UNIVERSITY OF COLLABORATIVE BACCALAUREATE NURSING PROGRAM Grande Prairie Regional College Red Deer College

University of Alberta Collaborative Baccalaureate Nursing Program

At

Red Deer College

NURSING 391

COURSE OUTLINE 2015 - 2016

Originally developed by the Clinical Experience Development Committee

Revised by the Learning Experiences Committee, April 2013

©UNIVERSITY OF ALBERTA COLLABORATIVE BScN PROGRAM, 1999 All rights reserved. No part of this module may be reproduced in any form or by any means without the publisher’s written permission. Approved: May 2013

Associate Dean:

Date: ______September 4, 2015______

N391 Course Outline 2015-2016 Course Outline

CALENDAR STATEMENT: NURS 391 Nursing Practice V *7 (fi 14) (either term, 3-26c-2 in 7 weeks). Practice focuses on restoration, rehabilitation, and support (including health promotion and disease prevention) of patients experiencing more acute variances in health across the life span. Practice occurs in primary-, secondary-, and tertiary-level acute care settings. Prerequisites: NURS 215, 274, 381, 384, 385.

COURSE HOURS: LEC: 0 SEM: 21 CLINICAL: 182 LAB: 15

COURSE DESCRIPTION: Opportunities will be provided for students to develop advanced skills in health assessment, intervention, and communication with patients across the life span. The focus of this clinical course will be the patient and their families with more acute variances in health. Students will continue to utilize health promotion and all levels of prevention in nursing practice. Nursing practice over a continuous block of time will occur in various acute care settings.

COURSE OBJECTIVES:

Levels of Independence In evaluating objectives, the following levels of independence will be used: With assistance: The student requires direction and information. With minimal assistance: The student requires occasional direction and information. With guidance: The student requires clarification, prompting, and confirmation. With minimal guidance: The student requires occasional clarification, prompting, and confirmation. Independently: The student works mostly on his or her own and seeks information, clarification, and consultation as appropriate. Direction: Clinical tutor tells the student what to do, about what steps to take. Information: Clinical tutor tells the student specifics about a concept or topic. Clarification: Clinical tutor, through questioning and feedback, assists the student to state their information in a different and clearer way, often with more details. The student asks questions to increase their understanding; questions asked demonstrate a sound knowledge base. Prompting: Clinical tutor provides the student with a cue that answer is incomplete or incorrect and how to resolve the lack of information. A prompt is broader than a hint. Prompting is generally used to add breadth or depth. Confirmation: Clinical tutor provides positive feedback for correct information and direction provided by the student. Consultation: The student provides clinical tutor with information and/or direction and asks specific questions about the information or direction which the instructor confirms.

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Occasional: The clinical tutor provides input every now and then.

OVERARCHING STATEMENTS:

Students are responsible to familiarize themselves with Graduate Competencies and Year Outcomes (with Cross Reference to courses 2015-2016. Attention must be given to the competencies that are identified as being relevant to NURS 391. Students must regularly refer to the document entitled Graduate Competencies and Year-End Outcomes Condensed Version 2015- 2016. Attention must be given to the Year 3 Column. This document serves as the basis for the evaluation of students’ clinical practice.

This course may be eligible for Prior Learning Assessment. Students should refer to the RDC Course Calendar for a list of excluded courses

Learning resources may be available to students in alternative formats. It is the student’s responsibility to discuss learning needs with their instructor.

It is the student’s responsibility to be familiar with the information contained in the Course Outline and to clarify any areas of concern with the instructor.

Students should be aware that Personal Counselling, Career, Learning and Disability Services are provided at RDC. Inquire about locations at Information Desk. It is the student’s responsibility to discuss their specific learning needs with the appropriate service provider.

RDC offers several learning support services: course-based peer tutoring, the Math Learning Centre, the Writing Skills Centre, and help with general learning strategies (e.g., time management, study skills, exam preparation and writing). RDC also offers services for students with disabilities. To access any of these services, visit the Learning Support desk in the Library, call (403) 357-3629, or email either [email protected] or [email protected] .

Students should refer to the Appeals: Formal Policy, Appeals: Informal Resolution Policy and Student Misconduct: Academic and Non-Academic Policy should they have questions or concerns about the Course Outline that cannot be resolved with the instructor.

Note that the following policies are in effect in this course:

Appeals: Formal Policy Appeals: Informal Resolution Policy Student Misconduct: Academic and Non-Academic Policy

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OBJECTIVES All students must practice in a manner that is consistent with:  CARNA Practice Standards for Regulated Members (2013) and all other CARNA standards  The CNA Code of Ethics for Registered Nurses (2008).

1. Demonstrate, independently, the processes of self-directed learning, critical thinking, and group process in utilizing inquiry-based learning, in all learning activities.

2. Demonstrate, independently or with guidance, the ability to practice in accordance with Year 3 competencies, as described in the document entitled: Graduate Competencies and Year-End Outcomes 2015-2016.

3. Demonstrate, with guidance, the ability to manage restoration, rehabilitation, and support activities for patients experiencing more acute variances in health.

4. Demonstrate, with guidance, the ability to provide evidence-based, competent nursing care to patients experiencing more acute variances in health, in a variety of settings (primarily, secondary and/or tertiary level acute care settings).

5. Demonstrate, with minimal guidance, the ability to manage health promotion and prevention activities using advanced therapeutic/interpersonal communication skills, health counseling skills, and teaching and learning principles.

6. Demonstrate the ability to integrate knowledge into clinical practice.

REQUIRED RESOURCES 1. Map of Theoretical Labs, Clinical Labs, and Clinical Seminars 2. Graduate Competencies and Year-end Outcomes 3. Grade Descriptors 4. Other site-specific resources

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REQUIRED LEARNING EXPERIENCES In order to pass NURS 391, students must consistently demonstrate safe ethical nursing practice, professional behavior, and complete the following experiences and assignments. Students are expected to implement previously learned nursing skills.

Please either download your lab manual from Blackboard or pick up from the bookstore and do the independent review (Lab 1). You will benefit from reviewing cardiac and respiratory assessment, oxygen therapy, medication administration, IV therapy, sterile technique for dressings, medication calculations and catheterizations prior to the first day of class. Students are expected to be proficient in these skills prior to the first day of clinical. Please see your lab manual for assistance in reviewing this content.

1. During this course, students will have a continuous experience in an acute care setting. Experiences will include nursing care of patients and families experiencing increasingly complex and more acute variances in health. These experiences will take place within the Red Deer Regional Hospital Centre. Setting options may include: Unit 22, 31, and 32. 2. Where the clinical setting allows, and bearing in mind the characteristics of specific placement settings such as patient acuity level, students will co-ordinate care for 2-3 patients. The emphasis should be on learning depth and breadth of student learning, and patient safety. 3. Participate in site-selected lab activities (see ‘Map of Theoretical Labs, Clinical Labs, and Clinical Seminars’). 4. Using a nursing model, assess and intervene with patients and their families. 5. Participate in patient and family education. 6. Collaborate with patient, family, community, nurses, and members of other disciplines.

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Seminars: There are several clinical seminars in this course. The purpose of clinical seminars is for students to bring relevant research and to discuss topics relevant to the units on which students are practicing. Several of the seminars have predetermined topics, while for others the topics may be determined by consensus within each clinical group about special interest topics generated by student’s experiences during clinical. Seminars will run like tutorials, with leaders, motivators, agendas, etc. However, the requirements for resources will be one to two articles, texts, etc. Please note that guest speakers, lab content review, and exam review are not considered appropriate for seminar discussions.

SUGGESTED OPTIONAL LEARNING EXPERIENCES (Alternative Experiences) 1. Participate in a follow-through experience with a more complex patient having a medical or surgical procedure. 2. Participate in discharge planning/referral from institutional settings. 2.1 Liaise with home care nurse where possible. 2.2 Follow-up visits with patient where the patient lives. May include a telephone follow-up or home visit. 3. Involvement with specific projects within institutional-based practice. 4. Observe and/or participate in a family conference. 5. Observe and/or participate in an off unit experience (for example, dialysis, ICU, hospice, etc.).

OTHER ALTERNATIVE EXPERIENCES:

1. Students from various units may have a variety of alternative experiences available to them. Your clinical instructor will discuss these options with you and will determine the learning objectives that correspond to each of these prior to your experience. No scents are to be worn and professional dress (uniforms/scrubs/name tags) is expected to be worn at all alternative placements.

2. Preparation for alternative experiences is required. Please refer to materials found in the lab manual.

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Important Dates Fall I Sept. 14 last day to add or drop courses for Fall I Oct. 22 last day to withdraw without academic penalty for Fall I

Fall II Oct. 30 last day to add or drop courses for Fall II Dec 10 last day to withdraw without academic penalty for Fall II

Winter I Jan. 7 last day to add or drop courses for Winter I Feb. 12 last day to withdraw without academic penalty for Winter I

Winter II Feb 26 last day to add or drop courses for Winter II Apr 11 last day to withdraw without academic penalty for Winter II

Spring May 6 last day to add or drop courses for Spring June 16 last day to withdraw without academic penalty for Spring

Changes to the course outline will occur in conjunction with consultation with students. Changes will be reviewed by the Associate Dean for consistency with College policies.

It is the student’s responsibility to be familiar with the information contained in the Course Outline and to clarify any areas of concern with the instructor.

Materials and Special Fees: When you paid your tuition, you also paid Material and Special Fees. The Nursing 391 fee is $50.00. Please refer to your student handbook for details.

Clinical Instructors

Fall I A Brenda Query Office: 2219 Phone: 403-342-3223 B Carly Legault Office: 1507-B Phone: 403-314-2455 C Erin Lowe Office: 1208 Phone: 403-357-3635

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Fall II D Brenda Query Office: 2219 Phone: 403-342-3223 E Lynn Parker Office: 1232 Phone: 403-342-3410

Winter I G Carly Legault Office: 1507-B Phone: 403-314-2455 H Mike Metzger Office: 1507-D Phone: 403-342-3501 I Amar Burchha Office: 1226 Phone: 403-314-2496

Winter II J Lynn Parker Office: 1232 Phone: 403-342-3410 K Amar Burchha Office: 1226 Phone: 403-314-2496 L TBA Office: TBA Phone: TBA

Spring M Mike Metzger Office: 1507-D Phone: 403-342-3501

Office Hours of Faculty

Since instructors are in clinical full-time and their schedules vary depending on the particular clinical group they have, office hours will vary. Students are to contact their instructor by phone or email to set up meeting dates and times to discuss any issues that cannot be resolved during clinical hours.

Textbooks and Resources

Please note: All texts used in Years One and Two of the Nursing Program are also required for N391. In addition, the following are also Required:

Adams, M.P., Holland, L.N., Bostwick, P.M., & King, S.L. (2010). Pharmacology for nurses: A pathophysiological approach (Canadian ed.). Toronto, ON, : Pearson. (Access code to My Nursing lab included.)

American Psychological Association. (2009). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.

College and Association of Registered Nurses of Alberta. (2013). Practice standards for regulated members with the Canadian Nurses Association code of ethics for registered nurses. , Alberta, Canada: Author. Retrieved from http://www.nurses.ab.ca/Carna- Admin/Uploads/Practice_Standards_Code_Ethics_2013.pdf

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Canadian Nurses Association. (2008). Code of ethics for registered nurses. (Centennial Edition). Ottawa, Ontario, Canada: Author. Retrieved from http://www2.cna- aiic.ca/CNA/documents/pdf/publications/Code_of_Ethics_2008_e.pdf

Perry, P. & Potter, P. (2013) Clinical nursing skills & techniques (8th ed.). Toronto, Ontario, Canada: Mosby.

Pagana, K.D., & Pagana, T.J. (2013). Mosby’s manual of diagnostic and laboratory tests (5th ed). St. Louis, MO: Elsevier Mosby.

Pickar, G., Pickar Abernethy, A., Swart, B., Graham, H., Swedish, M. (2015). Dosage calculations (3rd Canadian ed.). Toronto, ON, Canada: Nelson Education Ltd.

Wagner, K. D., & Hardin-Pierce, M. (2014). High acuity nursing (6th ed.). Upper Saddle River, NJ: Pearson Education Inc.

The purchase of a lab kit from the Bookstore is mandatory for all lab courses. **Elsevier Adaptive Quizzing/HESI Exam: (purchased through the book store). This online NCLEX prep resource is available for students to purchase at the bookstore and will assist with preparation for writing the RN registration exam. This resource will provide students with a 2 year online review/prep course to use as they progress through years 3 and 4 of the BSCN program as well as provide three NCLEX style prep exams to complete in the last 3 months of their 4th year.

Also required: Nursing 391 Lab Manual Assessment text (Jarvis or Jensen) Pathophysiology text (Hannon, Pooler, & Porth) Dictionary: Select your own. Medication Calculations/Safe Administration: e-dose and/or Pickar

Drug handbook: please use a handbook that has sufficient information about the drug, nursing care, and assessment. Some examples include:

Karch, A. (2016). Lippincott’s nursing drug guide. Philadelphia, PA: Lippincott Williams & Wilkins.

Skidmore-Roth, L. (2016). Mosby’s 2016 nursing drug reference (29th ed.). St. Louis, MO: Elsevier.

Wilson, B. A., Shannon, M. T., & Shields, K. M. (2016). Pearson nurse’s drug guide 2016. Upper Saddle River, NJ: Prentice Hall.

Lexi-Comp (2015). Drug information handbook with international trade names index (24th ed.). Hudson, OH: Lexi-Comp.

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Optional Resources: Alligood, M. R., & Marriner Tomey, A. (2010). Nursing theory: Utilization and application (7th ed.). St. Louis, MO: Elsevier Mosby.

Austin, W., & Boyd, M. A. (2010). Psychiatric nursing for Canadian practice (2nd Canadian ed.). Philadelphia, PA: Lippincott.

Boyd, D., Bee, H., & Johnson, P. (2011). Lifespan development (4th Canadian ed.). Toronto, Ontario, Canada: Pearson.

Miller, C. A. (2011). Nursing for wellness in older adults: Theory and practice (6th ed.). Philadelphia: Lippincott.

Health Canada Website: http://www.hc-sc.gc.ca/ (nutrition)

Johnson, M., Bulechek, G., Butcher, H., McCloskey Dochterman, J., Maas, M., Moorhead, S., & Swanson, E. (2006). NANDA, NOC, and NIC linkages: Nursing diagnoses, outcomes, & interventions (2nd ed.). St. Louis, MO: Mosby.

Stephen, T., Skillen, L., Day, R., & Jensen, S. (2013). Laboratory manual for Canadian Jensen’s nursing health assessment: A best practice approach. Philadelphia, PA: Wolters Kluwer/ Lippincott Williams & Wilkins. (Access to The Point Learning System included.)

Unit specific texts are available to order online but are NOT a requirement:

For students on Unit 22:

Aehlert, B. (2013). ECGs made easy (5th ed.). Maryland Heights, MO: Elsevier. Woods, S., Sivarajan Froelicher, E., Underhill Motzer, S., & Bridges, E. (2010). Cardiac nursing (6th ed.). Baltimore, MD: Lippincott Williams & Wilkins.

For students on Unit 31:

Daugirdas, J. T., Blake, P. B., Ing. T. S. (2014). Handbook of dialysis (5th ed.). Philadelphia: Lippincott Williams & Wilkins.

For students on Unit 32:

Langhorne, M. E., Fulton, J. S., & Otto, S. E. (2007). Oncology nursing (5th ed.) St. Louis, MO: Mosby. Guido, G.W. (2009). Nursing care at the end of life (1st ed.). Upper Saddle River, NJ: Prentice Hall.

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Optional Electronic Resources: Electronic resources that you may find useful include programs on drugs, laboratory and diagnostic tests, nursing skills, nursing diagnosis, diseases, health assessment, dictionaries etc.. Please be sure and order one that will work with the platform you are using (i-phone, Android, Windows, etc.). Examples:  Lexi-Comp Resources: www.lexi.com  PEPID. (n.d.). PEPID RN: Student clinical companion suite [Computer software]. Retrieved from http://www.pepid.com/products/rnscc/  MEDSCAPE. (n.d.). Retrieved from http://www.medscape.com

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REQUIRED EVALUATION:

To successfully complete N391, students must complete ALL of the following assignments and assessments. In addition, students must achieve a passing grade (36/60) in the Evaluation of Nursing Practice (ENP) and successfully complete the Clinical Calculation Assessment.

Students will be evaluated by means of the following:

1. N391 Lab Quiz 15% (of Final Grade) Fall I October 22, 2015 0900 – 1050 Fall II December 11, 2015 0900 - 1050 Winter I February 12, 2016 0900 - 1050 Winter II April 8, 2016 0900 - 1050 Spring June 16, 2016 0900 - 1050

2. Comprehensive Patient Review 25% (of Final Grade)

**All portions of the assignment are due at 1800h on the scheduled dates below:

Assessment and Term Care Plan Critical Thinking Links Relevant Concepts Fall I Sept. 27, 2015 Oct. 4, 2015 Oct. 11, 2015 Fall II Nov. 8, 2015 Nov. 22, 2015 Nov. 29, 2015 Winter I Jan. 17, 2016 Jan. 24, 2016 Jan. 31, 2016 Winter II Mar. 13, 2016 Mar. 20, 2016 Mar. 27, 2016 Spring May 15, 2016 May 22, 2016 May 29, 2016

This assignment is to be submitted as typed word documents in Blackboard in Safe Assign. Note: There will be draft Safe Assigns set up for students to submit and review their assignments for any concepts that may be inadvertently plagiarized. It is strongly recommended that students use this tool to review their document for appropriate acknowledgement of concepts, etc.

Note: The assignments must be submitted as scheduled in the course outline. Three (3) marks/25 (10%) will be deducted for each day that each portion of the assignment is late without an approved extension. Extensions require a minimum of 24 hours notice. The assignment is to be completed and submitted through Safe Assign.

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3. Clinical Performance: 60% (of Final Grade) This will be accomplished through observation and evaluation of the student during nursing practice in the clinical setting. See term schedules for days and hours of classes. Observations and evaluations will be made by the instructor and may be supplemented with input from peers, the staff of the clinical setting, and the patient/family. Students need to show evidence and rationale that they have met or are meeting the course objectives. Submission of the ENP will be either weekly or at the discretion of the instructor and will be through Blackboard with detailed, specific, and concise examples of how they are meeting or planning to meet objectives by the end of the course. Note that this is a professional document, and students must use appropriate spelling and grammar. In addition, at both the midterm and final evaluation, students will be expected to identify three strengths and three areas that they need to work on, with strategies outlining how they will address these three areas. The student and the instructor will complete a verbal midterm and a written evaluation at the end of the term. A written midterm evaluation MAY be required from the student. It is an expectation that students actively participate in labs and seminars. This includes coming to the lab and seminar having done the required preparation. Lab and seminar time is considered to be a part of the clinical experience and will be evaluated as such on the ENP. The pass mark for the ENP is 60% (36/60). Students must achieve a passing grade on the ENP to pass the course.

4. Medication Administration Safety Screen/Quiz Note: All quizzes are during seminar time – see term schedules for room and time.

Fall I September 18, 2015 Fall II November 6, 2015 Winter I January 15, 2016 Winter II March 4, 2016 Spring May 13, 2016

As part of safe medication administration, a medication assessment will be written to provide the student and instructor information about strengths and possible areas for growth with respect to medication calculations in the clinical area. Students will write an assessment within the first one to two weeks of the course. The pass mark for this quiz is 90%. If the student fails the assessment quiz the student, in consultation with the clinical instructor, will determine the extent of and the content of the remedial work. Following this, the student will be provided with an opportunity to write a supplemental, to be completed within 7 days from the first medication calculations assessment. The pass mark for the supplemental is also 90%.

NOTE: The student MUST demonstrate the ability to safely, competently, and in a timely manner administer medications (including calculations) in the clinical setting in order to pass and successfully meet the objectives of this course.

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Attendance Requirements The faculty of the RDC BSc Nursing Program believe that students are committed to their program and learning experiences. However, it is understood that there are times when students may be absent from those experiences. Any absence can be viewed as a potentially serious disruption of the learning process and necessary achievement of the learning objectives.

Attendance is required in all lab, seminar, and clinical experiences. Any student who, due to extenuating circumstances, will be late or absent for a lab, seminar, or clinical must notify the instructor or the hospital unit (ONLY if unable to contact the instructor) at least one hour prior to the beginning of the lab, seminar, or clinical. Missed clinical time will be made up. Failure to notify the instructor/unit indicates a serious breach of professional and ethical conduct.

A decision regarding make up of any extended absences will be formulated with the student, instructor, and the Chairperson of the Nursing Program.

Seminars: Make up experiences for missed seminars will be arranged on an individual basis, and may include written assignments, in addition to other experiences. It is an expectation that students come prepared and actively participates in seminars.

Labs: It is an expectation that students actively participate in labs. This includes coming to the lab having done the required preparation. Lab time is considered to be a part of the clinical experience and will be evaluated as such. Lab time provides students the opportunity to learn and practice nursing skills related to clinical practice. CARNA Nursing Practice Standards require all nurses to practice professionally and with competence. Make up lab time is required to obtain experience in nursing skills/assessments and to ensure students practice with confidence and competence. Demonstration of knowledge of missed content will be required before a skill can be practiced in clinical, as determined by the instructor. The lab must be made up within 7 days of the student’s return to clinical. A student will have restrictions placed on practice and be given an incomplete grade until he/she has followed the lab makeup time process.

Student process for lab makeup time:

1. The student’s instructor will notify the lab coordinator of the required lab content/topic the student will be practicing and demonstrating. 2. The student will notify the lab coordinator to arrange for practice time. 3. The student will be required to prepare for the lab and to demonstrate the skill. 4. The lab coordinator will communicate to the student and instructor to inform both of the satisfactory, competence lab skill(s) the student demonstrated in the makeup lab.

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Dress Code Students’ uniforms must comply with the policy and dress code of the agency to which they are assigned. See the RDC Student Handbook for the Red Deer Regional Hospital Center dress code.

Technology Guidelines The Nursing Department at Red Deer College recognizes that the use of technology in nursing has the potential to enhance learning and communication. We also recognize our obligation to use this technology responsibly and in a way that complies with the standards outlined by Red Deer College and by professional organizations such as CARNA and UNA. We are also aware of our obligation to represent nursing in a professional manner outside of the Red Deer College context. Students are asked to review the new technology guidelines that are included in their student handbook. In addition, all students should be aware of Alberta Health Services Code of Conduct as it applies to nurses: http://www.albertahealthservices.ca/pub-code-of- conduct.pdf

Blackboard Communication Course information, important notices, course content, and correspondence relating to all students in the course will be posted on the Nursing 391 Central Blackboard site. Each group will also have access to their own clinical group blackboard site to enable students to send their weekly ENP’s, to correspond with their clinical instructor and other students in their particular group. It is the student’s responsibility to be familiar with the use of Blackboard and to regularly access the site (at least daily) to receive information. Failure to do so may result in students missing important course-related information, resources, messages, instructor feedback and announcements. If students are unable to access Blackboard to receive and send their ENP’s, correspondence, etc., it is the student’s responsibility to immediately contact the Computer HELP desk at RDC to address this issue.

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Grading

Grading Schema For Final Calculations Raw Score Marks Grade Grade Point Descriptor Range 95 - 100 A+ 4.0 90 – 94.95 A 4.0 Excellent Performance 85 - 89.95 A- 3.7 80.5 - 84.95 B+ 3.3 76 - 80.45 B 3.0 Good Performance 71.5 - 75.95 B- 2.7 67 - 71.45 C+ 2.3 62.5 - 66.95 C 2.0 Satisfactory Performance 58 - 62.45 C- 1.7 53.5 - 57.95 D+ 1.3 50 - 53.45 D 1.0 Pass <50 F 0 Fail

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Plagiarism Policy: Refer to Red Deer College calendar for the policy complete policy available at http://rdc.ab.ca/sites/default/files/uploads/documents/2132/student-misconduct-academic- and-non-academic-policy_0.pdf

Consequences: Nursing Faculty considers plagiarism/cheating as serious offenses and related directly to the graduate outcome of “demonstrating integrity”. A student charged with plagiarism may:  Be given a reduced mark or no mark (i.e. a mark of 0)

 Be expelled from the course and given a grade of F

In either case, the instance of academic dishonesty will be recorded on the student’s academic file and the nursing student file, and further occurrences of any dishonesty may lead to expulsion from the College. Note: a plagiarism detection tool is used in this course http://wiki.safeassign.com/download/attachments/37191706/safe_assign_powerlink_student. pdf?version=1&modificationDate=1230913794537

CLINICAL PREPARATION: An essential component of nursing practice is the preparation students complete on their assigned patients prior to the time they provide care. Students should dress professionally and expect to spend approximately 1 hour (1600-1800h) on the nursing unit collecting patient information (e.g. reading patient charts, Kardex, and medication records) the day prior to clinical. Care must be taken when collecting assigned patient data to maintain confidentiality of individual’s private health and personal information. This includes, but is not limited to using initials, keeping identifying information separate from clinical information, properly disposing of confidential information on the assigned nursing unit, and writing all information (DO NOT photocopy any portion of the chart). A maximum of 2-3 hours additional time should be spent at home on in-depth, thorough preparation using resources and reference materials. Please bring all of this preparation with you to clinical. Expectations of the pre- conferences are as follows: Brief review of patient information, identification of patient priorities, and a nursing care plan for your patient (diagnosis, goal, intervention, rationale, and evaluation). Post conference time is an opportunity to point out applications of theory to practice, for analyzing the outcome of hypothesis testing, for group problem solving, and for evaluation of nursing care.

Head to Toe Assessment: Students will be assessed on their head to toe assessment within the first two weeks of clinical – any areas of concern will be discussed with the student and the student is expected to address these during assessments of patients throughout the rest of the practicum. Students will then be assessed on their head to toe assessment again during the last week of clinical. It is expected at that time that students will be proficient in doing their assessment and have appropriately responded to feedback provided in the first two weeks of clinical.

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Medications: Medications will be discussed with the instructor prior to administration. In order to facilitate this process, students are expected to have researched and have knowledge of ALL medications that their patient is receiving. Given the large number of medications that many of the patients will be receiving, it is acceptable for students to bring in resources. These could include preprinted drug cards or medication books that are underlined in pencil by students. Students may also use a PDA program or drug handbook for additional information. It is expected that students will have reviewed and be able to quickly retrieve the following information: Name of the drug Classification Indications (why is YOUR patient on the drug) Contraindications and cautions (any that apply to YOUR patient) Dosage (what is the typical dosage and what is YOUR patient’s dosage) Pharmacokinetics (peak, duration) Action (where does it work, where is it metabolized and excreted) Side effects (critical for YOUR patient) Effect on lab values Interactions (given YOUR patient’s medications) Nursing assessments Critical patient teaching

* Important note: Students who are unable to demonstrate preparation for clinical practice will not be allowed in the clinical area until such time as they have sufficient preparation completed for the provision of safe care to patients.

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Nursing 391: Comprehensive Patient Review % Description of Expectations Comments 10% Assessment Data: Includes subjective (behavioral and non-verbal observations, Part 1 patient’s/family’s perception of abilities/disease process/beliefs/health care needs/available resources, assessments of support systems/readiness for learning) and objective data (relevant physical assessments). Strengths and potential problems are identified throughout. Data should be concise and specific and a systematic process used. 15% Relevant Concepts: Includes comprehensive health history & health assessment Part 1 according to chosen theoretical model; pertinent anatomy & physiology (with citations); discussion of the Determinants of Health that are evident in this patient’s situation; impact of culture on patient’s health practices and health care needs; patient’s/family’s expectations of hospitalization; medications and reason pt is on medications; key lab values and reason why lab values are abnormal; treatments; & test results. Identifies 5 – 6 key relevant nursing diagnoses pertinent to this patient – should include physiological, psychological, spiritual, family and educational factors. Identifies the discharge planning considerations for this patient: patient’s/family’s hopes and desires for future health, appropriate goals for discharge (three in total) – each should have one long term and one short term goal, and links discharge considerations for patient to principles of Primary Health Care. 6% Nursing Diagnoses: Chooses 3 relevant priority problems to focus on and diagnoses Part 2 are prioritized. Are patient focused and the nurse can treat independently. Based on assessment data. Contain 3 clauses: response or problem; related to, and as (or would be) evidenced by. Supported by assessment data. Diagnoses are correctly prioritized. 3% Goals: Identify 3 goals derived from each of the 3 nursing diagnoses that are patient Part 2 centered – not what nurse will do - one goal per diagnosis. Are short term and state what observable behavior will occur and within a certain time frame. Are (S) single, specific; (M) measurable and observable, (A) achievable, (R) realistic, and (T) timely (include time frame). 9% Interventions: State what is to be done specifically. Two interventions per diagnosis. Part 2 Interventions must: relate to the contributing factors; help to meet the outcome criteria; include when and how intervention is to be done; be specific to patient/family situation; be comprehensive; provide for patient/family participation in health promotion, maintenance and restoration; include teaching activities. 9% Rationale: Rationale for each intervention should be stated and each must be Part 2 supported with a citation to a reference from a text or article (minimum of one article for each diagnosis); primarily nursing references are used. 9% Evaluation: Include date for each of the evaluations. State if goal met? Reviewed? Part 2 Resolved? or Revised? What measure or observe in patient that tells you if goal met or not. If unmet or partially met discuss why not met. Briefly indicate how plan could be modified to meet goals in future. 25% Critical Thinking/Linkages: 10 links required and must be derived from assessment Part 3 date. Identifies a variety of relevant biopsychosocial (2 required) and physiological links. Each link contains only two concepts and a statement clearly indicates how and why the concepts are linked. All links supported with references. 5% Formatting: Assessment/concepts: maximum three 8 ½ x 11 pages; data organized All with headings; use color to highlight or categorize ideas; main concepts are grouped; Parts minimum size font is Times New Roman 8. Care Plan: Maximum one page per nursing diagnosis: use table from Blackboard. Use 12 font. Links: maximum 1 page, minimum size font is Times New Roman 8. 9% APA: Title page for each part, running head (all pages of care plan and links All documents), and reference page(s) included for each part. Citations and references are Parts in standard APA format 6th edition. Appropriate grammar & spelling. Note: calculation of the mark will include consideration of student response to feedback provided. 100%

Total: /100 = /25

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