Semester Design Pediatric Revised - Feedback Remko (2)

8/2/2019 Semester Design Pediatric Revised - Feedback Remko (2)

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Semester design

PEDIATRIC

NURSINGPlus program for Nursing

Indonesia

Involved universities:Faculty of Nursing, University of Indonesia

Nursing program faculty of Medicine University of Diponegoro Semarang

Nursing program, faculty of Medicine, University of Airlangga, SurabayaNursing program, faculty of Medicine, University of Brawijaya, MalangNursing program, faculty of Medicine, University of Udayana, Denpasar

Nursing program, faculty of Medicine, University Hasanudin, MakasarNursing program, faculty of Medicine, University Andalas, Padang

Nursing program, faculty of Medicine, University Syah Kuala,Banda Aceh

Indonesia

Version 0.1, November 20072, December 2008


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CONTENTS

Introduction .................................................................................................................................3

Core task and level ......................................................................................................................41.Blueprint of the semester ...................................................................................................... 13

2.Core Assignments .................................................................................................................. 15

..................................................................................................................................................15

Knowledge ................................................................................................................................ 24

Assessment ................................................................................................................................ 27

Planning .................................................................................................................................... 30

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Introduction

The curriculum for the plus program for Paediatric Nursing for several universities in Indonesia was setup in a series of workshops in November 2007. The setup of the program is part of the projectDevelopment of Nursing Specialization, which was funded by Nuffic-NESO. This document is one ofthe results of this series of workshops, which was attended by participants of all universities in

Indonesia as mentioned. During the workshop series six plus programs have been developed: CriticalCare, Paediatrics, Maternity, Gerontology, Adult Nursing and Mental Health. This document describesthe design of the semester of Paediatric Nursing. The results preceding Semester Design are thegathered in the Curriculum Profile.

The design of the plus program is based upon guidelines, as mentioned in the Curriculum Profile.

In the Professional Profile (part of the Curriculum Profile) the tasks a professional should be able toperform in practice are described and the core task is defined for the Paediatric Nursing professional.In the Curriculum Profile the core task of the curriculum are detailed. For each core task level wasdefined. One plus program contains one semester.

The Curriculum Profile provides information on the core task that is central to this semester. This Core

task is: To provide direct nursing care using nursing process approach for hospitalized children withchronic, acute, and life threatening illnesses. To be able to design the core assignments of thesemester more information is needed, so a task analysis was done. Then the final core assignmentwas designed and assessment of the final assignment and therefore of the semester was considered.The next steps were designing the complete series of core assignments in the semester, drafting theassessment plan and adding the knowledge and skills to the design.After the core assignments were detailed, an assessment plan was made, and knowledge subjectsand routine skills were defined. Finally a draft planning was made.

The next chapter contains the core task and the description of the level (chapter 2). A completeoverview of the semester is given in (chapter 3): semester design, which includes the task hierarchythat is applicable to this semester. Chapter 4 describes all core assignments of the semester.Knowledge (chapter 5) and Routine skills (chapter 6) clarify the supportive information and skills to beacquired. Chapter 7 describes how students will be assessed. A draft planning completes thesemester design (chapter 8).

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Core task and level

The next, core task will be the focus of learning:

The main task is: to provide direct nursing care using nursing process approach for hospitalizedchildren with chronic, acute, and life threatening illnessesSince, there is only one main task that the students will be trained for three different type of illnesses,we divide the core task into three parts based on the types of diseases or illnesses. Therefore, therewill be three core tasks which derived from one main task for three different terms which should becompleted by the students of paediatric program.

In the following part, the core tasks are described in terms of knowledge

Core task A :To provide direct nursing care using nursing process approach focused on Special Treatment forhospitalized children with chronic illnesses, such as:

a. Patient with heredity diseases (thalassemia, hemophilia)b. Patient with congenital diseasesc. Patient with malnutrition problems

Related professional task action/process (verb) and result/product

- to assess the patient health status- to formulate nursing diagnosis based on the assessment data- to develop nursing care plan for the patient- to implement the nursing care plan- to evaluate the nursing care plan- to document and to report the patients nursing care delivery

result/product:- the document of: 1) nursing assessment, 2) nursing care plan,

3) the nursing progress report

- the fulfilment of patients needs as stated by the patients andfamily

- the patients health problems are solved based on patient andfamily evaluation

- the satisfaction of the patient and family according to thenursing care services as stated by the patient and family

-

Assessment criteria (how canone know if one performs thecore task properly?)

Complex skills

- Skill full- accurate- gentle- respond quickly based on patient needs

- based on SOP (standard operation procedures)- involve the patient and family if needed

Attitude- caring- empathy- independent- able to work in team or group- able to work under pressure- self confident- problem solver, not problem maker

Character- helpful- active and diligent

- smart- creative and full of initiative

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- less anxiety or panic- curious- self directed person

Knowledge items (whichknowledge items are related

to this core task? What doessomeone need to know inorder to perform the coretask?) (use nursing curriculaitems)

Knowledge related to

- the chronic diseases suffered by the children (patho physiology

of the diseases):a. heredity diseasesb. congenital diseasesc. malnutrition problemsd. pain management

- the analytical thinking of paediatric nursing care for patient withchronic diseases

- the specific interventions and procedures in handling thepaediatric patients who are suffered from the chronic diseases

- the nursing process approach for paediatric nursing care,specifically the phase of assessment, diagnosing, and planning

Skills (which routine skills are

necessary to perform the coretask?) (use nursing curriculaitems)

- Assessment skills:

how to interview or communicate with baby and toddler (heteroanamnesis)

how to conduct physical exams for baby and toddler

how to conduct Denver test on baby to pre school agediagnostic test:1) how to draw blood intravenously from baby;2) how to assist LP/BMP procedure

How to make interpretation and analysis for all the findingabove

How to manage pain in children- Specific Skills:

Maintaining IV therapy for children

Fluid balance for baby to school age

Phototherapy

Blood transfusion for children with haemophilia

Inserting IV-line for baby

Inserting IV-line for toddler

Administering injection (IM, SC, IV) for babies and toddler

Complex wound care and stoma care

- Nursing interventions for specific illnesses/ diseases:

patient with congenital disease ( heart, GI, urinary)

patient with chronic heredity illnesses, such as thalasemia,

and hemofilia patient with malnutrition problems

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Core task B:To provide direct nursing care using nursing process approach focused on Special Treatment forhospitalized children with acute illnesses, such as:

- Patient with Fever with seizure

- Patient with Pneumonia

- Patient with Meningitis/encephalitis- Patient with dehydration

- Patient with Sepsis- Patient with tetany

Related professional task action/process (verb) and result/product


result/product:- the document of: 1) nursing assessment, 2) nursing care plan,

3) the nursing progress report

- the fulfilment of patients needs as stated by the patients andfamily

- the patients health problems are solved based on patient andfamily evaluation


Assessment criteria (how can

one know if one performs thecore task properly?)

Complex skills

- skilful- accurate- gentle- respond quickly based on patient needs- based on SOP (standard operation procedures)- involve the patient and family if needed

Attitude- caring- empathy- independent- able to work in team or group- able to work under pressure- self confident

- problem solver, not problem makerCharacter

- helpful- active and diligent- smart- creative and full of initiative- less anxiety or panic- curious- self directed person


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Knowledge items (whichknowledge items are relatedto this core task? What doessomeone need to know inorder to perform the coretask?) (use nursing curricula

items)

Knowledge related to

Patophysiology of the diseases (acute illnesses) such as- Pneumonia- Meningitis/encephalitis- Dehydration- Sepsis

- Tetany

the analytical thinking of paediatric nursing care for patient withacute diseases and patient safety

the specific interventions and procedures in handling the paediatricpatients who are suffered from the acute diseases

the nursing process approach for paediatric nursing care,specifically the phase of assessment, diagnosing, and planning

Skills (which routine skills arenecessary to perform the coretask?) (use nursing curriculaitems)

- Assessment skills:

how to identify the signs and symptoms of respiratory distress

how to recognize the seizure and shock symptoms

how to analyse the abnormal vital signs

how to perform first aid for the emergency situation

how to interpret the blood gasses analysis and electrolytefindings

how to determine the level of dehydration- Specific Skills:

Measuring the fluid demands

Measuring and correcting the acid-base balance

Performing inhalation and suction Monitoring the intraoseus fluid procedure

Providing appropriate position for patient with respiratoryproblems

Performing patient safety to prevent injury- Nursing interventions for specific illnesses/ diseases:

patient with alteration in acute respiratory system (pneumonia)

patient with alteration in fluid electrolyte balance,

patient with dehydration

patient with seizure with fever

patient with sepsis

patient with tetany

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Core task C:To provide direct nursing care using the nursing process approach focused on special treatment forhospitalized children with life threatening illnesses, such asa. Cancer

b. HIV/AIDSRelated professional task action/process (verb) and result/product


result/product:- the nursing document of: 1) nursing assessment, 2) nursing

care plan, 3) the nursing progress report

- the fulfilment of patients needs as stated by the patients andfamily- the patients health problems are solved based on patient and

family evaluation


Assessment criteria (how canone know if one performs thecore task properly?)

Complex skills- skilful- accurate- gentle- respond quickly based on patient needs- based on SOP (standard operation procedures)

- involve the patient and family if neededAttitude

- caring- empathy- independent- able to work in team or group- able to work under pressure- self confident- problem solver, not problem maker

Character- helpful- active and diligent- smart- creative and full of initiative- less anxiety or panic- curious- self directed person


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Knowledge items (whichknowledge items are relatedto this core task? What doessomeone need to know inorder to perform the core

task?) (use nursing curriculaitems)

Knowledge related to- patophysiology of the diseases:

Cancer

HIV/AIDS

- the analytical thinking of paediatric nursing care for patient lifethreatening illnesses

- the concepts of universal precaution and palliative care

- the specific interventions and procedures in handling thepaediatric patients who are suffered from life threateningillnesses (universal precaution)

- the nursing process approach for paediatric nursing care,specifically the phase of assessment, diagnosing, and planning

Skills (which routine skills arenecessary to perform the coretask?) (use nursing curriculaitems)

- Assessment skills:- performing anthropometrics assessment- assessing pain level- Performing health assessment (physical and laboratory) for

patient with cancer and HIV/AIDS- Assessing sign and symptoms of opportunistic infection- Assessing the obedience level of patient

- Specific Skills:

Isolation techniques

Monitoring side effect Chemotherapy

Maintaining TPN (total parenteral nutrition)

Performing playing therapy

Performing standard procedure for HIV/AIDS

- Nursing interventions for specific illnesses/ diseases:

patient with cancer,

patient with HIV/AIDS

The core task at above described level results in the following Task Hierarchy (Figure1):

Figure: Task Hierarchy


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Task Hierarchy, part 1


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Task Hierarchy, part 2

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2.1.Different levels of the core task complicating factorsThe core task can be divided into different levels. Firstly complicating factors are stated. Eachcomplicating factor can be divided into easy, moderate and difficult level. As a choice for this program,the end level is shown in bold.

These are the specifications of the level that is applicable to the Core Task:

Complicating factorEasy/Beginner Moderate/Intermediate Difficult/Expert

Age of the children:

- Communications

with patients

- How to handle the

patients

School age/ teenage Pre school age Baby /toddler

Severity of illness mild Moderate Severe

Number of patient being

cared for a working

time (shift)

1 2-4 More than 5

Number of health

problems for each

patient

1-2 3-5 Many

Type of wardpoliclinic Regular High Care

The nature of illnessNo complications With complication With complications

Skills for nursing actionCommunication and

physical assessment

skills

Analytical thinking.

invasive

Communication,

assessment, analytical

thinking and Invasive

Type of documentationSelf reflection report Case analysis report Portfolio


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1. Blueprint of the semesterThe next table will show an overview of all subjects in the plus program:

Item Short description Chapter Core taskand coreassignmentsrelated t

A. Term 1 Core task: To provide direct nursing care usingnursing process approach for hospitalized children withchronic diseases

B. Term 2 Core task: to provide direct nursing care usingnursing process approach for hospitalized children with acuteillnesses

C. Term 3 Core task: to provide nursing care for hospitalizedchildren with life threatening illness

Core assignments consist of:1. Overview about how to provide nursingcare for hospitalized children using nursing process approach(from assessment to evaluation)

2. Completion task: conduct anassessment to children with chronic illnesses

3. Completion task: develop nursing careplan for children with acute illnesses

4. Completion task: specific nursingintervention and evaluation for children with life threateningillnesses

5. Provide comprehensive nursing care forhospitalized children

4

Knowledge(nonroutine)

A.1. The concepts of communicationand pediatric nursing

concepts of atraumatic careconcepts of nursing process4. Concepts physical assessment in pediatric patient and

interpration dataCritical Reasoning in nursing care

B.1. Specific intervention and procedure in handling pedatric patient

with chronic, acuteand life threatening illnesses

2. Decision making and evaluation the effectiveness of therapy

5

Routineskills

Term 11. Assessment skills:

how to interview or communicate with baby and toddler(hetero anamnesis)


how to conduct Denver test on baby to pre school age

diagnostic test: how to draw blood intravenously from

toddler patient

2. Specific Skills:

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Isolation technique for chronic heredity diseases

Phototherapy


Prevention of injury from seizures

Isolation technique for acute illnesses

Inhalation therapy

Chemotherapy

Assist patient undergoing radiotherapy

Maintaining TPN

Tracheostomy care

Complex wound care

Resuscitation Heart and Lung for paediatric patient

Term 23. Nursing interventions for specific illnesses/ diseases:


patient with chronic heredity diseases, such as thalasemia,

haemophilia

patient with malnutrition problems

patient with alteration in acute respiratory system

(pneumonia, diphtheria)

patient with alteration in fluid electrolyte balance,

patient with alteration of GI (diarrhoea, poisons)


patient with DHF (Dengue Hemorrhagic Fever)

patient with Fever with seizure

patient with Meningitis/encephalitis

high risk newborn: Hyper billirubinemia, BBLR, respiratorydistress

patient with sepsis

Term 34. Mastering in comprehensive care plans for the hospitalisedchildren with chronic, acute and life threatening illnesses

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2. Core AssignmentsIn the next Tables, the core assignments will be described. There is one Table for each Core

Assignment.

Before starting the program, the student should complete the personal assignment.Personal assignment : to develop a profile for the PDP (Personal Development Program)

To do Action/Result

By the end of the meeting, the students will be able to develop their personalprofile based on their competencies and experiences in clinical practices in orderto adjust their individual learning process during pursuing the certification programin paediatric nursing

Situation: Students comprehend about the profileCompose a personal profile based on the specific format:

o What Knowledge, Skills, Attitudes that students already have

(competencies)o What experiences that students already have ( include inside and

outside class/ school activities)o What should the students focus on to achieve during the plus

program based on their competencies and experience (students personalgoals)

Conditions - This assignment must be completed by the students before the program begin- They should submit their personal profile at the first meeting or classroom

activities

Assessmentcriteria

Product:Process:

Assessment criteria:- Product : Document of personal profile

- The document should consist of:o Competencies already owned by students

o Experiences

o Personal plan or personal learning goals for their personal study

during their certification program in paediatric nursing (the responsibility toachieve this plan is under the students themselves)

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Core AssignmentsThe following are description of the core assignment during the plus program.

Core Assignments consist of:

1. Description of Core Assignment 1: Overview about how to provide nursing care forhospitalized children using nursing process approach (expert example from nurses whom

successes in caring patient)2. Description of Core Assignment 2: Completion task: conduct a comprehensive

assessment to hospitalized children with chronic illnesses

3. Description of Core Assignment 3: Completion task: develop nursing care plan forhospitalized children with acute illnesses

4. Description of Core Assignment 4: Completion task: specific nursing intervention andevaluation for hospitalised children with life threatening illnesses

5. Description of Core Assignment 5: provide comprehensive nursing care for hospitalizedchildren and complete documentation

Core Assignment 1: Overview of nursing care for hospitalized children using nursing processapproach

To doaction/result

After the exploration, the Students will understand about:

- steps of nursing process approach

- the tasks of the paediatric nurse

- the nursing interventions specific to the diseases

Result: Students has an overview about nursing care for hospitalized children

- Students discussion within groups of students which facilitated by a

teacher who also act as an expert in paediatric nursing for 2 hours

Situation: Students explore their knowledge about nursing care for hospitalized childrenwith their colleagues in the classroom

Methods of delivery(choose one of these methods)1. Teacher act as an expert in providing nursing care and direct open

discussion with students2. Students sharing experience during their bachelor study about how to

deliver nursing care3. Using PBL approach

Conditions Pre conditions of students: Before the interaction with the teacher, the

students already have experience working in paediatric clinical setting duringtheir bachelor study; assessment of the students competency based on theirpersonal profile

Conditions to perform task: discussion within groups of students facilitated by ateacher who also act as an expert in paediatric nursing for 2 hours

- Number of students in a group: 5 students- Students Presentation about the result of group discussion (20 minutes)- The first week of program (in school)

Assessmentcriteria Product:Process:

Assessment criteria:

Product :

Written/computer typed group report in 2500-3000 words, will be submitted bynext week

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The criteria for product are:a) completeness of nursing process approach being usedb) consider the psychosocial aspect of the childrenc) includes the concept of play and non traumatic approach innursing care

Process

Active involvement for every students in group discussion

Core Assignment 2: Completion task: conduct comprehensive assessment to a number ofpatient with chronic illnesses

To do action /result:

The student will be able to

interview or communicate with baby and toddler (hetero anamnesis)

conduct physical exams for baby and toddler

conduct Denver test on baby to pre school age

diagnostic test:1) how to draw blood intravenously from baby;2) how to assist LP/BMP procedure

make interpretation and analysis for all the finding above

manage pain in children

Situation 1. Skills lab- trains physical assessment with simulated patient in couples

- trains children development test using DDST format with simulated patientin couples

2. Clinical practice- assess the patient with heredity disease (school age children)- assess the patient with congenital disease (baby-toddler)

- assess the patient with malnutrition (pre school school age children)

Conditions Skills lab:

- simulated patient is a voluntary patient- conduct complete physical assessment in 20 minutes per patient (simulated)

for 3 patients- conduct DDST test for 30 minutes per patient (simulated) for 3 patients

Clinical practice:- assess the patient with heredity disease (school age children): 3 patients- assess the patient with congenital disease (baby-toddler): 3 patients

- assess the patient with malnutrition (pre school school age children): 3patients

Complete the assignments: at the week seven


Assessment Criteria:

Product:

1. Document of nursing assessment using assessment format attached withthe patient record. These documents will be assessed by the clinicalinstructor

2. Presentations slides: summary about the experience in assessing thepatients for students presentations sessions at school

Criteria of the document:1. The assessment report should be SMART (specific, measurable,

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achievable, reasonable/realistic, time bound) based on the patientconditions

2. Documents are ready to evaluate or assess by the clinical instructor everyday

Criteria for Process Assessment:

1. Selection of the patient being cared based on the type of illness (heredity,congenital and malnutrition)

2. During assessment, students will demonstrate the following aspects: 1)utilize appropriate communications technique with the patients; 2)consider the psychosocial aspect of the children (holistic approach); 3)utilize the concept of play, and non traumatic approach in assessing thepatient. (observation sheets needed)

3. Every students may be assess by the clinical instructor according to theirpersonal pace, however by the end of second week program they shouldaccomplish the learning objectives

3. Core Assignment 3: Completion task: the students should develop nursing care plan for the patientwith acute diseases

To do action / result:

After completion the task, the student will be able to develop nursing care plan forpatient with :

1. DHF2. Fever with seizure3. Pneumonia

4. Meningitis/encephalitis5. GI problems: diarrhoea, poisons,6. Sepsis

Action/nursing activity :1. Interpreting patient assessment data2. Formulate nursing diagnosis based on data3. Prioritise nursing diagnosis4. Set patient objective of care based on diagnosis5. Define the outcomes for each diagnosis.6. Determine nursing intervention needed to overcome the problem.

Situation Setting: Clinical practice

Knowledge needed :A. Concepts related1. Nursing care of paediatric patient with DHF2. Nursing care of paediatric patient with seizures3. Nursing care of paediatric patient with pneumonia4. Nursing care of paediatric patient with GI problems5. Nursing care of paediatric patient with sepsis

B. Specific intervention1. Identify nursing intervention for patient with DHF2. Identify nursing intervention for patient with seizures3. Identify nursing intervention for patient pneumonia4. Identify nursing intervention for patient with GI problems

5. Identify nursing intervention for patient with meningitis6. Identify nursing intervention for patient with sepsis

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Conditions Clinical settingBased on the assessment data of the patient, the student develop nursing careplan for the patient using the steps of formulating the diagnosis and developingnursing care plan listed above. The minimum of two nursing care plan for eachtype of illnesses should be developed

The assignment must be completed on week ten



Product :Document of nursing care plans using provided format

Criteria of the document:

1. The nursing care plan document should be SMART (specific,measurable, achievable, reasonable/realistic, time bound) based on thepatient conditions and needs

2. The patient care plan should consider the patient as unique individualand holistic person

3. Documents are ready to evaluate or assess by the clinical instructorevery day

1. Description of Core Assignment 4: Completion task: conduct specific nursing intervention andevaluation for hospitalized paediatric patients with life threatening illnesses

To do action / result:

After completion the task, the students will be able to perform /conduct specificintervention to overcome the health problems for patient with:

1. HIV/AIDS,2. Cancer

Action to do:1. communicate with patients and family2. perform independent nursing action3. perform dependent nursing action4. perform collaborative action5. refer the patient to other appropriate health provider if needed6. counsel the family7. educate patient and family

Situation Setting:1. Skills lab for train specific interventions with models or simulated patient2. Clinical practice for train specific interventions with real patients3. School (classroom) for presenting the experiences

Knowledge needed :A. Concepts related

1. Nursing care of paediatric patient with HIV/AIDS

2. Nursing care of paediatric patient with Cancer

B. Specific intervention

1. Nursing interventions for specific illnesses/ diseases:

patient with cancer

patient with HIV/AIDS

2. Specific Skills needed: Isolation techniques for patient with low immune status (high risk)

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Chemotherapy

Assist patient undergoing radiotherapy

Maintaining TPN

Tracheostomy care

Complex wound care

Conditions Skills lab:

1. Each student may train their skill related to skills needed for implementingnursing care for patient using models or simulated patient.(see list of skillsabove )

2. The skills of the student will be asses by laboratory instructor/teacher.( needlist of nursing procedures/SOP)

Clinical setting1. Each day of clinical work the students must provide nursing care for a group

of patient (3-5 patients)2. The students may select the patients according to their needs3. Based on nursing care plan of each patient, the student conduct nursing

interventions (including dependent, independent, collaborative nursinginterventions, counselling, referring, or educating the patient and family) forpatient with

a. HIV/AIDS,b. Cancer

4. Each day activities (progress report of the patients) should be written downin the log book using SOAPIE/DAR formats

5. The accuracy and time needed for performing every procedures (based onSOP) are observed by clinical instructor using observation sheets

School setting:1. The students must report (present) their summary activities in the class

based on their log book

2. Student presentation is 30 minutes each



Product :

1. Document of nursing progress report according to the patients being caredfor using provided format (SOAPIE/DAR format) are available in theclinical fields. These document will be assessed by clinical instructor;

2. The nursing progress report document should be SMART (specific,measurable, achievable, reasonable/realistic, time bound) based on thepatient conditions and needs;

3. Summary of progress report for classroom presentations. The observation

sheet during presentations will be provided for peer assessment

Process

1. Selection of the patient based on the type of illness ( HIV/AIDS, Cancer )2. Each day of clinical work the students must provide nursing care for a group

of patient (3-5 patients)

3. Students attitude (quick respond , caring and empathy, utilize appropriatecommunications technique with the patients , utilize holistic approach, utilizethe concept of play, utilize non traumatic approach) during clinical practicealso evaluate by clinical instructor using observation sheets .

4. Every students may be assess according to their personal pace, however bythe end of second week program they should accomplish the learning

objectives5. the students may be assessed based on their competency profile, thestudents who are achieving the targets would design their own assessment

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schedule

6. Patients and family satisfaction of student interventions/performance onconducting specific intervention for the patient (instrument for assessingPatients and family satisfaction needed)

7. Students performance scores (observations made by the clinical instructors)includes: 1) for independent action and dependent action: clinical instructor

will observe student performance during performing the procedures; 2) forcollaborative action: case conference report (attended by the healthmember),

5. Description of Core Assignment 5: to provide comprehensive nursing care for hospitalizedchildren and complete the written documentation for the nursing care being provided

To do

action / result:

After completion the task, the students will be able to provide comprehensive nursing

care for patient with: chronic, acute, life threatening illnessesAction to do:

1. perform assessment2. develop nursing care plan3. implement and evaluate the plan4. make documentation5. communicate with patients and family6. refer the patient to other appropriate health provider if needed

7. provide counselling to the family8. educate patient and family

Situation: Real life situation: clinical setting

The students should provide the comprehensive nursing care for a group of

patients with each type of life threatening illnesses. The nursing care ofthese patients is provided by the students since patient admitted to thehospital until they discharge from the hospital.

The criteria of the patients are the patients who have several healthproblems with minimum of moderate severity conditions

Conditions Clinical Practice setting :1. The students could select patients

2. By the end of the clinical practice, the student should provide comprehensivenursing care for patient with: chronic, acute and life threatening illnesses

3. By the end of the clinical practice (seventh week), the students mustcomplete the nursing care documentation for each patient

4. During their clinical practice period the students should perform a minimumof one case conference with the attendance of other health team members5. During their clinical practice period the students should perform a minimum

of one referral for the patient to other health team member based onpatients need.

6. Final assignment is conducted at the end of term period: the eight week offirst term.

During the final assignment, the student will have one randomlyselected patient to be taken care of for the whole week and prepare thecomprehensive nursing documentation of the patient

In a determine time during the final week, the student will beobserved by the clinical instructor and teacher when performingselected procedures.

After the observation finished, there will be an oral examinationbetween the students and clinical instructor & teacher

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School setting:

1. Each student must present their summary of nursing care of the patients inthe class for 30 minutes during the classroom activities. Different casesand/or diseases will be presented each week by different students. Thestudents has an opportunity to present at least one case during the first term

2. By the end of the first term, the student must submit the completedocumentation of the selected nursing care as final assignments

This assignment must be completed on week 18



Product:

1. One documents of comprehensive nursing care for patient with2. Three documents of comprehensive nursing care for patient with

3. One document of health education program for a group of patients with4. One document of case conference report with other health team members

5. One document of referral report to the appropriate health team member

The product criteria:1.The document of comprehensive nursing care should be SMART (specific,

measurable, achievable, reasonable/realistic, time bound) based on patientconditions which includes:a. Literature review related to patient diseaseb. Complete patient assessmentc. nursing care pland. progress report

3. the health education program consist of :a. the objectives of patient educationb. the content or summary of teaching materialsc. the method of patient education

d. the teaching and learning activitiese. the media and resources used

4. the case conference report:a. summary of patient datab. nursing diagnosisc. nursing care pland. nursing care progress and evaluatione. summary of inputs or suggestions from participants during conference

5. the referral reporta. patient datab. nursing action which has been donec. reason for referral

Process criteria3. Students attitude (quick respond, caring and empathy, utilize appropriate

communications technique with the patients, utilize holistic approach, utilizethe concept of play, utilize non traumatic approach) during final clinicalperformance evaluation will be evaluated by clinical instructor and theteacher using observation sheets .

4. An oral examination about the patient case will be conducted after thecompletion of implementation of the procedures. A list of questions will beused by the evaluator which consist of:a. Patophysiology of the diseaseb. patient assessmentc. nursing diagnosisd. nursing care plan for selected nursing diagnosise. evaluation of patients condition3. Observation during case conference will be conducted by the clinical

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instructor using the observation format includes:a. clarity of presentationb. the accuracy of time managementc. the clarity and accuracy in answering questions raisedd. the appropriate media and resources being used

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Knowledge

In this chapter the knowledge to be acquired by the students is described.

Knowledge

item(Non Routine)

Short description

Whatknowledge?

A.1. The concepts of communication and pediatricnursing

concepts of atraumatic careconcepts of nursing processConcepts physical assessment in pediatric patient and interpration dataCritical Reasoning in nursing care

B.

1. Specific intervention and procedure in handling pedatric patient with chronic, acuteand life threatening illnesses2. Decision making and evaluation the effectiveness of therapy

How will thestudentacquire theknowledge?

Since the students already learn the knowledge during their bachelor study, in theplus program, the students only learn the knowledge in depth. Therefore, thestudents will explore their knowledge about nursing care for hospitalized childrenwith chronic, acute and life threatening illnesses according to term, through internetsearching or study literature in the library and discuss it with their colleagues.

Methods of delivery1. Teacher act as a coach in facilitating student in identify the action plan for

student that the student want to achieve

2. Students sharing experience during their bachelor study about how to delivernursing care with children

3. Using PBL approach: the students will divided into small group, and eachgroup should prepare literature study about each type of diseases.

4. Each group has to present their paper during the classroom activity. Thisactivity will be assess by peer group and the teacher

How muchtime will it

take thestudentapproximately?

Per term, classroom activities= 16 hours/term. The length of each term is 6 weeks.Every week there will be one day activities in the school. Therefore every week there

will be an approximately 160 minutes for learning theory or acquire the knowledgeand coaching group or individual coaching if needed (3 hours interactions).

When willthe studentacquire theknowledge?

Every week there will be one day classroom activities at school for a period of 160minutes. During this activity the students will be directed to acquire the knowledgelisted in planning table.

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6. Routine Skills

In this chapter the routine skills to be acquired are described.

Routine skillaspect

Short description

What routineskill?

Term 11. Assessment skills:

how to interview or communicate with baby and toddler (heteroanamnesis)


how to conduct Denver test on baby to pre school age

diagnostic test: how to draw blood intravenously from toddler patient

2. Specific Skills:







Isolation technique for chronic heredity diseases

Phototherapy


Prevention of injury from seizures

Isolation technique for acute illnesses

Inhalation therapy

Chemotherapy

Assist patient undergoing radiotherapy Maintaining TPN

Tracheostomy care

Complex wound care

Resuscitation Heart and Lung for paediatric patient

Term 23. Nursing interventions for specific illnesses/ diseases:


patient with chronic heredity diseases, such as thalasemia, haemophilia

patient with malnutrition problems

patient with alteration in acute respiratory system (pneumonia, diphtheria) patient with alteration in fluid electrolyte balance,

patient with alteration of GI (diarrhoea, poisons)


patient with DHF (Dengue Hemorrhagic Fever)

patient with Fever with seizure

patient with Meningitis/encephalitis

high risk newborn: Hyper billirubinemia, BBLR, respiratory distress

patient with sepsis

Term 34. Mastering in comprehensive care plans for the hospitalised children with

chronic, acute and life threatening illnesses

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How will thestudent train theroutine skill?

For each term, In the Skills laboratory practice:

discuss with laboratory instructor about POA

identify and prepare equipment for procedures

train specific skills with models or simulated patients

learn the standard operation procedures (SOP)

coached during exercises by laboratory instructor

skills lab examination

For each term, In Clinical practice

discuss with clinical instructor/ teacher

coached during clinical practice by clinical instructor

provide direct nursing care activity for patients

write report and nursing documentation

case conference with other health team member

manage patient care (team work collaboration, utilize referral system)

other clinical activity

clinical examination by the clinical instructor and the university teacher(only once in the end of term 3)

How much timewill it take thestudentapproximately?

1. Skills Laboratory practice

- Total credits for skills lab = 1 credit/term = 32 hours/term- The length of each term is 6 weeks. Every week there will be oneday activities in the school for theory and practicum. Therefore every weekthere will be an approximately 320 minutes for learning skills in the skillslaboratory (5 hours, 20 minutes of lab interactions)

2. Clinical Practice

- Total credits for clinical practice = 3 credit/term = 192 hours/term- The length of each term is 6 weeks. Every week there will be fourday activities in clinical practice. Therefore every week there will be anapproximately 32 hours of clinical working.

When will thestudent train theroutine skill?

Each term (6 weeks period).1) At school: one day per week 5 hours + 20 minutes: skills lab practice andclassroom activity2) Clinical practice: four days a week (8 hours per day) working in hospitals(paediatric ward) including the coaching group

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Assessment

In this chapter the assessment of this semester is described.

The assessment plan is given as follows:

CA1: Overview of Nursing Process

Method of Assessment- Groups reports of 1500 words- Feed back from teacher

CA2: Conduct Comprehensive assessment for chronic illnesses

Method of Assessment:- case report of nursing assessment

- Peer group review

CA3: Develop nursing care plan for acute illnesses

Method of assessment:- Nursing care plan report- Self reflection- Presentation

CA4: Provide specific nursing intervention and evaluation for hospitalised childrenwith life threatening illnesses

Method of assessment:- Case report- Feed back- Peer review

CA5: provide comprehensive nursing care for hospitalized children and completedocumentation

Method of Assessment:- Portofolio

- Feed back- Self reflection- Clinical Examination

Project:

Coaching Project (after week 13):Each student should plan a coaching program for bachelor student. The studentshould design a brief plan about coaching implementation. The teacher and clinicalinstructor will observe the student performance in implementing the coaching.Feedback will be given by teacher, CI and bachelor student whom get coached.

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Written Exam:Written Exam would be consists of 100 Multiple choice questions. The materials forwritten exam: communication, critical reasoning, health assessment and concepts ofatraumatic care.

Big evaluation:Big evaluation consist of clinical examination, self reflection and evaluation for thequality of competency their portfolio and the log book.

For the clinical practice each student should make an action plan about thecompetency they want to achieve. The action plan written in the log book, every feedback also will written in the log book signed by teacher or CI.

Assessment:

Attendance : 10 %

Presentation : 5 %- Content clarity (35 %)- Media (20 %)- Performance (20 %)- Argumentation (25 %)

Project : 5 %CA (Completeness) : 10 %

GRADING:

Written Exam : 30 %Clinical Exam/Big Evaluation : 40 %

A. Nursing Care Plan: 55 %1. Nursing Documentation: 25 %- Assessment (5 %)- nursing care plan (5 %)- progress report (5 %)- referral report (5 %)- case conference report (5 %)2. Final report on nursing care (10%)

3. Participation and attendance (15 %)

B. Knowledge: Concepts & theory related to 15 %1. case study (10%)2. Presentation: peer assessment (5 %)

C. Skills: Nursing intervention and procedure for acute illnesses = 30 %

1. Clinical observations2. Assessment3. execute specific nursing procedures

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For each assessment, the following criteria are stated:

Assessment Factors: Assessment Criteria perAssessment Factor:

Scoring Rules/Grading

1. Oral presentation (10 %),

consist of:a. presentation: peer

assessment duringclassroom activity (5%)

b. during final examination:oral clinical examination(5%)

1. clarity of speech (10)

2. body language (10)3. readiness (10)4. use of media and references

(10)

5. time management (10)6. deliver presentation

systematically (10)7. ability to utilize or apply

concepts or theory related inanswering questions andjustify the statements:analytical ability (40)

Likert scale:

1 = not available/worst2 = less3 = sufficient4 = good5= excellent- Total Score= (value x

score per item):5- Maximum score =100,

minimum score = 20- Minimum score to pass is

in line with the university orfaculty rules andregulations

- Grading system isaccording to universityrules and regulations

2.Report writing: (45%)- Group academic

paper (10%)

- Patient Assessmentreport (5%)

- Nursing Care plan(5%)

- Progress report (5%)- Referral report (5%)

- Case conferencereport (5%)

- Final report (10%)

1. grammar and spelling (5)2. structure of document (5)

3. clarity of the document (5)

4. specific according to theassignment (10)

5. accuracy of description ofcontent (20)

6. proper references to be used(10)

7. analytical intensity of report(25)

8. originality of the report (20)

3.Skill observations/performance (25%) consistof :During clinical practice(15%)

c. Assessment skillsd. Procedure skills

During final exams (10%)e. Assessment skillsf. Procedure skills

1. precision of action (25)

2. appropriate time being used(15)

3. procedure is done in order orneatly based on SOP (25)

4. efficient in handling materials(10)

5. body language used duringprocedures (15)

6. self confidence (10)

5. Skills lab: OSPE (10%) 1. precision of action (25)

2. appropriate time being used(15)

3. procedure is done in order orneatly based on SOP (25)

4. efficient in handling materials(10)

5. body language used duringprocedures (15)

6. self confidence (1

6.Participation andAttendance (10%) includes

activities inClassroomSkill lab

presence and active involvementin each assignments

- the student must attendthe clinical practice and

skills lab activity for 100 %,where as for a classroomactivity a minimum of 85 %

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Clinical practice

Planning

In this chapter firstly, an assessment planning of the semester is given. Then a more

accurate planning will be given.Week CA Method

AssessmentTeacher Activity Student

Activity

Term 1

1 CA 1Overview

Groupsreports

Provide ExpertexampleGive feedback

ListeningAskingquestionWriting groupreports

Term 2

7 CA2Conductcomprehensiveassessment forchronic illnesses

Case ReportsPeer Review

Provide caseGive FeedbackMarking casereport

ConductassessmentWrite casereport

10 CA 3Develop nursing careplan for acuteillnesses

NCP reportSelf ReflectionPresentation

Give feedback onNCP and studentperformance

Doingcomprehensiveassessment,Analysing dataand

interpretingFormulatingdiagnosis andidentify nursingintervention

Term 3

14 CA4Provide specificnursing interventionand evaluation for lifethreatening

Case reportPeer review

ObserveGive feedback

ConductnursingprocessWrite casereport

StartCoachingProject

18 CA 5Providecomprehensivenursing care forhospitalized childrenand completedocumentation

Clinical ExamPortfolioSelf reflection

Mark theperformanceFeedback

Conductclinical examSubmitportfolioDoing selfreflection

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PLANNING18 WEEKS FOR PEDIATRIC PLUS PROGRAM

Week

s

Integral Line Knowledge

(Theory)

Skills Remarks

Term I

1 CA1: OverviewExpert example

Communication InPediatric Nursing

Communication T : 1 daySL: 1 dayCP: 4 dayspracticeincl. CG

2 Conceptsatraumatic andnursing process

Patient Safety T : 1 daySL: 1 dayCP: 4 dayspracticeincl. CG

3 HealthAssessment

PhysicalAssessment

T : 1 daySL: 1 dayCP: 4 dayspracticeincl. CG

4 Critical reasoningand decisionmaking

Data interpretingand definingdiagnosing

T : 1 daySL: 1 dayCP: 4 dayspractice

incl. CG5 Chronic Illnesses Specificintervention forchronic disease


6 Written Exam Specificintervention forchronic disease


Term II7 CA2: Assessment

for chronic illnessesAcute Illnesses Specific

intervention foracute disease


8 Discussion Specificintervention foracute disease


9 Discussion Specificintervention for

T : 1 daySL: 1 day

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acute disease CP: 4 dayspracticeincl. CG

10 CA3: Develop NCPfor Acute illnesses

Presentation Specificintervention for

acute disease

T : 1 daySL: 1 day

CP: 4 dayspracticeincl. CG

11 Life threateningIllnesses

Specificintervention for lifethreateningdisease


12 Discussion Specificintervention for lifethreatening

disease

T : 1 daySL: 1 dayCP: 4 days

practiceincl. CG

Term III

13 Coaching Coaching T : 1 daySL: 1 dayCP: 4 dayspracticeincl. CG

14 CA4: Interventionand evaluation for

Life threateningillnesses

Discussion PerformanceNursing care for

pediatric andcoaching*coaching project

T : 1 daySL: 1 day

CP: 4 dayspracticeincl. CG

15 Discussion PerformanceNursing care forpediatric andcoaching*coaching project


16 Discussion PerformanceNursing care forpediatric and

coaching*coaching project

T : 1 daySL: 1 dayCP: 4 days

practiceincl. CG

17 Discussion PerformanceNursing care forpediatric andcoaching*coaching project


18 CA5:ClinicalExam:ComprehensiveCare Plan

BigEvaluation