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RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY Rutgers School of Nursing - Camden

Course: 50-705-201 Basic Clinical Nursing Competencies Credits: 3 Pre-Requisites: Successful completion of Seminar on Professional Nursing, Chemistry I and II, General Biology Co-Requisites: Anatomy and Physiology I Location: Class (1:20-4pm) Walt Whitman Auditorium or Fine Arts 108.

Lab (1:20-4pm or 420-7pm): Armitage Nursing Skills Lab or Cooper University Hospital Simulation Lab (lab sections will be assigned based on needs)

Hours: See above Faculty: Theory

Kevin Emmons, DrNP, RN, CWCN, DAPWCA Course Director kremmons@camden.rutgers.edu 4th Floor Armitage, Office 465 215-279-1827 Susan Norris, PhD, RN Susan.Norris@camden.rutgers.edu Lab Instructors Kathleen Polimeni RN, MSN, PCCN

polimeni-kathleen@cooperhealth.edu Rowena Rippa, RN, MSN, PCCN Ripa-Rowena@CooperHealth.edu Jan McFetridge, MSN, RN McFetridge-Janette@CooperHealth.edu Correinne McKenna, MSN, RN McKenna-Correinne@CooperHealth.edu

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_____________________________________________________________________ Course Description This course is designed to introduce the baccalaureate nursing student to clinical skills required to provide safe, high quality, evidence-based patient care. Students examine the scientific basis and evidence for the use of clinical skills in nursing practice. Opportunities for skills practice and mastery will be provided in the Clinical Skills Laboratory, followed by selected patient care experiences in structured nursing settings. These skills establish the foundation for care of patients with a range of health care needs in subsequent nursing courses. The course provides opportunities for students to explore the design of nursing care plans and concept/care maps, integrating nursing process, nursing care standards, issues of cultural and spiritual diversity, scientific evidence, and ethical and legal principles related to nursing practice. Students will complete a variety of assignments designed to help them develop critical thinking skills, which are the basis for professional nursing practice. Course Objectives: At the completion of this course, the student will:

1. Explain the scientific rationale and evidence for the use of various clinical nursing skills

2. Demonstrate competency performing and documenting selected clinical skills based on nursing care standards in simulated and actual patient care situations

3. Integrate ethical, legal, safety and quality principles into the basic care of patients. 4. Use knowledge from natural, behavioral and social sciences, the humanities, and

nursing science in the design and delivery of nursing care at a beginning level 5. Acknowledge the influence of cultural and spiritual diversity in planning,

implementing and evaluating nursing care. 6. Demonstrate critical thinking by using the nursing process to develop and

implement basic plans of care to address selected patient care needs. 7. Distinguish between therapeutic and non-therapeutic communication when

establishing a client relationship and providing nursing care.

Methods of Instruction: Teaching methods include lecture, discussion, written assignments, audio-visual media, computer programs, self-study materials, independent assignments, clinical skills laboratory sessions, demonstration and return demonstration, off-campus clinical experiences, and conferences with faculty.

Methods of Evaluation:

Quizzes, exams, successful return demonstration of skills, demonstration of therapeutic communication skills, simulation exercises, documentation, clinical evaluation, and care plans/care or concept maps for selected patients.

Course Content:

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1. Principles of nursing care related to: Development of a therapeutic nurse-patient relationship Legal, ethical, cultural, and spiritual context for health care Safety and quality Standards of care Design of care and nursing process Basic assessment of patient condition and needs Comfort Infection control Hygiene and personal care Fluid-electrolyte balance Oxygenation Mobility Nutrition Bowel and bladder elimination Administration of medications Documentation

2. Clinical skills Communication and interviewing Handwashing Vital signs Personal hygiene and care Bedmaking Isolation technique Sterile technique Wound care Fluid management and calculation of intake and output Intravenous therapy Administration of oxygen and respiratory care Comfort measures Nutrition measures Nasogastric and gastrostomy tube care Body mechanics and range of motion exercises Transfer and ambulation techniques Urinary catheterization Enemas Ostomy care Collection of specimens Medication dosage calculations Medication administration

Required Textbooks:

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Taylor, C., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of nursing: The art & science of nursing care (7th ed.). Philadelphia: Lippincott, Williams & Wilkins, bundled with the videos.

American Psychological Association. (2009). Publication manual of the American

Psychological Association (6th ed.). Washington, DC: Author. ISBN: 978-1-4338-0561-5 (required for all nursing courses)

Gray-Morris, D.C. (2010). Calculate with confidence (5th ed). St. Louis: Mosby ISBN-13: 978-

0323056298 Foundation of Nursing Package (2010). Guide to the Code of Ethics for nurses: Interpretation

and application; Nursing: Scope and standards of practice; Nursing's social policy statement, 2nd Edition. Go to: http://www.nursesbooks.org/Homepage/Featured-Items/Foundation-of-Nursing-Package.aspx (required for all nursing courses)

Gulanick, M. & Meyers, J.L. (2007). Nursing care plans (6th ed.). St. Louis, Missouri: Elsevier.

ISBN: 978-0-323-03954-3 (highly suggested) Course Requirements:

1. Attendance at all scheduled class and laboratory sessions is required. Students are to notify the course faculty, either by phone or email, prior to any absence. If absent, students are responsible for any material covered in class or lab.

2. Students must notify the course faculty preferably the night prior to the exam if an exam cannot be taken or morning of for urgent health issues. Students who do not comply with this policy will have 10 points deducted from their exam grade. Students must make arrangements within 24 hours of the original exam date with the course faculty to take a make-up exam. Students who do not make these arrangements within the 24 hours or who do not take the make-up exam at the agreed upon time, will receive a zero (O) as a grade for the exam. Make-up exam

format will be at the discretion of the faculty and may be in an alternate format.

3. Students are responsible for reviewing the policies regarding Test Time Allotment and Clinical Laboratory Experiences as described in the Rutgers School of Nursing – Camden, Student Handbook 2011-2012. Students must contact the course coordinator if they are unable to attend a lab session or any clinical component time the day prior to the session. Uniforms information can be found in the student handbook.

4. Assigned readings and videos are to be completed prior to class discussion and lab.

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5. Students must earn a passing score on all clinical skills return demonstrations and must achieve a satisfactory evaluation of clinical performance. Students who do not master all clinical skills or who do not demonstrate satisfactory clinical performance will not earn a passing grade in the course, regardless of examination and quiz grade averages.

6. All graded assignments are expected to be the sole work of each student unless the faculty state otherwise. Students are required to follow University Policy prohibiting

plagiarism and academic fraud as described here:

http://academicintegrity.rutgers.edu/integrity.shtml .

7. All assignments are due on the date specified unless the student has corresponded with the Professor prior to the due date and a new submission date has been negotiated. Late assignments will receive a 2 point deduction per day until received.

8. A satisfactory grade in this nursing course is a C+ or higher, plus a passing score on all clinical skills return demonstrations and a satisfactory clinical performance evaluation.

9. Computer technology is an important form of information sharing in healthcare today; so, it is essential that all healthcare providers have a basic literacy in computer technology. The Rutgers School of Nursing – Camden has moved toward incorporating computer technology into all aspects of the program. Some resources necessary to successfully progress through the program are only available via the Internet. Therefore, students enrolled in this course are expected to utilize the online course resources and log into the eCollege course page several times per week (Go here to login: https://ecollege.rutgers.edu/index2.jsp). Students are also expected to check their camden.rutgers.edu email daily.

Evaluation Criteria:

Evaluation Methods % of Grade

Date

Exam 1 20% Week 6: 10/10/12 Exam 2 20% Week 10: 11/7/12

Exam 3 20% Week 16 during finals

Medication calculation exam 20% Week 8 10/24/12 *makeups will be following week as scheduled with professors

Patient health history/Care Plan 10%

Class and Lab/Clinical P/F

Quizzes 10%

Grading Scale:

A 90 - 100

B+ 85 - 89

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B 80 - 84

C+ 75 - 79 PASSING

D 70 - 74 FAILING

F 69 and below

Clinical Skills Evaluation Criteria: SKILL OBJECTIVE CRITERIA COMMENTS Infection control practices

Demonstrates safe infection control practices in simulated and actual patient care situations (course objectives1, 2, 3,4,6)

1. Proper handwashing technique 2. Proper use of precautions 3. Recognizes need for condition-specific infection control practices 4. Identifies breaches in isolation techniques and self-corrects

Vital signs Assesses vital signs with 100% accuracy in a simulated situation (course objectives 1,2,3,4,6)

1. Correct TPR technique 2. Accurate TPR assessment (100%) 3. Correct BP technique 4. Accurate BP assessment (100%)

Personal care skills Uses proper body mechanics in providing personal care to patient in a simulated situation (course objectives 1, 2,3,4,5,6)

1. Correct body mechanics 2. Makes bed using correct infection control and patient movement practices 3. Provides personal hygiene (bedbath, bedpan, mouth care, skin protection) 4. Performs passive ROM with correct technique 5. Correctly positions immobile patient using assistive and positioning devices 6. Safely transfers patient from bed to chair 7. Recognizes need for additional assistance

Sterile technique Uses sterile technique to safely perform urinary catheterization in a simulated situation (course objectives 1,2,3,4,5,6)

1. Establishes sterile field 2. Recognizes breaches in sterile technique and self-corrects 3. Correctly inserts urinary catheter in female and male

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mannequin

Urinary catheterization Uses sterile technique to safely perform urinary catheterization in a simulated situation

1. Establishes sterile field 2. Recognizes breaches in sterile technique and self-corrects 3. Correctly inserts urinary catheter in female and male mannequin

Medication administration

Uses the 7 rights to accurately administer and document administration of oral and injectable medications in a simulated situation (course objectives 1,2,3,4,6)

1. Identifies and interprets prescription 2.Accurately calculates medication dosages 3. Accurately measures medication 4. Identifies additional data to be gathered and interpreted 5. Safely administers dosage based on ‘rights’ of medication administration 6.. Documents administration

Communication Establishes and maintains a therapeutic nurse-patient relationship in simulated and actual patient care situations (course objective 7)

1. Appropriately initiates interaction and introduces self 2. Establishes and maintains eye contact 3. Clearly explains nursing activities 4. Responds appropriately to patient interactions

Documentation Accurately documents patient care using a nursing process framework in simulated situations (course objectives 2,3,6)

1. For every skill, clearly and accurately documents: a. Patient condition, baseline, or need b. Intervention c. Patient response and/or evaluation of care

*other skills can be added as necessary

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Topical Outline DATE TOPICS READINGS SUPPLIES WK 1 9/5

COURSE INTRODUCTION AND EXPECTATIONS; INTRO TO NURSING, CULTURAL DIVERSITY, HEALTH AND ILLNESS, INDIV/FAM/COMMUNITY

HEALTH, EBP, SAFETY/SECURITY/EMERGENCY

PREPAREDNESS

TAYLOR: CHAPS 1-5 &

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SYLLABUS, NOTES/PPTS

WK 2

9/12 DOSAGE CALCULATIONS DOSAGE CALC GRAY-

MORRIS BOOK: CHAPS 1-

5, 14-16, 22, 25

PRACTICE

CLACULATIONS, CALCULATOR, PENCIL

AND PAPER WK 3

9/19 NURSING PROCESS, ASSESSING, DIAGNOSING, OUTCOME IDENTIFICATION AND PLANNING, IMPLEMENTING, EVALUATING, DOCUMENTING, REPORTING, CONFERRING, AND USING

INFORMATICS. INTRODUCTION TO THE CARE PLAN

TAYLOR: CHAPS 11-17

WK 4

9/26 LAB

COMMUNICATOR, VITAL SIGNS, ASEPSIS AND

INFECTION CONTROL, HYGEINE TAYLOR: CHAPS 21, 24, 27, 31

WK 5 10/3

LAB ON WEEK 3 TOPICS SKILLS: . SKILL 24-1: Assessing Body

Temperature . SKILL 24-2: Assessing a Peripheral Pulse

by Palpation . SKILL 24-3: Assessing Respiration . SKILL 24-4: Assessing a Brachial Artery

Blood Pressure . Introduction of skill “SKILL 39-1: Using

a Pulse Oximeter” . SKILL 27-1: Performing Hand Hygiene

Using Soap and Water (Handwashing)

. Skill Checklists: SKILL 27-2: Using Personal Protective Equipment

. Skill Checklists: SKILL 27-3: Preparing a Sterile Field and Adding Sterile Items to a Sterile Field

. SKILL 27-4: Putting on Sterile Gloves and Removing Soiled Gloves

. SKILL 31-1: Giving a Bed Bath

. SKILL 31-2: Assisting the Patient With Oral Care

. SKILL 31-3: Providing Oral Care for the

NURSING PACK, MAKE

SURE TO INCLUDE BP

CUFF AND STETHOSCOPE

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Dependent Patient . SKILL 31-4: Making an Unoccupied Bed . SKILL 31-5: Making an Occupied Bed

WK 6

10/10 MEDICATION ADMINISTRATION EXAM I

TAYLOR: CHAPTER 29 PRACTICE

CALCULATIONS FROM

GRAY-MORRIS BOOK

WK 7

10/17 LAB

LAB ON WEEK 6 SKILLS: . SKILL 29-1: Administering Oral

Medications . SKILL 29-2: Removing Medication from

an Ampule . SKILL 29-3: Removing Medication From

a Vial . SKILL 29-4: Mixing Medications From

Two Vials in One Syringe . SKILL 29-5: Administering an

Intradermal Injection . SKILL 29-6: Administering a

Subcutaneous Injection . SKILL 29-7: Administering an

Intramuscular Injection . SKILL 29-8: Administering Medications

by Intravenous Bolus or Push Through an Intravenous Infusion

. SKILL 29-9: Administering a Piggyback Intermittent Intravenous Infusion of Medication

. SKILL 29-10: Introducing Drugs Through a Medication or Drug-Infusion Lock (Intermittent Peripheral Venous Access Device) Using the Saline Flush

NURSING PACK

WK 8

10/24 SKIN INTEGRITY AND WOUND CARE, ACTIVITY, REST AND SLEEP, COMFORT MEDICATION CALCULATION EXAM

TAYLOR: CHAPS 32, 33, 34, 35

WK 9 10/31

LAB ON WEEK 8 SKILLS: SKILL 32-1: Cleaning a Wound and

Applying a Dry, Sterile Dressing . SKILL 32-2: Applying a Saline-Moistened

Dressing . SKILL 32-3: Performing Irrigation of a

Wound . SKILL 32-4: Caring for a Jackson-Pratt

Drain . SKILL 32-5: Caring for a Hemovac Drain . SKILL 32-6: Collecting a Wound Culture

NURSING PACK

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. SKILL 32-7: Applying Negative-Pressure Wound Therapy

. SKILL 32-8: Applying an External Heating Pad

. SKILL 32-9: Applying a Warm Compress

. SKILL 33-1: Applying and Removing Antiembolism Stockings

. SKILL 33-2: Assisting a Patient With Turning in Bed

. SKILL 33-3: Moving a Patient Up in Bed With the Assistance of Another Nurse

. SKILL 33-4: Transferring a Patient From the Bed to a Stretcher

. SKILL 33-5: Transferring a Patient From the Bed to a Chair

. SKILL 33-6: Providing Range-of-Motion Exercises

. SKILL 35-1: Giving a Back Massage

WK 10

11/7 NUTRITION, URINARY ELIMINATION, BOWEL

ELIMINATION EXAM II

TAYLOR: CHAPS 36, 37, 38

WK 11

11/14 LAB ON WEEK 10 SKILLS: . SKILL 36-1: Inserting a Nasogastric (NG)

Tube . SKILL 36-2: Administering a Tube

Feeding . SKILL 36-3: Removing a Nasogastric

Tube . SKILL 36-4: Obtaining a Capillary Blood

Sample for Glucose Testing

. SKILL 37-1: Assessing Bladder Volume Using an Ultrasound Bladder Scanner

. SKILL 37-2: Assisting With the Use of a Bedpan

. SKILL 37-3: Assisting With the Use of a Urinal

. SKILL 37-4: Applying an External Condom Catheter

. SKILL 37-5: Catheterizing the Female Urinary Bladder

. SKILL 37-6: Catheterizing the Male Urinary Bladder

. SKILL 37-7: Performing Intermittent Closed Catheter Irrigation

. SKILL 37-8: Administering a Continuous Closed Bladder Irrigation

. SKILL 37-9: Emptying and Changing a Stoma Appliance on an Ileal

NURSING PACK

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Conduit . SKILL 37-10: Caring for a Hemodialysis

Access (Arteriovenous Fistula or Graft)

. SKILL 37-11: Caring for a Peritoneal Dialysis Catheter

. SKILL 38-1: Administering a Large-Volume Cleansing Enema

. SKILL 38-2: Irrigating a Nasogastric Tube Connected to Suction

. SKILL 38-3: Changing and Emptying an Ostomy Appliance

WK12 11/21

THANKSGIVING RECESS NO CLASS

WK 13

11/28 OXYGEN, FLUID/ELECTROLYTE/ACID-BASE

BALANCE LOSS/GRIEF AND DYING TAYLOR: CHAPS 39, 40, 43

WK 14

12/5 LAB FOR WEEK 13 . SKILL 39-1: Using a Pulse Oximeter . SKILL 39-2: Suctioning the

Nasopharyngeal and Oropharyngeal Airways

. SKILL 39-3: Administering Oxygen by Nasal Cannula

. SKILL 39-4: Administering Oxygen by Mask

. SKILL 39-5: Suctioning the Tracheostomy: Open System

. SKILL 39-6: Providing Tracheostomy Care

. SKILL 40-1: Initiating a Peripheral Venous Access IV Infusion

. SKILL 40-2: Changing an IV Solution Container and Administration Set

. SKILL 40-3: Monitoring an IV Site and Infusion

. SKILL 40-4: Changing a Peripheral Venous Access Dressing

. *Central Venous line Dressing Change*

. SKILL 40-5: Capping for Intermittent Use and Flushing a Peripheral Venous Access Device

. SKILL 40-6: Administering a Blood Transfusion

CLINICAL SKILL CHECK OFF ON PREVIOUS LAB

WEEKS

NURSING PACK

WK 15 12/12 OR 12/8

CLINICAL DAY AN INTRODUCTORY UNIT BASED CLINICAL IS

REQUIRED. ONE 6HR DAY WILL BE COMPLETED. THE INSTRUCTOR WILL DECIDE THE TIME AND

COMPLETE CARE PLAN

PER INSTRUCTIONS STETHOSCOPE AND BP

CUFF

12

STUDENTS WHO WILL COMPLETE THIS DAY.

WK 16 EXAM III DATE TBA