Nursing 208: Health/Illness Transitions in Chronic Illness

Northern Arizona University School of Nursing NURSING 212 Theory Transitions: Acute Health-Illness Spring 2012

Credit Hours: 4 hours weekly in classroom (4 credits) 12 hours weekly in clinical (4 credits)

Prerequisites: NUR 208

Course Description: This course focuses on nursing care of individuals and families in increasingly complex health-illness transitions and continues (from NUR 208) to develop the professional nursing role.

Faculty: Linda Paul, RN, MS, CMSRN Office 104 [email protected] (928) 523-2660 office Office hours: Monday 1000 – 1400 or by appointment

Class Times: Thursdays 0800 – 1200pm room 124

Student Learning Outcomes: Upon completion of the course the student will be able to:

Clinical Practice and Prevention

•Develop sound nursing judgment using expanding nursing and scientific knowledge, prioritization and delegation skills. •Apply an expanding range of knowledge to promote health and well-being and to prevent complications in adults experiencing illness and disease. •Apply the nursing process to increasingly complex patient learning needs.

Communication

•Demonstrate professional, empathetic and therapeutic communication skills in all learning situations

Critical Reasoning

•Analyze nursing situations to plan and prioritize safe, effective, patient-centered nursing care using nursing knowledge, information technologies and research evidence.

Leadership

•Apply principles of collaboration, delegation, and advocacy to manage safe patient care

Professionalism and Professional Values

•Demonstrate professional behavior in all learning situations. •Apply professional values and their associated behaviors to the practice of nursing. •Apply ethical and legal principles and professional standards to nursing practice. •Apply caring’s affective characteristics into patient-centered care and with other healthcare professionals

1 Course Structure and Approach: NUR 212 will utilize a variety of approaches to meet the course learning outcomes. These instructional methods may include but are not limited to the following: lecture, audio-visual material, on-line modules, discussion, group work, demonstration, clinical experiences, clinical conferences, simulations, case studies, concept maps, written tests and written assignments.

TEXTBOOKS AND REQUIRED MATERIALS:

ALL REFERENCE TEXTBOOKS from previous classes, journal articles (in Bb Learn) plus:

Lewis, S.L., Dirksen, S.R., Heitkemper, M.M & Bucher, L. (2010). Medical-Surgical Nursing: Assessment and Management of Clinical of Clinical Problems (8th ed.). Elsevier. ISBN: 9780323065801

Evolve Apply: RN Medical-Surgical Online Case Studies

RECOMMENDED REFERENCE TEXTBOOKS

LaCharity, L.A., Kumagai, C.K., Bartz, B. (2011). Prioritization, Delegation, and Assignment: Practice Exercises for the NCLEX Examination (2nd ed). Elsevier.

Smith, Duell and Martin. (2011). Clinical Nursing Skills: Basic to Advanced Skills (8th ed): Prentice Hall.

Silvestri, L.A. (2010). Saunders comprehensive review for NCLEX-RN examination (5th ed.). Philadelphia, PA: W. B. Saunders.

*Wilson, Shannon and Shields. (2012). Pearson Nurse’s Drug Guide 2012: Prentice Hall.

*YOU MAY USE ANY NURSING DRUG OR LABORATORY/DIAGNOSTIC RESULTS BOOK AS LONG AS IT IS NOT OVER TWO YEARS OLD.

EVALUATION METHODS

ASSIGNMENTS:

Quizzes: There will be 5 quizzes throughout the semester. Each quiz will be worth 1 point.

Online Case Studies: See course schedule for specific assignments and due dates. The case studies are due by 11:59pm the day assigned.

Evidence Based Practice Project: (Group project) You will determine how the hospital is utilizing one of the 2011 or new 2012 National Patient Safety Goals.

Care Plans: See the NUR 212L clinical syllabus for requirements.

EXAMINATIONS:

Four examinations will be given throughout the semester; the fourth is a comprehensive final exam. In addition, there will also be a Kaplan exam which will cover all medical-surgical content (Fundamentals, NUR 208 and NUR 212). Tests will cover materials from both the lecture and clinical course components, including all required readings, assignments and lecture content. You will need to average 78% or higher on all exams, except the Kaplan exam, to pass the class. 2 To get the 15 points for the Kaplan exam you will need to score a 68% or higher on it otherwise no points will be given.

If a student receives less than a “B” grade on an assignment or exam, the student is encouraged to meet with the course instructor to review the material and develop a more effective learning, testing and/or writing strategy. The student may be referred to other NAU resource centers for further assistance, if needed.

GRADING SYSTEM: Both the clinical and lecture portions of the course must be passed in order to pass this course and progress to the next nursing course. The clinical portion of this course, NUR 212L, is PASS/FAIL. You must pass the NUR 212L (clinical) portion of NUR 212, as well as the lecture portion, in order to pass Nursing 212.

Evaluation Tool Points On-line Case Studies – 10 cases @ 0.5 point each. 10 Quizzes - 5 random in class quizzes at 1 point each. 5 Evidence Based Practice Project 15 Exam 1 50 Exam 2 50 Exam 3 50 Comprehensive Final Exam 75 Kaplan Exam 15 Clinical Written Assignments Pass/Fail TOTAL POSSIBLE POINTS 270

Clinical Evaluation: Successful completion of the clinical portion of NUR 212 will consist of: - Successful return demonstration of selected skills in laboratory audits - Safe demonstration of selected skills in clinical experience - Satisfactory completion of all other written assignments as outlined in the NUR 212L packet

Student Clinical Portfolio · Maintaining and updating your Student Clinical Portfolio is a clinical requirement beginning in NUR 205, continued in NUR 208 and will continue in NUR 212 and 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. It is suggested that you also include clinical evaluations and certificates.

NUR 212 Final Grades: The total number of points possible in NUR 212 is 265. The minimum point total required to earn each grade is listed below. Upon completion of all course requirements, the final grade will be calculated as follows: A = 251 - 270 points B = 224 – 250 points C = 210.6 – 223 points F = anything less than 210.6 points will be considered a course failure.

3 NAU, School of Nursing and NUR 212 COURSE POLICIES

Important Notice: There is strict adherence to every part of the NAU Student Handbook and the NAU School of Nursing Undergraduate Student Handbook.

Attendance Policy Under NAU Policy, students are expected to attend every session of class in which they are enrolled. Attendance is considered to be essential to the learning process, as the faculty believes that active participation and engagement facilitate learning. As you will be responsible for the content in the lectures, it is to your advantage to attend classes. You are expected to attend ALL CLINICAL sessions (this INCLUDES LAB SESSIONS AND PRE/POST CONFERENCES). Failure to attend clinical will prevent you from meeting clinical course objectives. Failure to notify faculty of absence from clinical (INCLUDING LAB AND POST CONFERENCE) prior to missing or being late will be considered as unprofessional conduct and will be handled as such. Notification must be made by phone (we do not have access to e-mail at the clinical sites).

Withdrawal Policy If a student is unable to attend the course or must drop the course for any reason, it will be the responsibility of the student to withdraw from the course before the withdrawal deadline (see current NAU Schedule of Classes for deadline).

Students with Disabilities If you have a documented disability, you can arrange for accommodations by contacting the office of Disability Support Services (DSS) at 523-8773 (voice), 523-6906 (TTY). In order for your individual needs to be met, you are required to provide DSS with disability related documentation and you are encouraged to provide it at least eight weeks prior to the time you wish to receive accommodations. You must register with DSS each semester you are enrolled at NAU and wish to use accommodations. Faculty are not authorized to provide a student with disability related accommodations without prior approval from DSS. Students who have registered with DSS are encouraged to notify their instructors a minimum of two weeks in advance to ensure accommodations. Otherwise, the provision of accommodations may be delayed. Concerns or questions regarding disability related accommodations can be brought to the attention of DSS or the Affirmative Action Office.

Academic Integrity The university takes an extremely serious view of violations of academic integrity. As members of the academic community, NAU’s administration, faculty, staff and students are dedicated to promoting an atmosphere of honesty and are committed to maintaining the academic integrity essential to the education process. Inherent in this commitment is the belief that academic dishonesty in all forms violates the basic principles of integrity and impedes learning. Students are therefore responsible for conducting themselves in an academically honest manner. Individual students and faculty members are responsible for identifying instances of academic dishonesty. Faculty members then recommend penalties to the department chair or college dean in keeping with the severity of the violation. The complete policy on academic integrity is in NAU’s Student Handbook. http://home.nau.edu/images/userimages/awf/9476/ACADEMIC%20DISHONESTY.pdf

Academic Contact Hour Policy The Arizona Board of Regents Academic Contact Hour Policy (ABOR Handbook, 2-206, Academic Credit) states: “an hour of work is the equivalent of 50 minutes of class time…at least 15 contact hours or recitation, lecture, discussion, testing or evaluation, seminar, or colloquium as well as a minimum of 30 hours of student homework is required for each unit of credit.” The reasonable interpretation of this policy is that for every credit hour, a student should expect, on average, to do a minimum of two additional hours of work per week PER CREDIT HOUR TO GET A GRADE OF C

4 (so 3 hours per week per credit hour for a B and 4 hours per week per credit hour for an A); e.g., preparation, homework, studying.

Plagiarism All forms of student academic dishonesty, including cheating, fabrication, facilitating academic dishonesty and plagiarism are prohibited and subject to disciplinary action. For further explanation of policies related to academic dishonesty refer to the School of Nursing Undergraduate Student Handbook and Northern Arizona University Student Handbook.

Testing, Makeup Tests and Retests Testing will begin promptly at the scheduled time. Students who arrive late for examinations will not be allowed extra time to take the test. Make up tests may be arranged for valid reasons such as illness or personal/family emergencies. ARRANGEMENTS TO TAKE A MAKE UP EXAM MUST BE MADE WITH THE FACULTY WITHIN ONE WEEK OF THE EXAM. Make up tests may be in any form (oral, written, essay) over the same objectives as the multiple choice exam.

Visitors Visitors (friends, family members, children, significant others) will not be permitted in the clinical (hospital, lab) settings under any circumstances. Visitors will be permitted in the classroom only with approval of the faculty.

Confidentiality Statement Students must maintain client confidentiality at all times. No discussion regarding clients is acceptable outside the classroom or clinical setting. In clinical conferences and in the classroom references to actual client experiences, refer to the client by their initials only.

You may not remove from the clinical setting ANY part of a medical record that staff may tell you is “extra” and “you just have to cross out their name” (i.e. medication administration record back copies). These forms contain other identifying information on them and therefore should stay in the facility to avoid violating patient confidentiality. Too, please be careful what you say in halls, elevators and bathrooms while in clinical.

Client records are not to be photocopied under ANY circumstances.

Failure to adhere to this policy can result in removal from the clinical experience, the course, and/or referral in accordance with the communication of concerns process in the NAU School of Nursing Student Handbook.

Safe Environment Policy NAU’s Safe Working and Learning Environment Policy seeks to prohibit discrimination and promote the safety of all individuals within the university. The goal of this policy is to prevent the occurrence of discrimination on the basis of sex, race, color, age, national origin, religion, sexual orientation, disability, or veteran status and to prevent sexual harassment, sexual assault or retaliation by anyone at this university. You may obtain a copy of this policy from the college dean’s office. If you have concerns about your learning environment, it is important that you contact the faculty first, then the Dean of the School of Nursing, the Office of Student Life (523-5181), the academic ombudsperson (523-9368), or NAU’s Office of Affirmative Action (523-3312).

Classroom Management Statement Membership in the academic community places a special obligation on all members to preserve an atmosphere conducive to the freedom to teach and to learn. Part of that obligation implies the responsibility of each member of the NAU community to maintain a positive learning environment in which the behavior of any individual does not disrupt the classes of teachers or learners. (From NAU Student Handbook http://www4.nau.edu/stulife/handbookmanagement.htm).

5 Evidence Based Practice Project

Purpose To identify a 2011 or the new 2012 National Patient Safety Goals, evidence based practice guidelines and hospital policies.

Instructions

1. Select a 2011 National Patient Safety Goal and let your instructor know via assignment box by January 31,2012.. 2. Research the guidelines related to the safety goal. www.guideline.gov 3. Identify how the hospital is integrating the selected National Patient Safety Goal (find the Policy and Procedure). Turn in the guideline and hospital policy to your instructor via assignment box by February 20,2012. 4. Compare and contrast the policy and guideline. Describe what the hospital is doing well to implement the safety goal, how the hospital could improve and your groups suggestions for implementing the safety goal. Discuss the significance of goal. Give examples related to your patient safety goal. Also, include why your group feels this safety goal is important and how achieving 100% compliance of this goal would improve patient safety. This should be in APA format. This portion is due by March 19,2012.. 5. Your group will post your findings in Bblearn by April 16,2012. You will post a 5 slide power point presentation for your classmates to view. You must comment on each groups presentation as well by April 30, 2012.

Option

You have the option not to do the above project if instead you want to put together a poster for Honors Day covering the evidence supporting a particular practice in medical-surgical nursing. The poster would focus on just the evidence to support the practice and not what is being done at your hospital. You would then present your poster at Honor’s Day. This generally occurs on a Thursday in April. Dates have not been announced yet. If you are interested in presenting – looks very good on a resume – then I will provide the guidelines, the application and an article on how to present an effective poster presentation.

6 Evaluation of Group Evidence Based Research Project Rubric: 15 total points

Names of Presenters:

______

Criteria Possible Points Comments Points Earned Overview of Safety Goal 3

Guideline review 3

Significant Findings 3

Conclusion/Recommendations 3

Presentation (5 slide power point 3 presentation and comments on each groups presentation)

Total 15

7 NUR 212 Course Outline Schedule—Spring 2012

Week Date Topic Delivery Chapters & Articles

1 1/19 Orientation to 212, Lecture Syllabi Delegation/Prioritization and Math Exam 2 1/26 Respiratory Lecture Lewis: 26-28 Blume 1/26 COPD with Pneumonia On-line Case Evolve Online Study 3 2/2 Respiratory continued Lecture Lewis 29 & 68 4 2/9 Exam #1 8-9:30 am Weeks 1-3 2/9 Dysrhythmias Lecture Lewis 36 2/9 Heart Failure with A-Fib On-line Case Evolve Online Study 5 2/16 Cardiovascular: HTN, CAD, Lecture Lewis 32-34 ACS Dechard, Reynolds 2/16 Hypertension On-line Case Evolve Online Study 6 2/23 Heart Failure, Vascular, Lecture Lewis 35, 37 & 38 Inflammatory & Structural Heart Disorders 2/23 Coronary Artery Disease On-line Case Evolve Online Study 7 3/1 Shock Lecture Lewis 67 Strickler, Powers 8 3/8 Exam #2 8-9:30 am Weeks 4-7 9 3/15 Spring Break No School 10 3/22 Hematology Lecture Lewis 30-31 11 3/29 Nervous System Lecture Lewis 56, 59 & 60 Rank 3/29 Seizure Disorder On-line Case Evolve On-line Study 3/29 Parkinson’s Disease On-line Case Evolve On-line Study 12 4/5 Nervous System continued Lecture Lewis 57, 58 & 61 Nayduch 4/5 Cerebrovascular Accident On-line Case Evolve On-line Study 4/5 Vision and Hearing Disorders Independent Lewis 21 & 22 Study Bb Learn 13 4/12 Exam #3 12pm-1:30pm Weeks 10-12 4/12 Gastrointestinal Disorders Lecture Lewis 39-43 4/12 Inflammatory Bowel Disease On-line Case Evolve On-line Study

14 4/19 Gastrointestinal Disorders Lecture Lewis 44 continued and Liver Pancreas Smith (MM) and Biliary Tract Disorders 8 4/19 Reproductive System Independent Lewis 51-55 Disorders Study Bblearn 4/19 Cervical Cancer On-line Case Evolve On-line Study 4/19 Breast Cancer On-line Case Evolve On-line Study 15 4/26 Emergency, Terrorism and Lecture & Lewis 69 Disaster Nursing and Simulation Lab Smith (JS) Mock Disaster 16 TBD Kaplan Exam Read Week (5/3) 17 5/10 Comprehensive Final Exam