university of florida€¦ · web viewall seminar postings and responses are to be in ms word...

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UNIVERSITY OF FLORIDACOLLEGE OF NURSING

COURSE SYLLABUSSpring 2013

COURSE NUMBER NGR 6242L, Section 0377 Gainesville

COURSE TITLE Adult Acute Care Nurse Practitioner 1

CREDITS 03

PLACEMENT DNP Program: Adult Acute Care Nurse Practitioner (ACNP) Track

PREREQUISITES NGR 6002C: Advanced Health Assessment and Diagnostic Reasoning

NGR 6636: Health Promotion and Role Development in Advanced Nursing Practice

NGR 6140: Physiology and Pathophysiology for Advanced Nursing Practice

NGR 6101: Theory and Research for Nursing

PRE/CO-REQUISITES NGR 6241: Common Adult Health ProblemsNGR 6052C: Diagnostics & Procedures for Adult NursingNGR 6172: Pharmacotherapeutics for Advanced Practice

NursingNGR 6230C: Adult Acute Care Nurse Practitioner: Diagnostics

and Procedures for Acutely Ill Adults

FACULTY OFFICE PHONE OFFICE HOURS

Tonja Hartjes, DNP, ARNP, ACNP-BCCourse CoordinatorAdjunct Clinical Assistant [email protected]

HPNP 3217 (352) 215-6278 [cell] By Appointment

Kae Pearson, MSN, ARNP, ACNP-BCAdjunct Clinical Assistant [email protected]

HPNP 3217 (352) 273-6355 [O](352) 317-6560 [cell]

TBD

Jeannie Schiller, MSN, ARNP, ACNP-BCAdjunct Clinical Assistant [email protected]

ORMC (321) 239-8085 [cell] TBD

DEPARTMENT CHAIRJoyce Stechmiller PhD, ARNP, ACNP-BC, [email protected]

HPNP 3230Gainesville

(352) 273-6394 [O] By appointment

COURSE DESCRIPTION This course provides the student with foundational clinical experiences necessary for the management of adult health, including wellness promotion, illness prevention and treatment in post-pubescent client from diverse backgrounds. Emphasis is on the utilization of critical thinking and evidence-based practice to formulate differential diagnoses, clinical impressions, diagnoses, and treatment and evaluation plans for adults. This course provides clinical opportunities in the acute care setting to provide safe, cost effective,

NGR 6242L (Section 0377) – Spring 2013 – Hartjes - Final

mailto:[email protected]




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legal, and ethical care for adults with acute and critical episodes of common acute and chronic health problems.

COURSE OBJECTIVES Upon completion of this course, the student will be able to:1. Apply knowledge from health, psychological, physiological, and social sciences in the

advanced nursing management of adults with acute and critical episodes of common health problems in acute care settings.

2. Accurately assess adult clients presenting with acute and critical episodes of common health problems.

3. Develop diagnosis and differential diagnoses based on a holistic health assessment including medical and social history presenting symptoms, physical findings, and diagnostic information.

4. Develop appropriate diagnostic and therapeutic interventions for adults with emphasis on safety, cost, efficacy, and client’s immediate condition and needs.

5. Implement treatment plans for illness prevention, wellness promotion, and health problem management based on current research, evidence-based standards of care and practice guidelines for adults with acute and critical episodes of common health problems.

6. Evaluate the effectiveness of treatment plans based on client outcomes.7. Integrate legal and ethical principles into decision-making in the advanced nursing

practice role.8. Integrate cultural sensitivity into advanced nursing practice care.9. Demonstrate effective oral and written communication skills.10. Collaborate with preceptor and interdisciplinary health care team in facilitating the

adult’s progress toward maximum functional health.

CLINICAL SCHEDULE

Variable hours. A total of 144 clinical hours are required. E-Learning is the course management system that you will use for this course. E-Learning is accessed by using your Gatorlink account name and password at http://lss.at.ufl.edu. There are several tutorials and student help links on the E-Learning login site. If you have technical questions call the UF Computer Help Desk at 352-392-HELP or send email to [email protected].

It is important that you regularly check your Gatorlink account email for College and University wide information and the course E-Learning site for announcements and notifications.

Course websites are generally made available on the Friday before the first day of classes.

TEACHING METHODSSupervision of clinical practice with onsite clinical and faculty preceptors and guided

seminar group discussions

LEARNING ACTIVITIES Supervised onsite clinical practice and seminar presentations with analysis of selected clients reflecting ongoing and emergent clinical issues; verbal and written reports related to assessment, diagnosis and management plans.

NGR 6242L (Section 0377) – Spring 2013 – Hartjes- Final


http://lss.at.ufl.edu/

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EVALUATION

Clinical experience will be evaluated through faculty observation, verbal communication with the student, written work, and agency staff reports using a College of Nursing Clinical Evaluation Form. Faculty reserve the right to alter clinical experiences, including removal from clinical settings, of any student to maintain patient safety and to provide instructional experiences to support student learning. The College of Nursing supervising faculty member is the person ultimately responsible to assign a final grade for this course.

Evaluation will be based on achievement of course and program objectives using a College of Nursing Clinical Evaluation Form. All areas are to be rated. A rating of satisfactory represents satisfactory performance and a rating of unsatisfactory represents unsatisfactory performance. The student must achieve a rating of Satisfactory in each area by completion of the semester in order to achieve a passing grade for the course. A rating of less than satisfactory in any of the areas at semester end will constitute a course grade of unsatisfactory.

Faculty will hold evaluation conferences with the student and preceptor at site visits and during conference calls. The faculty will write a summary of each conference. This summary will be on the Elearning web site as a link to the grade book/clinical site visits. Final evaluation conferences with the faculty are mandatory and will be held during the last few weeks of each clinical rotation. A student or the faculty may request additional conferences at any time by contacting the clinical faculty.

GRADING SCALE:

S SatisfactoryU Unsatisfactory

TEXTS All texts from previous and current required in current graduate program

Gomella, L. G. & Haist, S.A. (2007). Clinician’s Pocket Reference (11th ed.). Stamford, CT: Lange Clinical Science.

RECOMMENDED CLINICAL RESOURCES ( OPTIONAL ):

Aehlert, B. (2006). Pocket reference for ECGs made easy (3rd ed.). St. Louis, MO: Mosby Elsevier Mosby.

Cooper, D.H., Krainik, A.J., Lubner, S.J., & Reno, H.E.L. (Eds). (2007). The Washington manual of medical therapeutics (32nd ed.). Philadelphia: Lippincott Williams & Wilkins.

Grauer, K. (2007). 12-Lead ECGs: A pocket brain for easy interpretation (4th ed.). Gainesville, FL: KG/EKG Press.

Green, S.T. (2009). Tarascon pocket pharmacopoeia. Lompoc, CA: Tarascon. (Print & Mobile Applications)

Greenwald, J. L. (2003). Writing a history and physical. Philadelphia, PA: Hanely & Belfus.


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Maxwell, R. (2006). Maxwell quick medical reference (5th ed.). Tulsa, OK: Maxwell Publishing (www.MAXWELLBOOK.com).

Hinshal, J.S., & Lederman, R.J. (2007). Tarascon internal medicine & critical care pocketbook (4th ed.). Lompoc, CA: Tarascon.

OTHER:

Up To Date (Library Web Site Access): Excellent current clinical information

Smart Phone Application Options: Epocrates (drug emphasis but also general), Merck Medicus (general medical), Medscape (latest news/research), Med Calc (frequently used equations), Blackbag (new research and news), Eponyms (medical terms, signs & symptoms, dictionary), Sanford Guide to Antimicrobial Therapy (antibiotic standards), Harrison’s Internal Medicine (general medical), American College of Cardiology (cardiac standards)

Personal Pocket Pal: Personal pocket notebook/cards on important information learned from class/clinical that you want at your fingertips. Also, helpful for writing down questions that need researched.

Approved: Academic Affairs Committee: 12/07Faculty: 01/08UF Curriculum: 10/08


http://www.MAXWELLBOOK.com/

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Addendum: Adult Acute Care Nurse Practitioner Common Health Problems Laboratory

CLINICAL SCHEDULEVariable hours. A total of 144 clinical hours are required (approximately one day per week). First

day of clinical can not occur before January 7, 2013. In addition all of the UF requirements and hospital orientation requirements must be completed. Last day of clinical is April 24th, 2013.

Students are responsible to submit planned clinical dates and times in calendar format to the course

faculty prior to beginning the clinical rotation. Any changes to the calendar (dates or times) must be submitted in writing to the course faculty before the change is planned to occur. Clinical hours accrued without prior knowledge of the faculty will not be counted toward the total number of clinical hours required for the course.

Minimal Requirements for Appearance in Clinical Practice Areas * Any faculty member has the right to remove any student from a clinical area if, in the faculty member's judgment, the student presents an unprofessional appearance or in anyway is a threat to patient safety or comfort. 1. Graduate students are identified with the Health Science Center ID badge in clinical settings

at all times during planning and/or provision of care. 2. Graduate students wear clean, pressed, white lab coats over professional attire in clinical

settings at all times during planning and/or provision of care.3. Overall appearance conveys a professional image. This includes as a minimum:

Minimal jewelry (one earring per lobe) No perfumes/scented lotions/etc. Minimal makeup No artificial fingernails or nail polish Hair extending beyond collar length must

be neatly secured away from face (ponytail)

Closed-toes shoes (sandals are not allowed)

Neat, short fingernails (not visible from the palmar surface of the hand)

No gum chewing. Length of shirts and/or blouses must

prevent exposure of upper and/or lower torso (no low-rise pants and/or low cut blouses/shirts).

4. Personal hygiene and grooming are of a standard that ensures the safety and comfort of clients.

5. Students arrive in clinical areas with all the required equipment (e.g., stethoscope) necessary for client care.

6. Activated cell phones and/or pagers are not allowed in either the clinical or classroom setting.

CLINICAL EVALUATIONFeedback from clinical preceptors, direct observations of students’ performance, written documentation samples, and participation in mandatory online seminars will be used to complete a minimum of two progress evaluations: mid-term and final evaluation. More than two progress evaluations may be performed at faculty discretion, based on students’ performance and learning needs. The College of Nursing supervising faculty member is the person ultimately responsible to assign a final grade for this course.


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Students must complete ALL of the following criteria to successfully pass the course:1. Maintain patient safety in the clinical setting.2. Satisfactory demonstration of advanced practice professional accountability to include:

a. Compliance with attendance and appearance guidelines as described in this syllabus.

b. Complete and submit written assignments within established guidelines and time frames per expectations as described in this syllabus.

3. Satisfactory participation in scheduled online seminar activities as per the seminar guidelines described in this syllabus.

4.Satisfactory performance in the clinical setting as indicated using the NGR 6242L clinical evaluation tool.

5. A rating of less than satisfactory in any of the above stated criteria at semester end will constitute a course grade of U.

Grading Scale: S=Satisfactory U=Unsatisfactory

Clinical Seminar ExpectationsMandatory clinical seminars will be held online. The TurnItIn anti-plagiarism technology will be used to evaluate this educational activity.

Each student is responsible to: 1) Participate and successfully complete online course orientation BEFORE attending first

clinical experience date 2) Participate in all scheduled on-line seminars . Seminar absences associated with

extenuating circumstances will result in an “I” in the course and will need to be made-up before the course can be successfully completed.

3) POST one evidence-based Clinical Pearl and RESPOND to two Clinical Pearl peer postings as assigned (refer to schedule on website). Students posting Clinical Pearl information will be assigned to respond to peer clinical pearl postings during the assigned seminar period. Refer to the Online Clinical Pearls: Seminar Presentation Guidelines and Clinical Pearls: Evaluation Criteria (see attached) for completion of these activities.

Unexcused absences/lack of participation will result in a zero score and unsatisfactory performance for scheduled seminar activity. A rating of less than satisfactory in any of the areas at semester end, will constitute a course grade of U.

4) Submit completed copies of the following material at the following scheduled submission dates (2-4-13, 3-18-13, and 4-22-13) :

Clinical Hours Log signed by the preceptor (including all data from the start of the semester to the day before submission of the paper).

Patient Summary Log (including all data from the start of the semester or previous submission date to the day before the form is submitted)

Two (2) HIPAA compliant samples of the student’s clinical documentation (one complete assessment and one focus assessment) during the time from the start of the semester or previous submission day. Format for documentation samples as per the Documentation Samples Guidelines (attached). (Faculty members may request more than 3 submissions based on individualized needs of students).

Submit the following by the end of the semester on or before April 22 th , 2013 : Form A, F and Form G


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5) Submit the Clinical Evaluation Tool, completed by the preceptor (posted on the course website):

at midterm (after 50% of the total required clinical hours have been completed) and

at the end of the course , on or before April 22th, 2012.

6) Make copies of all paperwork submitted to faculty for their personal records.


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Online Clinical Pearls: Seminar Presentation Guidelines

The TurnItIn anti-plagiarism technology will be used to evaluate this educational activity.

Seminar Presentations will follow this schedule:

Online Orientation

First week of classes (successful completion required before 1st clinical experience date)

Seminar 1 Seminar 2

Schedule of dates

Posting Students

Question posted on or before 2-11-13

Question posted on or before 3-11-13

Responding Students

Referenced responses posted on or before

2-18-13

Referenced responses posted on or before

3-18-13Posting students

Referenced answer posted on 2-25-13

( not earlier )

Replies to responding peers on or before

2-28-12

Referenced answer posted on 3--21 ( not

earlier )

Replies to responding peers on or before

3-25-13

Clinical Seminar activity instructions: All students will be assigned to post on ONE clinical seminar question:

The seminar question will be posted by course coordinator on the course web site under the appropriate “Discussion Forum” by 12 midnight on the assigned date.

A first student will be assigned to post a scholarly response to the posed seminar question on the course web site under the appropriate “Discussion Forum” by 12 midnight on the assigned date.

A second student will be assigned to respond to the first students posted scholarly response to the posed seminar question on the course web site under the appropriate “Discussion Forum” by 12 midnight on the assigned date.

The first student will then reply to the second student’s response on the course web site under the appropriate “Discussion Forum” by 12 midnight on the assigned date.

Failure to participate in the scheduled seminar as assigned (posting or responding) will result in a zero score and unsatisfactory performance for scheduled seminar activity. A rating of less than satisfactory in any of the areas at semester end, will constitute a course grade of U.

ALL seminar postings and responses are to be in MS Word file format. Students are responsible for submitting their postings through the TurnItIn technology

(see course website for this tool) and to ensure that the similarity index is less than 24% (green on the tool) prior to submission via the course Discussion Board section of the website for peers and faculty to review.

ALL seminar postings must be HIPAA compliant (no identifiers). The seminar postings are to comply with the assigned dates and time frames as listed

above. Students will accrue a total of 4 clinical hours for seminar participation this semester as

assigned (successful completion of both seminars with a satisfactory score is required).


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All seminar presentation postings should be accompanied by at least one relevant specific reference from the current research literature (less than 5 years old). Textbooks or online text resources will not be accepted as the sole reference for any answer.

Current APA format is required for all references. The level of evidence (LOE) that the reference presents and rationale for selection of the LOE must be included.

Postings should be clear, concise (no more than 400 words), and scholarly. Seminar participation is graded using the participation grading criteria as posted on the

webpage. Students that obtain an unsatisfactory (U) for the seminar submissions will have one

opportunity per submission period to submit another seminar posting (as assigned by faculty) for grading purposes. Students must demonstrate improvement in order to obtain the minimum satisfactory score associated with this activity.

The UF Honor Code applies to this activity, as to all coursework. Please refer to Student Policy S1-12 which is available via the College of Nursing website

in the “Current Student” area.


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University of FloridaCollege of Nursing

NGR 6242L: Adult Acute Care Nurse Practitioner Common Health Problems Laboratory

CLINICAL HOURS LOGStudent: _________________________ Clinical Site: ___________________Semester: Spring 201 3 Preceptor: _____________________

Total number of clinical hours needed 144.

Clinical date Hours complete

d

Semester hours

remainingPreceptor signature

Online seminar x 2 participation 4 140 T. Hartjes DNP, ARNP


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University of Florida College of Nursing

NGR 6242L: Adult Acute Care Nurse Practitioner Common Health Problems Laboratory

PATIENT SUMMARY LOG*(*List all activities for each patient interaction on each clinical date)

Student: _________________________ Clinical Site: ___________________Semester: Spring 201 3 Preceptor: _____________________

Clinical date

Age range & gender

Chief complaint

Differential diagnoses (total of 5)

BRIEF summary of clinical experience(list activities toward course objectives)


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University of Florida College of Nursing

NGR 6242L: Adult Acute Care Nurse Practitioner Common Health Problems LaboratoryDocumentation Samples Guidelines

You will be expected to submit two (2) samples of clinical documentation for each assigned date below (one complete assessment and one focused assessment).

o This activity will allow faculty to assess your ongoing progress toward the course objectives. You may/may not be actually documenting your findings on the facility records. However, you will need to demonstrate that you can accurately and appropriately document your findings in a medical record. Faculty members may request more than 3 submissions based on individualized needs of students.

o Students that obtain an unsatisfactory (U) for their documentation submissions will have one opportunity per submission period to submit another set of documentation samples ON A NEW PATIENT(as assigned by faculty) for grading purposes. Students must demonstrate improvement in documentation skills in order to obtain the minimum satisfactory score associated with this activity.

Submit your 2 documentation samples along with a copy of your clinical hours log, and a copy of your patient summary log to your clinical faculty as scheduled: (February 4, 2012 and March 18, 2012. Include your name and the date on the submission.

1. All required documents are to be typed and should be submitted via the course website in the “Assignments” section.

2. Your documentation sample submissions should be typed and should be organized using the format below. The documentation should not include any patient identifier data (HIPAA compliant). COPIES FROM ASSIGNED CLINICAL AGENCY MEDICAL RECORDS ARE NOT PERMITTED.

3. The content of the documentation samples should follow the format described in Gomella, LG (2007). Clinician’s Pocket Reference (11th ed.) on pages 20-23 utilizing the following headings:

History/demographics (complete ROS for complete exams) Physical Exam Problem List Analysis of pertinent data Differential diagnoses

- Include a prioritized list of the top 5 differential diagnoses for the patientbased on the data above. Include rationale for your choices.

- Include rationale for “rule in” or “rule out” (what is your rationale basedupon?)

Treatment plan - Include: patient education, diagnostics, appropriate referrals, rationale for admission, patient disposition, pharmacotherapies, and specific follow up needed

Students are responsible to make copies, for their own records, of all submissions to the course faculty.


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NGR 6242LDocumentation Samples: Evaluation Criteria

CriteriaPossible

pointsSubmitted as scheduled.* 10

Documentation is HIPAA compliant. 10

Documentation incorporates pertinent clinical data (as applicable for complete/focused exam) to describe physical assessment findings:

-Hx & demographics (14)-Physical exam (20)-Analysis of pertinent data (20)

Formulates problem list Identifies five (5) differential diagnoses with rationale to rule in/out

- Treatment plan (16 points) plan addresses problems

o prioritizes needso acknowledges other problems to be addressed

patient and/or family education recommended diagnostics pharmacotherapies health promotion appropriate referrals patient disposition

o rationale for admission or discharge specific follow up needed

70

Documentation is pertinent to the clinical scenario accurate organized concise non-judgmental

10

Total possible points 100*10 Points will be deducted for late submissions

Scores of 80-100% = Satisfactory79-0% = Unsatisfactory



NGR 6242LClinical Pearls: Evaluation Criteria

Evaluation Criteria (Student Posters)

Posting Student Criteria(used when not assigned as the responding student)

Possible points

Question posted on or before assigned date. 5

Question pertinent to ACNP practice in the management of patient populations/conditions in the acute care practice setting:

-Contains information describing clinical relevance/problem/issue [5 points]-Concise (100 words or less) [5 points]-HIPAA compliant [5 points]

15

Answer to question posed:-Contains organized, pertinent, key clinical data [10 points]-Accurate and concise (400 words or less), reference list and addendum are not included in word limit [5 points]-Includes:

Standard of care based on most current guidelines [10 points]Role of the NP specific to clinical issue [10 points]Conclusions and recommendations [10 points]

-Posted on assigned date (not earlier) [5 points]

50

Scholarly format:-Presentation is accompanied by at least one current, appropriate evidence based reference listed in APA format [5 points](references should be published less than 5 years prior to the submission date to be considered current)-Compliance with current APA format guidelines. [5 points]Minimum APA requirements: running head, pagination, double space, appropriate use of citations, & reference list

10

Includes a brief description below each reference on the reference list of:1] The level of evidence (LOE) that the reference provides including

correct rationale for LOE selection [5 points]2] How the reference supported a particular aspect of the clinical

decision making. [5 points]*Textbooks or online text sources will not be accepted. **Correct integration of reference content is demonstrated.

10

Thoughtful, clinically pertinent replies to peer responses on or before assigned date 10

Total possible points 100Scores of 80-100% = Satisfactory

79-0% or TurnItIn similarity index >24% = Unsatisfactory


NGR 6242LClinical Pearls: Evaluation Criteria

Evaluation Criteria (Student Responders)

Responding Student Criteria(used when not assigned as the posting student)

Possible points

Responds to TWO peer postings as assigned on or before assigned period.

10

Response is:1] Scholarly, clear, and concise (400 words or less), reference list and addendum are not included in word limit [15 points]2] Includes:

Standard of care based on most current guidelines [20 points]Role of the NP specific to clinical issue [20 points]Conclusions and recommendations [15 points]

70

Response is accompanied by at least one current evidence-based reference. Includes a brief description of:1] The level of evidence that the reference provides and rationale [5 points]2] How the reference supported a particular aspect of the clinical decision making in the case.[5 points]

*Textbooks or online text sources will not be accepted. **Correct integration of reference content is demonstrated

10

Compliance with current APA format guidelines.Minimum APA requirements: running head, pagination, double space, appropriate use of citations, & reference list

10

Total possible points 100Scores of 80-100% = Satisfactory

79-0% or TurnItIn similarity index >24% = Unsatisfactory


Graduate Student Clinical Visit Evaluation Tool (could be used by either faculty or clinical preceptor or both)

Score* RecommendationsProfessional behavior

Communication written

Communication verbal

Interdisciplinary collaboration

History of the Present Illness

Past Medical History

Review of systems

Physical exam

Assessment & Differential Diagnosis

Treatment plan

Generation of appropriate related clinical questions

Utilizes research findings and content/concepts learned previously to support and articulate rationale for diagnosis and/or treatment

Key*SATISFACTORY5 = demonstrated in a primarily consistent, correct independent manner (demonstrated for all cases; 2/2 cases)4 = demonstrated mostly in a consistent, correct manner with minimal assistance from preceptor (demonstrated for almost all cases; 1.5/two cases)UNSATISFACTORY3 = demonstrated in a moderately consistent, correct manner with moderate assistance from preceptor (partial demonstration; 2/2 cases)2 = demonstrated inconsistently, needs preceptor to assist frequently (disorganization is obvious and assistance is almost complete for each case)1 = very slow/ineffective, needs preceptor to do most of it (disorganized, disrupts facility flow and complete assistance is needed for 2/2 cases)0 = unable to perform behavior, unsafe, needs preceptor to demonstrate/perform (2/2 cases; is an observational experience)NA = no opportunity to demonstrate behavior

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