1 Course Description Nursing Education consists of 18 units of study dealing with direct bedside nursing care. Clinical experience will consist of supervised practice in the nursing home, as well as demonstrations in the classroom. Students can be registered by Tennessee Department of Health after the completion of the course, 100 hours clinical and theory, passing a state test (both written and skills) and will be job ready. Students may complete a clinical internship following this course. Jobs include registered nurse, clinical nurse specialist, nurse practitioner, nurse midwife, nurse anesthetist, forensic nurse, and other occupations. It is strongly recommended that administration and guidance follow the scope and sequence and course recommendations as listed. Recommended Credits: 1 Recommended Grade Level(s): th Number of Competencies in Course: 30 Note: Teachers who teach this course must be properly endorsed and, per federal guidelines, be a registered nurse with two years experience and at least one in a long-term health care facility, if students are to be certified as nurses aides. They must also have completed eight of biennial stateapproved Nursing Education training and eight hours of biennial Clinical Internship Training and the state-approved 40-hour work-based learning training and internship or the state-approved course equivalent. This course requires prior approval by the Tennessee Department of Health. If the students are certified as nursing assistants, they must complete a minimum of 100 hours course work: 40 hours classroom, 40 hours clinical hours in a Long-Term Care Facility and 20 hours in either Long-Term Care Facility or Classroom Clinical setting. Student: Teacher Ratio for clinical setting is 15:1 INTEGRATION/LINKAGE Code of Federal Regulations for Nurse Aide Training Programs, Biology, Math, National HOSA Standards, Industry Standards
2 STANDARDS 1.0 The student will complete at least 16 hours of training before any clinical contact with a patient 2.0 The student will know and apply the academic subject matter required for proficiency within nursing education. 3.0 The student will evaluate the organizational chart beginning with the nursing assistant and other health care professionals documenting responsibilities of each worker focusing on direct patient care. 4.0 The student will demonstrate patient interaction skills depending on the cognitive level, mental health, emotional, spiritual and social service needs of the resident/patient/client and/or family. 5.0 The student will compare and contrast basic human needs during health and emergency illness for the patient and analyze ways to maintain dignity and respect for all persons. 6.0 The student will complete the hours in long-term care facility, clinical setting and/or classroom clinical as outlined in the Federal Guideline Standards for Nursing Homes and put into practice the skills and knowledge outlined.
3 STANDARD 1.0 The student will complete at least 16 hours of training before any clinical contact with a patient/resident/client. LEARNING EXPECTATIONS 1.1 Demonstrate verbal and non-verbal communications and interpersonal skills. 1.2 Demonstrate knowledge of OSHA guidelines, Standard Precautions, infection control, chemistry, and physics as related to patient and employee safety. 1.3 Demonstrate knowledge of safety/emergency practices including the Heimlich maneuver and basic first aid. 1.4 Examine, evaluate, and promote patients rights, independence, and the respect of patients rights. 1.5 Demonstrate the ability to adapt communication to individual/family needs, i.e., age and development and multicultural/multilingual needs. PERFORMANCE INDICATORS; EVIDENCE STANDARD IS MET 1.1 Role-play verbal and non-verbal communication skills. 1.2 Demonstrate infection control by utilizing standard precautions while performing patient skills. 1.3 Demonstrate proper use of body mechanics during patient transfer and positioning. 1.4 Examine and analyze chemicals in a health care facility by reviewing MSDS documents. 1.5 Perform Heimlich maneuver without prompting. 1.6 Have students read and copy Patients Rights from book, sign stating they understand and place signed document in student s record. 1.7 Create a list of basic Medicare and health phrases. Communicate with ESL patients/residents and family using the created list.
4 SAMPLE PERFORMANCE TASKS Given scenarios the student will practice both verbal and non-verbal skills Prepare mock emergencies. Students will demonstrate safety practices in each of the medical emergencies. Visit a nursing facility to practice verbal and non-verbal skills Using National HOSA Biomedical Debate Guidelines, debate issues as related to the rights of the patient in a health care facility. Using scenarios assess student s ability to communicate effectively with individuals at all levels of understanding.
5 STANDARD 2.0 The student will know and apply the academic subject matter required for proficiency within nursing education. LEARNING EXPECTATIONS 2.1 Demonstrate the use of medical terminology by writing case plans for resident s/patient s disorder. 2.2 Demonstrate appropriate documentation on facility policies, procedures, charts, and reports. 2.3 Apply medical mathematical principles related to multiple areas of nursing and related pharmacology. 2.4 Demonstrate knowledge of anatomy and physiology of residents/patients at all age levels. Identify abnormalities. PERFORMANCE INDICATORS: EVIDENCE STANDARD IS MET The student will 2.1 Use appropriate abbreviation, prefixes, suffixes, root words, and spelling of medical terminology, including the Tennessee Vocabulary List, from the CAN Testing handbook. 2.2 Demonstrate adherence to facility policies and procedures in relation to documentation. Examine and utilize charts and reports. 2.3 Present findings to class maintaining confidentiality of residents. 2.4 Develop a mini care plan for a pediatric patient, adult patient, and geriatric resident, incorporating correct medical terminology and diagnosis or disorders. 2.5 Perform mathematical functions to convert body temperature (using Celsius/Fahrenheit method), patient weight and height, intake and output and food consumption percentages. 2.6 Calculate medication dosages for pediatric, adult, and geriatric population. 2.7 Compare and contrast normal and abnormal functions of body systems with emphasis on geriatric residents. 2.8 Incorporate concepts of microbiology by utilizing standard precautions while performing patient care.
6 SAMPLE PERFORMANCE TASKS In a scenario, students will be given a situation that is within the scope of training for a nursing assistant. They will utilize the long term care facility resources to problem solve and determine the course of treatment. The scenario follows: The patient has AIDS and has many conditions directly related to AIDS. The student will use the local facility policies and procedures to determine the proper techniques to use in caring for the patient. Using National HOSA Nursing Assistant guidelines, transfer the AIDS patient from the bed to a wheelchair; make the bed, transfer person back into the bed, and place in a comfortable position. Calculate intake and output using National HOSA Medical Math guidelines.
7 STANDARD 3.0 The student will evaluate the nursing organizational chart beginning with the nursing assistant, documenting responsibilities of each level focusing on direct patient care, incorporating legal/ethical responsibilities and rights of patients. LEARNING EXPECTATIONS 3.1 Analyze and apply the role of the health care team with specific roles, responsibilities and functions. 3.2 Apply behavior codes as related to legal and ethical responsibilities and maintaining privacy and confidentiality. 3.3 Compare and contrast career opportunities of all levels of nursing. 3.4 Evaluate the use of tele-health care in the delivery of health care in a clinical and home setting. 3.5 Demonstrate knowledge of assessment skills. 3.6 Examine the individual rights of the clients/residents in a health care facility and process for resolving grievances and disputes. PERFORMANCE INDICATORS: EVIDENCE STANDARD IS MET The student will 3.1 Prepare a poster or role-play team member specific roles, responsibilities, and functions. Analyze leadership skills necessary for a health care worker. 3.2 Utilize National HOSA Research Persuasive Speaking guidelines; write a research paper on a selected legal and ethical issue in health care. 3.3 Promote situations to demonstrate the residents right to be free from abuse, mistreatment, and neglect and the need to report any instances of such treatment to appropriate staff. 3.4 Compare the education, salary, and responsibilities of each person in a health care team. 3.5 Develop a presentation using technology to share information with classmates. 3.6 Prepare an article for the local HOSA chapter Newsletter informing the readers of the uses of telehealth in a clinical setting. Investigate the uses of tele-health in a home health setting by inviting home health nurses into classroom as guest speakers. Compare and perform basic assessment skills used by health care professionals.
8 3.7 Role-play residents rights issues such as how to promote the resident s right to make personal choices to accommodate their needs; providing needed assistance in getting to and participating in resident and family group activities; maintaining, securing and caring for residents personal possessions; and avoiding the need for restraints in accordance with current professional standards. SAMPLE PERFORMANCE TASKS Role-play situations in the classroom dealing with legal and ethical issues related to pediatric and geriatric patients; include forms of abuse and invasion of privacy. Interview at least one of the following: a Nurse s Aide, Licensed Practical Nurse, Registered Nurse, or and an advanced degree nurse. Working with local chamber of commerce, community leaders, Labor and Workforce Development and/or The Source (an on-line product) to research job projections in your community for the next 10 years. Using National HOSA Community Awareness guidelines, present a project to the Board of Directors of the local health care facility. The project could include but is not limited to health care worker needs, education, and salaries, cross training, concerns, and activities necessary to meet the workforce needs in health care for ten years. Invite an attorney to discuss legal issues related to all patients but particularly geriatric residents. Interview residents of long-term care facilities to determine their understanding of their rights and write a persuasive paper on why maintaining their rights is so important. Using National HOSA Biomedical Debate guidelines, debate issues as related to the rights of the patient in a health care facility
9 STANDARD 4.0 The student will demonstrate patient interaction skills depending on the cognitive level, mental health, emotional, spiritual, and social service needs of the resident/patient/client and/or family. LEARNING EXPECTATIONS 4.1 Compare physical, psychological, social, and developmental tasks and changes that may occur during the aging process. 4.2 Investigate behaviors of residents/patients with cognitive changes and develop plans of care for providing care, including the following: a. Techniques for addressing needs and behaviors of individuals with dementia or head injuries b. Communication techniques c. Understanding the behavior of cognitively impaired individuals d. Appropriate responses to the behaviors e. Methods of reducing effects of cognitive impairments 4.3 Demonstrate nursing measures designed to modify nursing behavior in response to resident behavior and how to modify both. 4.4 Analyze mental, physical, and social problems, treatments, and nursing interventions related to common diseases/disorders found in the elderly. 4.5 Create comparative charts of cultural and religious beliefs that affect health care provided to multiple ages of patients. PERFORMANCE INDICATORS: EVIDENCE STANDARD IS MET The student will 4.1 Identify growth and development changes in all age groups. 4.2 Role play in classroom, then, practice in health care facility rules and accepted practices related to adverse behaviors of patients of all age groups who have cognitive impairments either from head injuries, dementia or Alzheimer s. Identify adverse behaviors common in pediatric, geriatric, and/or adult patients that have underlying causes of mental health, social, and spiritual issues. 4.3 Summarize a professional nursing journal dealing with maintaining resident choices and dignity.
10 4.4 Interview nursing personnel to ascertain methods used by residents and family members to deal with emotional situations and the associated support systems. 4.5 Research primary degenerative dementia, secondary dementia, and Alzheimer s disease. 4.6 Document the research. Research cultural and religious beliefs that can affect nursing care. 4.7 Design a visual aid to compare and contrast differences in cultural and religious beliefs and their relation to the health care they receive. SAMPLE PERFORMANCE TASKS Research the Internet for growth and development changes that occur in the elderly, then, share findings with the class using visual aids. Role-play situations that can be encountered in which there are adverse behaviors in a health care setting with pediatric, teenage, adult, and geriatric patients. Using HOSA Care Plan guidelines, develop a care plan as related to changes identified for each body system of the geriatric patient. Interview family members of residents/patients with cognitive impairments and share findings with class utilizing National HOSA Prepared Speaking Guidelines. Invite guest speakers of different cultures and religions into your classroom to discuss their beliefs related to their health care. Invite a mental health professional to speak on mental health diseases and disorders.
11 STANDARD 5.0 The student will compare and contrast basic human needs during health and during emergency illnesses of the patient, including strategies to maintain dignity and respect for all persons. LEARNING EXPECTATIONS 5.1 Analyze procedures initiated during emergency situations such as CPR, Basic First Aid and Heimlich maneuver. 5.2 Demonstrate knowledge of safety practices involving fire, environmental factors, and disasters. 5.3 Differentiate the types of advanced directives. 5.4 Research the life span of acute, chronically ill and disabled residents and relate possibility of increased abuse of this group 5.5 Demonstrate care of the terminally ill resident/patient recognizing the grief process when death is imminent. PERFORMANCE INDICATORS: EVIDENCE STANDARD IS MET The student will 6.1 Participate in mock emergencies. Students will demonstrate safety practices in each of the medical emergencies.perform one and two person CPR competently. 5.2 Develop protocols for emergencies. Implement the process for handling emergencies using the policies and procedures of the local health care facility. 5.3 Given a set of examples, students can differentiate between the various types of advanced directives. 5.4 Adapt appropriate nursing care to meet the needs of the acute, chronically ill, and disabled person throughout the life span. 5.5 Research the grief process, including trauma, terminal illness and complication of pre-operative care.
12 SAMPLE PERFORMANCE TASKS Set up a mock emergency at the local long term care facility and at the area middle school. Compare the nature of injuries and differences in the treatments with the two groups. Practice CPR and Care of Choking conscious and unconscious victim. Invite social services department personnel to discuss advanced directives. Research information and write a research paper on caring for a terminally ill patient. Invite a hospice nurse to classroom.
13 STANDARD 6.0 The student will complete hours in classroom clinical and/or clinical setting as outlined in the Federal Guidelines Standards for Long Term Care Facility and put into practice the skills and knowledge outlined. LEARNING EXPECTATIONS 6.1 Demonstrate the following skills in a nursing lab and/or at the clinical site: a. Hand washing b. Measuring and recording vital signs c. Measure and record height and weight d. Care of the residents environment e. Performing hygiene measures/complete and partial bed bath/perineal care with inclusion of skin care f. Assist with dressing g. Grooming, including mouth care h. Toileting and assisting with elimination/intake and output, bedpans, catherization and drainage bag i. Assisting with eating and hydration and record measurement of intake and output and calculation of percentage of food consumption j. Proper feeding techniques k. Oral hygiene and denture care l. Transferring, positioning, and turning residents/patients m. Bed making occupied and unoccupied n. Performing post-mortem care o. Applying and removing restraints 6.2 Analyze and discuss the following: communication, patients rights, information control, Health Insurance Portability and Accountability Act (HIPPA). 6.3 Recognize abnormal changes in body functioning and the importance of reporting such changes to a supervisor. 6.4 Demonstrate skills associated with basic restorative care of a resident: a. Training the resident in self care according to the resident s ability b. Use of assistive devices in transferring, ambulation, eating, and dressing c. Performing ROM exercises to maintain range of motion d. Turning and positioning in a bed and chair e. Bowel and bladder training f. Care and use of prosthetic and orthotic devices 6.5 Research the proper procedure in administering the following competencies: a. Performing sterile procedures
14 b. Applying anti-embolism stockings c. Performing wound care d. Collecting specimens e. Administering a NG/PEG tube feeding f. Supplying oxygen therapy g. Providing tracheotomy care h. Suctioning i. Performing catheterization PERFORMANCE INDICATORS: EVIDENCE STANDARD IS MET 6.1 Demonstrate all skills necessary for a nurse s aide. 6.2 Demonstrate communication skills. 6.3 Research and document patient s rights in a health care facility. 6.4 Demonstrate information control of patient records, i.e., confidentiality, legal, and ethical issues that are involved in patient information. 6.5 Research the Health Insurance Portability and Accountability Act (HIPPA). Document findings. 6.6 Demonstrate, in the nursing lab and/or clinical facility, competencies necessary for certain individuals in a health care facility. SAMPLE PERFORMANCE TASKS Given scenarios, perform nursing assistant skills in a nursing lab using mannequins and/or other students.
LINDA LINGLE GOVERNOR LILLIAN B. KOLLER, ESQ. DIRECTOR HENRY OLIVA DEPUTY DIRECTOR STATE OF HAWAII DEPARTMENT OF HUMAN SERVICES Med-QUEST Division Medical Standards Branch P. O. Box 700190 Kapolei, Hawaii
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