

BeginningWeek of 10/25/10

Clinical Day #1:

Orientation to the Clinical Facility

All day at the Clinical Facility

Clinical Days

#2 – #5:Direct

Patient Care(includes pre- and

post-conference)


1. Adhere to legal, ethical, and professional standards in the delivery of patient care.

2. Demonstrate professional caring behaviors in the delivery of patient care.

3. Apply safely selected nursing therapeutics to basic care of patients in clinical setting.

4. Perform basic assessment of patient.

5. Apply nursing process to care of patients.

6. Effectively communicate with patients and others in clinical setting.

7. Effectively manage time, resources, and self in the delivery of safe, limited patient care.

8. Safeguard patient confidentiality

Clinical Day 1: Week NineFOCUS: Orientation to the Clinical Facility

Students will complete the Orientation to the Clinical Facility (e.g., safety issues, learning/reviewing policies & procedures, documentation, charting, completing a “scavenger hunt” at the facility, etc.) which will be organized and conducted by your Clinical Instructor. During this one-day Orientation to the Clinical Facility, students will not provide direct care to patients.

As part of your Orientation, your Clinical Instructor will also discuss the system and schedule you will need to use in subsequent weeks to: (a) obtain your patient assignment, (b) access the patient’s chart, and (c) prepare for your next patient care experience.

Weekly Journal (Due date and method of submission is determined by your Clinical Instructor.)

Clinical Days 2, 3, 4, and 5FOCUS: Direct Resident/Patient CareEach student will go to the clinical site PRIOR to his/her clinical day to get information (from the patient’s chart) so the student is prepared and knowledgeable about the patient’s health care needs. Please note: You must adhere to the Clinical Facility’s requirements and expectations concerning “researching” your patient (refer to your Orientation to the Clinical Facility and discuss with your Clinical Instructor). When at the Clinical Facility to “pick up” your patient assignment, please wear your NAU uniform (including name badge), or appropriate attire and a white lab coat (including name badge). You may not go to the Clinical Facility during another group’s clinical session or during the change of shift. In addition, you may not touch or speak to any patients if your Clinical Instructor is not on site. Use the form provided in NUR 205L for information to be completed PRIOR to the clinical experience.

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Clinical Day #2: Blood Glucose

Monitoring Check-Off


Clinical Days

#2 – #5:Direct

Patient Care(includes pre- and

post-conference)


Clinical Days 2, 3, 4, and 5 – CONTINUED

If you arrive for your Clinical session without this information, you will be sent home. You will be expected to choose your own patient on the last clinical day.

Each student will arrive prepared, on time, and in time for shift report/pre-conference. After report/pre-conference, you will complete an assessment of your patient, including assessing your patient’s vital signs. Please remember, this is a supervised experience for NUR 205L students—your Clinical Instructor is your supervisor—in the health care setting.

You will also provide all of the care to your patient that you have learned to perform thus far in NUR 205L Skills Lab (this does NOT include giving medications, or any other skills NOT included in NUR 205L). Seek assistance from your NUR 205L Clinical Instructor, as needed, to ensure that the care you provide to your patient is safe, appropriate, and within your scope of practice.

You may be working in “Student-Partnerships”. This will depend on your Clinical Facility. Your Clinical Instructor will make this decision. If you do have the opportunity to work in student-partnerships, then your student partner is a resource to help you while working in the Clinical Facility. You will be responsible for your patient and your partner’s patient. You will need to cover for each other when you take a break and you may not leave the floor at the same time. Your student partner will change from week to week.

Weekly Journal (Due date and method of submission is determined by your Clinical Instructor.)

Documentation required 2 out of the 4 Clinical Days:You will be required to write one, 3-part nursing diagnosis with a Care Plan for your patient AND a nursing note based on the nursing diagnosis you identified for your patient. You will need to write your assessment and any care given (including the patient’s response).

Use the Care Plan form provided in the NUR 205 Vista Shell. This assignment is

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due at the end of the day’s clinical session and is to be turned in to your Clinical Instructor at the Clinical Facility, or the due date and method of submission will be determined by your Clinical Instructor. This is NOT documented or entered into the patient’s chart.

If after a student has completed the activities described above, the student may be able to use his/her extra time in additional activities (FIRST, discuss with your Clinical Instructor): 1. Help with care, feeding patients, performing blood glucose monitoring, vital

signs, lifting help, answering call lights, etc. Ask the staff if any help is needed. A willing student is more apt to have a rich clinical experience.

It is up to you to seek out the experiences you need. If you feel that you are lacking in some skills, you MUST let your Clinical Instructor know so that these experiences can be found/reinforced for you.

Some Important Rules while in the Clinical Facility:

We are guests. I know you will remember this and act accordingly.Please be aware of and abide by the rules, regulations, and policies of the Clinical Facility.When in doubt, ask your Clinical Instructor at the Clinical Facility.

When at the Clinical Facility to “pick up” your patient assignment, please wear your NAU uniform (including name badge), or appropriate attire and a white lab coat (including name badge). You may NOT go to the Clinical Facility during another group’s clinical session or during the change of shift.

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Week Final Clinical Evaluation Meeting

Week Fourteen/Fifteen

Week of11/29/10

OR

Week of 12/6/10

Note Holiday

Schedule during the semester

Final Clinical Evaluation Meeting with your Clinical Instructor (date, time, & location: TBA)

Includes Student’s Final Self-Evaluation form and Evaluation of Clinical Learning Experience -- completed by each student and handed-in to your Clinical Instructor (due date and method of submission: TBA).

ALSO, evaluation of the Clinical Facility/site is to be completed and handed-in to your Clinical Instructor.

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Care Plan for (insert condition)

Student Current Date:

Patient’s Initials:

Age: Sex: Date Care Given:

Admission Diagnosis/History:

Nursing Diagnosis/Definition:

ASSESSMENTObjective Data (Signs) Subjective Data (Symptoms)

Potential Complications:

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Nursing Diagnosis (PES format): ___________________________________________________________________

_________________________________________________________________________________________________

Planning: Patient-centered Outcomes (Goals)

Interventions/Implementation Scientific Rationales* Evaluation

Assess the degree and etiology of (Nursing Diagnosis).Degree: (e.g., mild, moderate, severe) Etiology: (cause)

Knowing the degree and etiology of (Nursing Diagnosis) directs nursing interventions

1. 1. 1. 1.

2. 2. 2. 2.

3. 3. 3. 3.

4. 4. 4. 4.

*Include citation from textbook (Potter & Perry) or (Gulanick & Myers) and page number to support scientific rationale, e.g., (P & P, page 25) or (G & M, page 398)

Signature: _______________________________________ Date: __________________

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Professional appearance in the clinical setting:

Professional appearance in the clinical setting promotes patient confidence in your skills, identifies you as a nursing student, and generally reflects on the profession of nursing. Requirements for dress/appearance while in outside clinical agencies include:

Blue top with snap or button front (available at the NAU bookstore); must wear clean and neat white or yellow shirt with sleeves and high neckline underneath (T-shirt, golf shirt, or turtleneck shirt).

Blue elastic waist pants available at the NAU bookstore (no drawstring pants, hip huggers, jeans, etc.)

Flat soled shoes that are clean with closed toes (sole no greater than 1” and heel no greater than 2”). White or black athletic shoes are suggested. Please avoid brightly colored footwear. NOTE: The shoes should be reserved for use in clinical settings.

You must wear your NAU uniform with NAU name badge (and many agencies will require you to wear the agency ID badge as well).

No bare midriffs, exposed cleavage, or gluteus maximi will be tolerated. Body tattoos and/or piercing must be hidden from view . If piercing is on your

face or tongue or any other place that cannot be concealed, it needs to be removed for the clinical setting.

Wedding bands or a single simple ring may be worn; all other jewelry (necklaces, pins, bracelets, etc.) should be avoided in the clinical area.

Only a single simple post earring in each ear lobe may be worn. Finger nails need to be short and clean. Any nail polish must be in a neutral

shade. Make-up should be simple and conservative. Fragrances should not be used

at all in clinical settings due to some patients’ hypersensitivities. Hair should be clean and neatly groomed. Hair that is

shoulder-length or longer must be secured up and off the collar in a manner that is both professional looking and should not interfere with patient care. Facial hair will be neatly trimmed.(Note: While trendy colors may be considered fashionable and acceptable in some social situations, they are not professional and may interfere with your establishment of a professional relationship with staff, patients, and families.)

No gum or tobacco chewing permitted during clinical. NOTE:Appearance in the clinical setting that does not meet these standards is cause for you to be removed from that setting, and repeated behavior may be a risk for failure of the clinical portion of the course.

Additional source: Northern Arizona University’s BSN Handbook.

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Appendices

Supplemental information and forms

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NUR 205L: Weekly JournalMy Thoughts & Reflections from Weekly Skills Lab/Clinical

_______________________(Name)

_______________________(Date of Skills Lab/Clinical; Wk

#)Activities this week:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Describe specific competencies met (see competencies listed in NUR 205 L Syllabus p. 3)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Describe in detail how the competencies (identified in previous section and again identified in this section) were met (give examples):________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

New areas of learning for me:________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Insights into your learning experience: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What would you do differently in the future? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Insights into Nursing: How has this experience added to my understanding/practice of nursing? ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

How can my instructor support my future learning?__________________________________________________________________________________________________________________________________________________________________________________________

Any other thoughts?__________________________________________________________________________________________________________________________________________________________________________________________

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Patient Information Sheet (Required for each Patient/Resident Care Day in the Clinical Facility)NUR 205Clinical Chart Review

Date: __________________________Patient Initials: DOB/Age:

Code Status:

Allergies:

Vital Sign Ranges: Admission Date & Diagnosis: Concurrent Medical Conditions:

Past Medical History Medications Significant Labs

Braden Scale

Dietary: Activity Level: PT/OT/ST

Most Recent Medical Orders:

Nursing Care for Your Shift:Example-Blood Glucose at 1100.1.2.3.4.Notes

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Criteria for Clinical EvaluationFinal Skills Check-Off – NUR 205 L

Performs skill or behavior:

Outstanding

5 points

Above average

4 points

Satisfactory

3.75 points

Needs to Improve

(unsatisfactory3 points

Safely, accurately, & effectively?

Without supporting

cues

With occasional supporting

cues

With some verbal &

physical cues & assistance

With frequent or continuous

verbal & physical cues

and assistanceIn a

coordinated manner?

Very Mostly Usually Somewhat or not coordinated

In a confident manner?

Very Mostly Usually Somewhat or not at all confident

In a timely manner?

Expedient Reasonable time period

Work usually completed on

time

Prolonged time period or usually a

delayed time period

Efficiently? No excess energy

expenditure

Occasional excess energy

expended

Some excess energy

expended

Considerable excess energy

expended

Equals _____/25 points

22.5 - 25 points = 90 - 100%20 - 22 points = 80 - 88%18.75 - 19.5 points = 75 - 78% (75% required to pass course)<18.75 points= failure

____________________________________ ____________________________________

Student name Faculty

Date _____________________

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Nursing Therapeutics Skills List

(11/20/07)

Northern Arizona University27

Nursing Therapeutics Skills List

This Skills List Belongs to:______________________________________

NOTE:This skills list is to be retained by the student throughout the NAU BSN program. It should be reviewed with Clinical Instructors at the beginning and completion of each clinical course. It is the student’s responsibility for ongoing maintenance of

this record.

DIRECTIONS:When signing off skills put your initials and date in the appropriate section for

each skill and sign the back of this list.

Skill Course Taught

Perform: Lab

Return Demo

Perform: Clinical

Professional Communications and

PresenceTherapeutic nurse/patient communications

NUR 205

Therapeutic presence NUR 216Interviewing NUR 214Full narrative history NUR 350Interdisciplinary communication NUR 350Communication with Preceptor NUR 450

Physical AssessmentTemperature: oral NUR 205Temperature: tympanic NUR 205Temperature: rectal NUR 205Temperature: axillary NUR 205Temperature: temporal artery NUR 205Radial pulse NUR 205Respiratory rate NUR 205Blood pressure NUR 205Breath sounds NUR 205Bowel sounds NUR 205Apical pulse NUR 205Peripheral pulses NUR 205Integument NUR 205Level of consciousness (LOC) NUR 205

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Skill Course Taught

Perform: Lab

Return Demo

Perform: Clinical

Oxygen saturation NUR 205Pain assessment NUR 205Focused Assessment NUR 205Comprehensive (Head-to-Toe) NUR 205

Infection ControlHandwashing NUR 205Universal/standard precautions NUR 205Airborne precautions NUR 205Droplet precautions NUR 205Contact precautions NUR 205Bloodborne precautions NUR 205Gown/gloves/mask/goggles NUR 205Aseptic technique NUR 205Sterile technique (gloves & sterile field)

NUR 205

Disposal of contaminated wastes

NUR 205

Patient SafetyPatient identification NUR 205Bedrails/position NUR 205Call light NUR 205Restraints NUR 205Documentation NUR 205

HygieneBathing NUR 205Oral/denture care NUR 205Perineal care NUR 205Scalp/hair care NUR 205Foot care NUR 205Bed making: unoccupied NUR 205Bed making: occupied NUR 205TED hose NUR 205

EliminationBedpan NUR 205Commode NUR 205Ostomy care NUR 205Straight catheter insertion: M & Fe

NUR 208

Foley catheter insertion: M & Fe NUR 208Foley catheter care: M & Fe NUR 205Condom catheter/care NUR 205Enemas: small volume NUR 208Enemas: large volume NUR 208Fleets enema NUR 208Rectal tubes NUR 208

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Skill Course Taught

Perform: Lab

Return Demo

Perform: Clinical

Urine specimen: clean catch NUR 205Urine specimen: specicath NUR 208Urine specimen: Foley NUR 208Stool specimen NUR 205Stool: occult blood NUR 205Urine: labstix NUR 205Intake/output measurement NUR 205

Mobility & PositioningTurning & positioning NUR 205Transfers NUR 205Ambulation NUR 205Range of motion NUR 205Hydraulic lift NUR 205Assistive devices: walker, canes, crutches

NUR 205

Safe lifting NUR 205Gait belt NUR 205

Nutrition NUR 205Feeding clients NUR 205Insertion of Nasogastric tube (NGT)

NUR 208

Care of feeding tubes NUR 208Tube feedings NUR 208Remove Nasogastric tube (NGT)

NUR 208

Blood glucose monitoring NUR 205Comfort

Massage NUR 205Pain Assessment NUR 205Pain Management NUR 208

Administer MedicationsPrinciples NUR 208Oral meds NUR 208Topical meds NUR 208IM injections NUR 208Subcutaneous injections NUR 208Intradermal injections NUR 208Inhaler NUR 208Nasal instillation NUR 208Ophthalmic instillation NUR 208Ear instillation NUR 208Rectal suppository NUR 208Vaginal suppository NUR 208IV infusion management NUR 208IV site assessment NUR 208Intermittent infusion device NUR 208IV pump NUR 208IV push/bolus NUR 208

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Skill Course Taught

Perform: Lab

Return Demo

Perform: Clinical

IV piggyback NUR 208Hep/saline lock flush NUR 208IV to INT NUR 208D’C IV NUR 208Insert IV NUR 208

Advanced IV CareCentral line care NUR 212PICC care NUR 212Port-a-cath care NUR 212Blood administration NUR 212Total Parenteral Nutrition (TPN) NUR 212Central line dressings NUR 212Administer meds via central line NUR 212Patient controlled analgesia NUR 212Epidurals NUR 212

Wound CareSterile dressings NUR 205Wet to moist dressings NUR 205Wound packing NUR 205Duoderm wound care NUR 205Surgical staple removal NUR 205Suture removal NUR 205Steri-strip application NUR 205J-P drains/care NUR 205Hemovac/care NUR 205Pin site care NUR 205

Respiratory CareOxygen administration NUR 205Incentive spirometer NUR 208Oral/nasal suctioning NUR 208Nasal pharyngeal airway (NPA) insertion

NUR 208

Oral pharyngeal airway (OPA) insertion

NUR 208

Ambu bag/mask NUR 208Peak flow meter NUR 208Sputum specimens NUR 208Advanced Respiratory CareAirway management: Endotracheal Tube

NUR 212

Airway management: Tracheostomy

NUR 212

Chest tube care and management

NUR 212

Endotracheal/Tracheostomy suctioning

NUR 212

Tracheostomy care NUR 212Ventilator care NUR 212

Advanced Assessment Monitoring

Electrocardiogram NUR 212Hemodynamic monitoring NUR 212

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Skill Course Taught

Perform: Lab

Return Demo

Perform: Clinical

Neurologic Assessment NUR 212Pre-op/ Post-op Care

Monitoring Post Op vital signs NUR 208Cough & deep breath NUR 208Positioning post-op NUR 208Hip precautions NUR 208Sequential Compression Device (SCDs)

NUR 208

Doppler to assess pulses NUR 208Pediatric/Labor and

Delivery/Obstetric CareAdminister Medications Principles NUR 211 Dosage calculations NUR 211 OB drip calculations NUR 211 Oral medications NUR 211 Topical medications NUR 211 IM injections NUR 211 Subcutaneous injections NUR 211 Intradermal injections NUR 211 Inhaler NUR 211 Nasal instillation NUR 211 Ophthalmic instillation NUR 211 Otic instillation NUR 211 Rectal suppository NUR 211 Vaginal suppository NUR 211 IV infusion manage NUR 211 IV site assessment NUR 211 Intermittent infusion NUR 211 IV pump NUR 211 IV push/bolus NUR 211 IV piggyback NUR 211 Hep/saline lock flush NUR 211 IV cont to intermittent NUR 211 DC IV NUR 211 Developmental Assessment

Newborn NUR 211 Infant NUR 211Toddler NUR 211School Age NUR 211Adolescent NUR 211Teaching Inpatient NUR 211 Outpatient NUR 211 Well Child NUR 211 Family NUR 211

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Skill Course Taught

Perform: Lab

Return Demo

Perform: Clinical

Physical AssessmentNewborn

Temp: oral NUR 211 Temp: tympanic NUR 211 Temp: rectal NUR 211 Temp: axillary NUR 211 Temp: temporal artery NUR 211 Radial pulse NUR 211 Respiratory rate NUR 211 Blood pressure NUR 211 Breath sounds NUR 211 Bowel sounds NUR 211 Apical pulse NUR 211 Peripheral pulses NUR 211 Integument NUR 211 Level of consciousness (LOC) NUR 211 Oxygen saturation NUR 211 Physical AssessmentPediatricTemp: oral NUR 211Temp: tympanic NUR 211Temp: rectal NUR 211Temp: axillary NUR 211Temp: temporal artery NUR 211Radial pulse NUR 211Respiratory rate NUR 211Blood pressure NUR 211Breath sounds NUR 211Bowel sounds NUR 211Apical pulse NUR 211Peripheral pulses NUR 211Integument NUR 211Level of consciousness (LOC) NUR 211Oxygen saturation NUR 211Physical AssessmentOB

Maternal assessment NUR 211 Electronic fetal monitor NUR 211 Post-partum assessment NUR 211 Comfort Measures Pain assessment NUR 211Non-pharmaceutical measures NUR 211

Note: Beginning Summer 2009—content/course changes are in italics.

Signatures and Initials:

33

__________________________ ___________________________

__________________________ ___________________________

__________________________ ___________________________

__________________________ ___________________________

__________________________ ___________________________

__________________________ ___________________________

__________________________ ___________________________

__________________________ ___________________________

__________________________ ___________________________

__________________________ ___________________________

__________________________ ___________________________

__________________________ ___________________________

_________________________ ___________________________

__________________________ ___________________________

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(Evaluations to be completed as directed by your Clinical Instructor)

35


NUR 205L Mid-Term Self-Evaluation

Student: _____________________________________________

Directions: For each conceptual strand, discuss how you have changed during the first half of this semester. In your discussion, you will be comparing how you were doing in the beginning of this semester to your current abilities. Use the course clinical competencies as a guide to evaluate your growth and accomplishments. Finally, suggest specific strategies for continued improvement that you want to employ in this course through the end of this semester.

Critical ThinkingComparison:

Strategies for Improvement:

Competency:Comparison:


36

CommunicationComparison:


Caring:Comparison:


37

Culture:Comparison:


Learning-TeachingComparison:


Accountability:Comparison:

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Leadership/Management:Comparison:


Additional Comments:

_______________________________________ _____________Student Signature Date

______________________________________ ______________Faculty Signature Date

39


NUR 205L Final Self-Evaluation

Student: _____________________________________________

Directions: For each conceptual strand, discuss how you have changed during this semester. In your discussion, you will be comparing how you were doing in the beginning of this semester to your current abilities. Use the course clinical competencies as a guide to evaluate your growth and accomplishments. Finally, suggest specific strategies for continued improvement that you want to employ in future semesters.

Critical ThinkingComparison:


Competency:Comparison:


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CommunicationComparison:


Caring:Comparison:


41

Culture:Comparison:


Learning-TeachingComparison:


Accountability:Comparison:

42


Leadership/Management:Comparison:


Additional Comments:

_______________________________________ _____________Student Signature Date

______________________________________ ______________Faculty Signature Date

43

NORTHERN ARIZONA UNIVERSITY SCHOOL OF NURSINGCLINICAL PERFORMANCE EVALUATION CRITERIA

SCALE/LABEL STANDARD NURSING

CARE

PERFORMANCE QUALITY

PERFORMANCE CAPABILITIES ASSISTANCE

INDEPENDENT5

SafeAccurate

Proficient, coordinated, confident. Expedient use of time.

Consistently able to determine outcomes, conceptualize and assess patient needs, select appropriate interventions, and evaluate care using the nursing process. Consistently able to appropriately apply knowledge, set priorities, problem solve and make decisions based on sound evidence, judgment, and common sense during nursing care activities.

Without direction/ cues

SUPERVISED4

SafeAccurate

Efficient, coordinated, confident. Expedient use of time.

Usually able to determine outcomes, conceptualize and assess patient needs, select appropriate interventions, and evaluate care using the nursing process. Usually able to appropriately apply knowledge, set priorities, problem solve and make decisions based on sound evidence, judgment, and common sense during nursing care activities.

With occasional physical or verbal direction/cues

ASSISTED3

Safe Accurate

Partial performance of nursing care. Inefficient or uncoordinated. Delayed time expenditure.

Frequently able to determine outcomes, conceptualize and assess patient needs, select appropriate interventions, and evaluate care using the nursing process. Frequently able to appropriately apply knowledge, set priorities, problem solve and make decisions based on sound evidence, judgment, and common sense during nursing care activities.

Frequent verbal and/or physical direction/cues

MARGINAL2

Questionable safety and

questionable accuracy

Unskilled or inefficient nursing care. Considerable and prolonged time expenditure.

Occasionally able to determine outcomes, conceptualize and assess patient needs, select appropriate interventions, and evaluate care using the nursing process. Occasionally able to appropriately apply knowledge, set priorities, problem solve and make decisions based on sound evidence, judgment, and common sense during nursing care activities.

Continuous verbal and/or physical direction/cues

DEPENDENT 1

UnsafeInaccurate

Unable to demonstrate nursing care. Lacks confidence, coordination and efficiency. Extensive time expenditure.

Unable to determine outcomes, conceptualize and assess patient needs, select appropriate interventions, and evaluate care using the nursing process. Unable to apply knowledge, set priorities, problem solve and make decisions based on sound evidence, judgment, and common sense during nursing care activities.

Continuous verbal and/or physical direction/ cues

PERFORMANCE RATINGS MUST BE 3 OR ABOVE IN ALL CLINICAL EVALUATION AREAS TO RECEIVE A PASSING GRADE FOR THE COURSE. Reference: Montana State University Northern, Dept. of Nursing. Retrieved April 22, 2007 from: http://www.msun.edu/academics/nursing/Clinical%20Forms/BSN%20Forms/2005%20NURS%20349%20Skills%20Evaluation.pdf

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http://www.msun.edu/academics/nursing/Clinical%20Forms/BSN%20Forms/2005%20NURS%20349%20Skills%20Evaluation.pdf

http://www.msun.edu/academics/nursing/Clinical%20Forms/BSN%20Forms/2005%20NURS%20349%20Skills%20Evaluation.pdf

Northern Arizona University School of NursingNUR 205L -- Student Clinical Evaluation

Student Name: ___________________________Course: ____________________ Semester: ________________Evaluator Name: __________________________Evaluator Position: Clinical Faculty ___ Course Faculty ___ Course Coordinator ___RATING: The student's performance, related to each BSN outcome strand, will be rated using the criteria in the Clinical Evaluation Criteria rubric, on a 1 (dependent) to 5 (independent) scale. Performance ratings must be 3 or above in all areas to receive a passing grade for the course.

Student has demonstrated required competencies (listed in clinical syllabus) derived from the following strands:

Ratings:

Midterm Final

Comments to support rating (required for rating of 3 or below)

Accountability

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Clinical Competency

Critical Thinking

Caring

Culture

Communication

Learning/Teaching

Management/Leadership

See the clinical syllabus for detailed descriptions of clinical competencies for each specific nursing course.

_____________________________________ _____________________________________Student signature/date Faculty signature/date

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NORTHERN ARIZONA UNIVERSITYSCHOOL OF NURSING

EVALUATION OF CLINICAL LEARNING EXPERIENCENUR 205L

The purpose of this questionnaire is to help faculty make your clinical experience meaningful. Your answers are used to make decisions about the best clinical placement for a particular course. We also welcome comments.

Clinical Agency: Semester/Year:

Please rate your clinical experience using a number from 1 to 7. For each item, circle the number that best describes your experience.

Example:I understand how to complete this questionnaire:Completely 1 2 3 4 5 6 Not at all

LEARNING OPPORTUNITIES: COMMENTS

1. I had the opportunity to apply theory from classes to the clinical experience:

Rarely 1 2 3 4 5 6 7 Every Clinical.

2. I was able to have many different learning experiences:

Many 1 2 3 4 5 6 7 Very Few

3. The experience improved my understanding of holistic nursing

Very Much 1 2 3 4 5 6 7 Not At All

STAFF 1. The staff contributed to my learning:

A Great Deal 1 2 3 4 5 6 7 Not At All 2.The staff was supportive of my learning:

Very 1 2 3 4 5 6 7 Not At All Supportive Supportive

3. From my perspective, the majority of the professional staff were excellent role models:

Excellent 1 2 3 4 5 6 7 Poor

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PHYSICAL SPACE COMMENTS1. Travel was a

Financial 1 2 3 4 5 6 7 No Hardship Hardship

Family 1 2 3 4 5 6 7 No Hardship Hardship ______Not applicable to this experience2. Space for reading charts, reading reference materials, conferencing was

Adequate 1 2 3 4 5 6 7 Inadequate

______Not applicable to this experience2. Safe space for personal belongings was

Available 1 2 3 4 5 6 7 Not Available

______Not applicable to this experience3. Meals were

Available 1 2 3 4 5 6 7 Not Available ______Not applicable to this experience

We would appreciate your comments on the above questions and the following:

1. What was the most challenging part of the clinical experience?

2. Overall, what is the most important issue that the faculty needs to be aware of regarding this clinical experience?

3. Please share any other thoughts you have about the clinical experience or things that you think would make this learning experience more beneficial.

THANK YOU!

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C:/My Documents/NAU/NUR 205 FALL 2010/ NUR 205 L_TUCSON_Clinical Syllabus_FALL 2010_2010-08-15_bt_mg.doc (8/15/10bt) Final Version: 8/10

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