Educational Materials: Required Textbooks: Same books as required for lecture course (RNSG 1327) LVN to RN Transitions

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1 RNSG 1327: Clinical for LVN to RN Transition Course A health-related work-based learning experience that enables the student to apply specialized occupational theory, skills and concepts. Direct supervision is provided by the clinical professional. This beginning level course helps students synthesize new knowledge, apply previous knowledge, and gain experience managing workflow. Practical experience is simultaneously related to theory. Close and/or direct supervision is provided by the clinical professional (faculty or preceptor), generally in a clinical setting. Clinical education is an unpaid learning experience. Content includes applicable DELC competencies. Course Credit: Credit obtained through Lab Course Prerequisites: Admission to the Associate Degree Nursing Program. Concurrent enrollment in RNSG 1327 (LVN to RN Transition) is required. Successful completion of both theory and lab courses is required for progression. Kellie Richardson, MSN, RN Office: Techno-Vocational Building Office # 111 Phone: Cell: Mailing Address: 1100 Broadway, Kilgore, TX On campus: 8:00a.m. 4:30p.m. Monday Thursday (class and office hours) Address: krichardson@kilgore.edu Course Rationale: The student will apply the theory, concepts, and skills involving specialized materials, tools, equipment, procedures, regulations, laws, and interactions within and among political, economic, environmental, social, and legal systems associated with the occupations and the business/industry and will demonstrate legal and ethical behavior, safety practices, interpersonal and teamwork skills, and appropriate written and verbal communication skills using the terminology of the occupation and the business/industry. Educational Materials: Required Textbooks: Same books as required for lecture course (RNSG 1327) LVN to RN Transitions Other educational resources include: Kilgore College Library Nursing Computer Labs, the Nursing Skills Lab, and the Simulation Lab located in the Applied Technology and Technical Vocational Buildings on the Kilgore College campus. Various local nursing homes and hospital facilities

2 Evaluation: Clinical Evaluation Criteria and Tool: Competency of clinical performance in the various health care settings is evaluated as the ability to perform a qualified duty or job skill of the ADN. The clinical evaluation is a continuous, systematic process of collecting data to determine whether the student has achieved the clinical objectives for a specific course. It also includes identification of individual strengths and weaknesses by focusing on competencies needed by the student to perform adequately as a registered nurse upon graduation. * The progressive clinical evaluation tool is an evaluation tool which uses behavioral objectives that reflect progression/maintenance through the four clinical levels of the KC ADN program. The first Level, RNSG 1327, will be evaluated through use of the behavioral objectives listed in Level 1. * The organization of the objectives uses the three major roles of the practicing nurse: Provider of Care, Coordinator of Care, and Member of the Profession of Nursing. The tool is further subdivided into the areas of: the nursing process, teaching/learning, communication, technical skills, professional judgment and professional role. Faculty will use the clinical evaluation tool to evaluate a student s performance in the clinical setting. The clinical grade will be determined as follows: **80% of the objectives must receive a satisfactory rating by the end of the clinical course to pass the course. a. As outlined in the Progressive Clinical Evaluation Tool an evaluation of the student will be done weekly in the clinical area: S (satisfactory) = maintains behavior with no more than one coaching, N (needs improvement) = requires coaching 2 or more times to meet an objective, or U (unsatisfactory) = cannot perform behavior without coaching. b. A final clinical evaluation score will be given to each student based on the criteria outlined in the syllabus. c. Data for clinical evaluation is possibly derived from direct observation by instructor, student self evaluation, reports from other health team members, student nurse portfolio d. Letter grade will be determined by Final Clinical Evaluation where 80% of objectives must be a satisfactory rating, the cumulative daily clinical score of the two (2) patient care days, clinical paperwork of the two (2) patient care days. e. Objectives marked by an asterisk (*) are considered to be critical areas of performances and must always be satisfactorily met in the clinical setting. f. Specific clinical objectives known as critical behaviors contain aspects of nursing care related to the client s physical and emotional well being. Unsatisfactory performance of any of the critical behaviors, which necessitates an instructor s intervention, may result in immediate termination of the clinical experience (SEE, Statement of Unsafe Practice ).

3 DAILY CLINICAL EXPECTATIONS YOU MUST COME TO CLINCAL PREPARED! Failure to arrive on time prepared to give care for the patient you are assigned reflects unsafe clinical practice. You will have failed a critical course competency and will be asked to leave the clinical setting. It is the responsibility of the student to meet with the course coordinator and the clinical instructor prior to returning to the clinical setting. PREPARATION WILL INCLUDE BUT IS NOT LIMITED TO THE FOLLOWING: 1. Complete Prep Sheet 2. Medication sheet prepared on ALL of the medications the patient you are assigned. The following information is to be on the Medication Sheet (provided in syllabus). Generic Name: Trade Names: Drug Classification: Action and uses: (include drug classification) Side effects and/or adverse reactions: (these should be common side effects and life threatening reactions) Drug Interactions: Nursing measures: 3. Bring folder with side pockets and three brads each clinical day. To be included in the folder area the following: a. In the brads: (in the following order) 1. Grading scale for paperwork 2. Progressive Clinical Evaluation Tool 3. Weekly Clinical Comment Sheet 4. The required clinical skills list for Foundations 5. Daily Narrative Reflection of Practice a. Consider events of the day b. Think about what you brought to each event c. Think about how each situation might have been framed differently if you had a different understanding, experience or assumptions. d. Think about goals/ends for acting as you did e. Think about who determined the ends, the degree to which the ends were agreed upon f. Think about what things are under your control g. Think about what is beyond your control h. Was the situation like others you have encountered?

4 b. In the left hand pocket put all of the materials being utilized during the current week. This will include your med sheets, prep sheet, care plan, etc. Also, the clinical skills check off list will need to be in your folder for clinical but not in the folder that you turn into your instructor. 4. Please buy at least 2 folders (color to be determined by the clinical instructor) This folder will need to be turned into your clinical instructor the day following clinical each week Clinical Policies: The student who has achieved a satisfactory (competent) rating on technique (skills) performances will then be allowed to perform techniques in the healthcare clinical environment. The student will spend 1 day per week in the clinical area. Dress Code: The student is responsible for adhering to the dress code as outlined in the student handbook. Attire for the clinical environment is addressed by the handbook. Full uniform will be required in the clinical facility at this time. The Kilgore College School of Nursing navy polo and Khaki pants with casual dress shoes or white leather tennis shoes is required for assigned clinical facility activities not requiring direct patient care. Please refer to the Kilgore College Associate Degree Nursing Program Student Handbook, 2011/2012, pages Whenever you are in uniform, you need to adhere to the Dress Code Policy whether on campus or clinical. ** Kilgore Picture ID s must be worn at all times when on campus and in the clinical facility.** Attendance Policy: Clinical is an essential part of the nursing program. Because the total number of clinical hours per semester for each nursing course is mandated by WECM and NLN, the Kilgore College Attendance Policy does not apply as outlined in the KC catalog. If a student is unable to attend an assigned activity, they are expected to call and report their absence as listed in each course syllabus. Absent students are responsible for all announcements, assignments, and course content. The total number of hours mandated for this course (144) must be met to pass the clinical. Make up time for missed clinical will be not be available for this course.. Clinical: Any time missed from a clinical course must be made up before the conclusion of that clinical course in order to fulfill state requirements and in order to pass the course and progress in the nursing program. Clinical Make-Up Policy: For absence notification on clinical days, the student is to call the clinical instructor and call the assigned unit of assigned facility at least 1 hour before designated clinical time. The student is to give his/her name, assigned division, reason for absence, and get the person's name spoken to. Make-up clinical time will be arranged at the discretion of the instructor

5 Tardiness: Students should arrive at the clinical setting at or before the designated time. Any student arriving after report is given will be sent home and an absence will be counted. Patient Jeopardy: Any time a student jeopardizes a patient s physical or emotional environment, violates safety or asepsis, the instructor can require the student to leave the premises. Practice in skills lab will be required and arranged by the student with the Lab Assistant using the Skills Referral form which defines the deficiency. This practice will help overcome deficiencies with skills. This must be done satisfactorily by the next clinical day, or the student will not be allowed to return to the clinical facility. The student will bring the Skills Referral form signed by the Lab Assistant showing that the student has met the minimal competency or better in that skill. If, however, the skills laboratory practice does not promote a safer or more health-promoting environment, that student cannot meet the clinical objectives and will fail to pass Nursing All assigned criteria must be met on a competent level before the final exam or the student fails Nursing It is the student s responsibility to make arrangements with the appropriate instructor(s) when the clinical has not been completed satisfactorily. Academic Integrity: Students are expected to assume full responsibility for the content and integrity of all academic work submitted as homework and examinations. Students found guilty of violation of academic integrity may fail the course and/or be dismissed from the nursing program. The school of nursing reserves the right to dismiss students from the program for any serious infractions of a legal, moral, social or safety nature, pursuant to the procedures detailed in the Nursing Student Handbook. Regulation Awareness: It is the responsibility of the student to become familiar with the regulations of Kilgore College and to satisfy them in the proper way. The Kilgore College ADN faculty members support the above excerpt from the TBON Rules & Regulations relating to Professional Nurse Education. Failure to demonstrate competency in the above criteria can result in a rating of unsafe clinical performance and not meeting professional conduct standards, as defined in the syllabus of each clinical nursing course. Drop Date: The Drop Procedure per KC Catalog will be announced the first day of class. It is your responsibility to drop a course or withdraw from the college; failure to do so will result in receiving a performance grade, usually a grade of F. The last day to drop/with a grade of W is when approximately 75% of the course is over. The exact date will be on the syllabus you receive for that specific semester. DISCLAIMER: Your instructor reserves the right to make modifications in content and schedule as necessary to promote the best education possible within prevailing conditions affecting this course

6 STATEMENT OF UNSAFE CLINICAL PRACTICE: Any act of omission or commission, which may result in harm to the client, is considered unsafe clinical practice. Students must be aware that certain nursing behaviors place the client at risk. It is the student s responsibility to practice safe client care. During the clinical practicum, unsafe clinical practice is defined as any one of the following: 1. Violates or threatens the physical, psychological, microbiological, chemical, or thermal safety of the client/patient. This includes, but is not limited to: a. Leaving clients with limited sensorium, strength or coordination, unattended in an unsafe situation. b. Failure to report errors or that an ordered/required client procedure was not carried out. c. Failure to recognize and report a serious change in a client s condition, or a serious hazard in the client s immediate environment. d. Failure to use therapeutic communication. e. Arrives at a clinical setting unprepared to provide safe client care. f. Arrives at clinical setting too late to provide safe care. 2. Violates previously mastered principles/learning/objectives in carrying out nursing care skills and/or delegated medical function. This includes, but is not limited to: a. Medication administration b. Vital signs c. Therapeutic communication d. Invasive/non-invasive procedures 3. Assumes inappropriate independence in action or decisions. This includes, but is not limited to: a. Medication administration (Oral medications, gastric tube medications, and IV piggyback medications may be given with an instructor or a nurse after the student has been checked off, IV pushes and ANY injection must be given with an instructor, there will be NO chemotherapy or blood products given by a student.) b. Nursing procedures c. Use of equipment 4. Does not adhere to current CDC Guidelines for Infection Control. 5. Fails to recognize own limitations, incompetence and/or legal responsibilities. 6. Fails to accept moral and legal responsibility for his/her own actions. 7. Violates professional integrity as expressed in the ANA Code for Nurses. This includes, but is not limited to: a. Willful dishonesty regarding information given to faculty, students, hospital staff, or clients. b. Willful dishonesty regarding client documentation. c. Stealing medication, equipment, books, etc. d. Failure to keep client information confidential. (i.e. copying patient records, taking pictures by cell phone, etc.) e. Destruction of a client s confidence in other health care team members. 8. Inability to practice safely demonstration of actual or potential inability to practice with reasonable skill and safety to clients by reason of illness, use of alcohol, drugs,

7 chemicals, or any mood altering substance or as a result of any mental or physical condition. 9. Unprofessional conduct that is contrary to professional standards or ethics or not befitting members of the nursing profession with language, behavior or conduct. Unsafe clinical practices will be documented by the clinical instructor. An act of omission or commission which, in the judgment of the clinical instructor, constitutes an unsafe clinical practice may be considered on one of the following levels: 1 st Degree: Consists of paperwork issues, such as, lack of preparation, turning in paperwork late, inappropriate charting, etc. Such an infraction could result in a written reprimand to/or contract with the student. Repeated infractions could result in failure of the course. 2 nd Degree: Consists of repeated poor performances in previously mastered skills or theory application, such as, but not limited to: breaks in sterile technique, lack of medication knowledge, omission of medication administration, omission of care, etc. Such an infraction could result in a written reprimand to/or contract with the student, failure of the course, or termination from the Kilgore College ADN program, or reported to the T-BON as unfit to practice. 3 rd Degree: Consists of any single action or omission that places a patient s life in immediate jeopardy. Incidents of alcohol or drug abuse, manifestations of mental illness or unprofessional conduct will be considered a 3 rd degree offense. Such an infraction will result in immediate suspension from the clinical practicum, failure of the course, or termination from the Kilgore College ADN program, or reported to the T-BON as unfit to practice. The student will be notified immediately of any infraction. The Director of the Associate Degree Nursing Program will be notified as soon as possible of a 1 st or 2 nd Degree infraction. The Director and the Dean will be notified immediately of a 3 rd Degree infraction. While there is no absolute rule to determine what response, if any, may be necessary to address an unsafe clinical practice, the appropriate response in each individual case for a 1 st or 2 nd Degree infraction is left to the informed discretion of the instructor, guided by experience, education and training. The appropriate response in a 3 rd Degree infraction will be determined by the instructor after consultation with the Director and the Dean who are guided by a combination of different types of experiences in leadership, education, and in training. Students who have been failed from a course for Unsafe Clinical Practice may return to the program if approved by the Admission/Readmission/Progression Committee. The student would return under strict contract if allowed to be re-instated in the program. Unsafe Clinical Practice failure for: 1 st Degree Infraction: Student will attend counseling for time management and tutorials for paperwork improvement.

8 2 nd Degree Infraction: Student will return to the skills lab to practice and repeat the check-off on the skills in question, review skill content in text and on computer assisted programs. 3 rd Degree Infraction: Student, if allowed to return, must come before the Admission/ Readmission/Progression Committee to appeal for reinstatement. They must convey full knowledge of the risk to the patient and a full review of the skill or content involved. This review will be with a tutor and computer assisted programs. The student must be re-checked in the skills upon completion of the review. Unprofessional Conduct towards faculty or staff will be referred to counseling and student will be expected to follow counseling recommendations. Unprofessional Conduct towards patients or families will not be tolerated. Students who have been failed due to Unprofessional Conduct will be reviewed for readmission on an individual basis. Impaired status will be confirmed by drug screen or confession. Positive drug screen or confession of drug use will be referred to the Texas Peer Assistance Program for Nurses and students must be under their protocol to return to the program. Displays of psychiatric instability or confession of such will be referred to a Psychiatrist and student must have a release by a Psychiatrist to return to the program. Sleep Deprivation, with resulting inability to function, will result in student s being sent home and given an un-satisfactory for the clinical day. Second occurrence will result in failure of the course. The student must appear before the Admission/Progression/Readmission Committee to appeal return to the program. Failure, with no return, will occur at the 3 rd occurrence. STUDENT LEARNING OUTCOMES: A. Students will identify the health status and health needs, including physical, cultural, emotional and spiritual needs, of adult clients and their families based upon interpretation of health data, in collaboration with clients, their families, and other interdisciplinary health care team members. Activities: Client Assessment; Clinical Performance Assessment: Clinical Evaluation (SCANS 1, 4, 5, 7) (PLO 1-6) B. Students will recognize goals and plan of care for clients and their families based on nursing diagnoses in collaboration with clients, their families, and other interdisciplinary health care team members. Activities: Client Assessment; Clinical Performance Assessment: Clinical Evaluation, Nursing Care Plans (SCANS 2, 3, 4, 5, 6, 7) (PLO 1-6) C. Students will develop the plan of care in a safe and caring manner, within legal and ethical parameters, including scope of practice, in collaboration with clients, their families and other interdisciplinary health care team members, to assist clients and their families in meeting health care needs. Activities: Clinical Performance Assessment: Clinical Evaluation (SCANS 2, 3, 4, 5, 6, 7, 8) (PLO 1-6)

9 D. Students will define the teaching plans for clients and their families concerning promotion, maintenance, and restoration of health. Activities: Client Assessment; Clinical Performance Assessment: Clinical Evaluation, Nursing Care Plans (SCANS 1, 2, 4, 5, 6, 7) (PLO 1-6) E. Students will evaluate clients and family s response to therapeutic interventions. Activities: Client Assessment; Clinical Performance Assessment: Clinical Evaluation, Nursing Care Plans (SCANS 4, 5, 6, 7) (PLO 1-6) F. Students will provide for the care of multiple clients and their families either through direct care or assignment and/or delegation of care to other members of the health care team. Activities: Clinical performance Assessment: Clinical Evaluation, Nursing Care Plans (SCANS 1, 2, 3, 4, 5, 6, 7, 8) (PLO 1-6) G. Students will use critical thinking approach to locate and select data and current literature as a basis for decision making in nursing practice. Activities: Clinical performance Assessment: Clinical Evaluation; Nursing Care Plans (SCANS 1, 5, 6, 7, 8) (PLO 1-6) H. Students will identify human and material resources for the provision of care for clients and their families. Activities: Clinical performance Assessment: Clinical Evaluation (SCANS 4, 5, 6, 7, 8) (PLO 1-6) I. Students will collaborate with clients, their families, and the interdisciplinary health care team for the planning and delivery of care. Activities: Clinical performance Assessment: Clinical Evaluation, Nursing Care Plans (SCANS 1, 2, 4, 5, 6, 7) (PLO 1-6) J. Students will refer clients and their families to resources that facilitate continuity of care. Activities: Clinical Performance Assessment: Clinical Evaluation, Nursing Care Plans (SCANS 5, 6, 7) (PLO 1-6) K. Students will function within the organizational framework of various health care settings. Activities: Clinical Performance Assessment: Clinical Evaluation (SCANS 5, 6, 7, 8) (PLO 1-6) L. Students will assume accountability and responsibility for the quality of nursing care provided to clients and families. Activities: Clinical Performance Assessment: Clinical Evaluations (SCANS 2, 4, 5, 6, 7) (PLO 1-6) M. Students will act as an advocate to promote the provision of quality health care for clients. Activities: Clinical Performance Assessment: Clinical Evaluation, Nursing Care Plans

10 (SCANS 4, 5, 6, 7) (PLO 1-6) N. Students will participate in activities that promote the development and practice of professional nursing. Activities: Clinical Performance, Post-Conference participation and discussion, Student Nursing Association Assessment: Clinical Evaluation (SCANS 1, 2, 4, 5, 6, 7) (PLO 1-6) O. The students will apply the theory, concepts, and skill involving specialized materials, tools, equipment, procedures, regulations, laws, and interactions within and among political, economic, environmental, social, and legal systems associated with the occupations and the business/industry. Activities: clinical setting. Assessment: demonstration of skills in clinical, quizzes, and clinical forms using the nursing process. (SCANS 1, 2, 4, 5, 6, 7, 8) (PLO 1, 2, 3, 4, 5, 6) P. The student will demonstrate legal and ethical behavior, safety practices, interpersonal and teamwork skills. Activities: skills lab and clinical setting. Assessment: demonstration of skills in skills lab clinical, clinical forms using the nursing process. (SCANS 1, 2, 3, 4, 5, 6, 7) (PLO 1, 2, 3, 4, 5, 6) Q. The student will use appropriate written and verbal communication skills using the terminology of the occupation and the business/industry. Activities: skills lab and clinical setting. Assessment: skills lab quizzes, clinical forms using the nursing process, and client interviewing during the clinical setting. (SCANS 1, 2, 4, 5, 6, 7, 8) (PLO 1, 2, 3, 4, 5, 6) R. The student will demonstrate increasing critical thinking and clinical judgment during clinical decision making exercises and in the clinical setting. Activities: decision making lab and clinical setting. Assessment: computer modules, virtual excursions, clinical forms using the nursing process and other clinical activities involving client assessment. (SCANS 1, 2, 4, 5, 6, 7, 8) (PLO 1, 2, 3, 4, 5, 6) S. The student will develop a comprehensive plan of care for a variety of patients demonstrating knowledge of the nursing process and clinical judgment. Activities: decision making lab and clinical setting. Assessment: computer modules, virtual excursions, clinical forms using the nursing process and other clinical activities involving client assessment. (SCANS 1, 2, 4, 5, 6, 7, 8) (PLO 1, 2, 3, 4, 5, 6) SCANS MATRIX LEGEND (Competency References) 1 Reading 2 - Writing 3 - Arithmetic or Mathematics 4 Speaking and Listening 5 Thinking Skills 6 Personal Qualities 7 Workplace Competencies

11 8 Basic Use of Computers PLO- See Program Learning Outcomes in the Kilgore College Associate Degree Nursing Program Student Handbook. CLINICAL COMPETENCIES A. As a provider of care, the Kilgore College ADN LVN to RN Transition Nursing student will: 1. Utilize the nursing process as a tool to determine the health status and the health needs of adult persons and their families based upon interpretation of health data in collaboration with client, their families and health care professionals (SCANS 1, 2, 3, 4, 5, 6, 7) (PLO 1, 2, 3, 4, 5, 6) a. Assessment 1. Perform and document a client interview 2. Perform and document client observation a. subjective data b. objective data 3. Measure and record: a. oral, rectal, axillary, and tympanic temperatures b. radial, apical, and pedal pulses c. respirations d. blood pressure e. height f. weight 4. Measure and record client intake and output a. oral fluids b. I.V. fluids c. diet 5. Gather data to assess environment a. temperature b. ventilation c. asepsis d. psychosocial 6. Given a simulated client situation, perform basic physical assessment b. Diagnosis and Planning 1. List three needs/problems a. nursing history b. nursing interventions c. nursing diagnosis 2. Write short and long term goals for a given client situation c. Implementation 1. Write a nurse s note a. focus b. POMR c. narrative 2. Positioning d. Perform medical hand washing procedure e. Plan and demonstrate selected bathing

12 1. Complete 2. Partial 3. Self-help 4. Shower 5. Therapeutic f. Perform transfer techniques safely 1. Wheelchair 2. Stretcher 3. Gerichair g. Perform personal hygiene skills 1. Oral Hygiene 2. Hair care 3. Nail care 4. Peri care with/without foley catheter h. Apply restraint devices 1. Mitt 2. Vest restraint 3. Soft wrist/ankle restraint i. Transfer client from bed to chair 1. One person assist 2. Two person assist 3. Hydraulic lift j. Perform active and passive exercises k. Insert urethral/foley catheter l. Administer enema 1. Tap water/soap suds 2. Premixed/fleets m. Obtain urine specimen 1. closed urinary drainage 2. Midstream catch 3. Clean catch n. Perform colostomy care 1. Irrigation 2. Change Bag 3. Empty/clean bag 4. Record contents o. Wound Care 1. Wound assessment and identification 2. Aseptic wound dressings with standard precautions 3. Sterile wound dressings with standard precautions p. Control environment for nurse/patient communication q. Plan safe environment for client 1. Ventilation 2. Temperature 3. Internal/external 4. Intellectual, psychosocial, interpersonal

13 r. Demonstrate infection control techniques 1. Standard Precautions 2. Universal Precautions 3. Body substance isolation 4. Category specific isolation 5. Protective (reverse) isolation 6. Gowning and gloving techniques s. Administer medications safely 1. Oral 2. Parenteral 3. Rectal 4. Nasal 5. Ophthalmic 6. Otic 7. Topical 8. Vaginal 9. Inhaled B. As the manager of care the Kilgore College ADN LVN to RN Transition Student will: 1. Coordinate resources to manage care by initiating decision-making, assertiveness, motivation, and time management. (SCANS 5, 6) (PLO 1-6) C. As a professional member of nursing, the Kilgore College ADN LVN to RN Transition Student will: 1. Act within the framework of legal and ethical considerations of nursing and the Kilgore College and Nursing policies to be an accountable member of the collaborative healthcare team by displaying integrity above reproach. (SCANS 1,2,3,4,5,6,7,8) (PLO 1-6) a. Adherence to KC policies b. Regular attendance c. Adherence to uniform policies d. Punctual for clinical experiences e. Competent in clinical f. Participates in post-conference g. Recognizes strength and weaknesses h. Maintains confidentiality i. Values nursing as a profession j. Accepts constructive criticism k. Reports current information 1. nursing journals 2. allied health journals 3. internet The following list some examples of performance objectives the student must accomplish daily in the clinical facility.

14 I. NURSING PROCESS Patient Assessment/Care Plan Research information about patient before giving care Know patient diagnosis and what it means Do a complete patient assessment within the first hour after report Complete and turn in written assignment as required by the instructor II. III. IV. SAFE-EFFECTIVE CARE ENVIRONMENT Punctuality/Dress Punctual to pre and post conference Follow dress code in the ADN student handbook Skills Performance Perform skills safely, correctly and efficiently Seek opportunities to practice skills listed in the check list Practice skills appropriate to level of learning Check with instructor to get permission before doing skills Time Management Efficient, organized, and show initiative in seeking learning experiences PHYSIOLOGICAL MAINTENANCE Medication Administration Follow the 5 rights while administering medications Give medications only as allowed by instructor Research medications before administering to patient Turn in medication cards at the due date assigned by the clinical instructor Pathophysiology Use appropriate references; briefly research the following about the patient: pathophysiology of diagnosis meaning of diagnostic tests reason patient is receiving medications rationale for planned nursing/medical interventions PSYCHOSOCIAL MAINTENENANCE Communication Demonstrate appropriate written, verbal and non-verbal communication Participate relevantly in post-conference Communicate closely with the clinical instructor Ethics Demonstrate confidentiality and a respect of rights of all (patient, staff, students instructors) V. HEALTH MAINTENANCE Patient Teaching Explain nursing procedures to the patient Begin to identify basic learning needs

15 Kilgore College Associate Degree Nursing RNSG 1327 Clinical Lab for LVN to RN Transition Practice GRADING EVALUATION TOOL (paperwork) Fall 2011 Student name: DATE: 1. Clinical prep sheet 4 points 2. Three (3) Nursing Diagnosis/Problems 6 points 3. Medication Cards 5 points (for ALL the medications you might give the patient on your shift) 4. Lab Values and Radiology (other test results) 5 points 5. Client assessment 20 points 6. Nursing Diagnostic Statement 5 points 7. Patient goals (at least two (2) measurable goals) 10 points 8. Nursing Interventions with rationales 20 points (at least five (5) interventions) 9. Subjective Data 5 points 10. Objective Data 5 points 11. Evaluation of patient goals 10 points (not nursing interventions) 12. Documentation 5 points TOTAL POINTS 100 points ***For paperwork in the clinical setting; points for two (2) patient care days.

16 Kilgore College Associate Degree Nursing Progressive Clinical Evaluation Tool RNSG 1327: Level 1 Weekly Eval Tool The following behavioral objectives reflect progression/maintenance through the four clinical levels of the KC ADN Program. The first Level, RNSG 1327, will be evaluated through use of the behavioral objectives listed in Level 1. 80% of the objectives must receive a satisfactory rating by the end of the clinical course to pass the course. PROVIDER OF CARE 1.*Demonstrates the ability to gather subjective and objective data. 2.*Demonstrates the basic components of a nursing assessment. 3. Assesses needs of clients according to Maslow s hierarchy of needs and Erickson s developmental stages. 4. Records data accurately and descriptively according to assessment. 5. Identifies NANDA nursing diagnosis based on assessment data. 6. Develops a list of nursing diagnosis based on assessment data. 7. Establishes realistic and measurable long-term and short-term client goals. 8.*Begins to evaluate the effectiveness of nursing interventions in meeting client goals. 9. Seeks assistance from appropriate persons. TEACHING/LEARNING (Level 1) 1. Assesses knowledge deficit related to the promotion of wellness. 2. Explains procedures, treatments, and nursing care to assigned clients. 3. Emphasizes safety teaching when appropriate. COMMUNICATION (Level 1) 1. Communicates using effective verbal and nonverbal techniques. 2. Obtains a nursing history, using effective interviewing techniques. 3. Uses nursing behaviors that assist in developing a trusting relationship with clients of all developmental stages. 4.*Communicates appropriately with other team members. TECHNICAL SKILLS (Level 1) 1.*Maintains client safety. 2.*Demonstrates the critical elements of aseptic technique when performing skills. TECHNICAL SKILLS CONTINUED 3.*Uses the eight rights of medication administration. 4.*Accurately calculates drug dosages using various systems of equivalents. 5.*Identifies classification, action, side-effects, and nursing responsibilities of pharmacologic agents administered to clients of various developmental stages and ethnic backgrounds. 6.*Uses correct CDC techniques for observing blood and body fluid precautions.

17 COORDINATOR OF CARE PROFESSIONAL JUDGMENT (Level 1) 1. Functions within the organizational framework of the health care setting. MEMBER OF A PROFESSION PROFESSIONAL ROLE (Level 1) 1.*Takes the initiative for self-directed learning. 2. Accepts professional guidance and criticism and incorporates appropriate suggestions into learning experience. 3.*Upholds legal and ethical standards of the profession in the clinical facility by maintaining confidentiality of all material pertinent to each client, including refraining from gossip. 4. Reports to clinical on time. 5.*Reports on and off unit to appropriate personnel with appropriate information. 6.*Maintains professional behavior and appearance. 7. Participates in pre and post conferences. 8.*Protects client from physical and emotional harm. 9. Demonstrates evidence of preparation for clinical experience. 10.*Adheres to school and health care agency policies. 11. *Accomplishes all clinical assignments as indicated, assuming responsibility for own behavior. 12. Supports a caring, professional and skilled attitude toward clients, families, and healthcare personnel in various healthcare settings. TOTAL POINTS: Instructor s Signature Student s Signature (Revised January 1, 2010) Objectives marked by an asterisk are considered to be critical areas of performance and must always be satisfactorily met in the clinical setting. Satisfactory (S) = Maintains behavior with no more than one coaching. Needs improvement (NI) = Requires coaching 2 or more times to meet an objective. (U) = Cannot consistently perform behavior without coaching. * = Critical Behaviors S (Satisfactory) = 2 points N (Needs Improvement) = 1 point U (Unsatisfactory) = 0 points

18 Assessment Subjective Data: Objective Data: Critical Decision Making Nursing Process Grading Criteria 5 points 5 points Nursing Diagnosis Related Factor/Risk Factor: Causative Factor No Medical Diagnosis Planning Patient Goal: The no duh statement (Long term) Outcome Criteria: Observable Measureable Objective Patient Directed Timed (on your shift) Short & Specific Realistic 5 points 10 points 20 points Implementation Nursing Intervention/Rationales: 40 points Interventions: Begin with action verb Tell what, when, how, how much, how often, and who is to do the action Demonstrate comfort measures when appropriate Provide medications, IVs, treatments and procedures when appropriate Nursing observations relating to medications, V/S, changes inpatient condition that are planned for Include teaching when appropriate Rationales: A scientific statement which supports the nursing intervention as it relates to the problem and has a physiological basis Each nursing intervention is followed by the rationale for it Each rationale is supported by the source (you must appropriately document the source of your rationale using APA format)

19 REMEMBER: ***When appropriate Assess Comfort Treatment/Meds Teach Evaluation Observations & Conclusions: 5 points Were the goal/outcome criteria met? If not, why not? Were the goals attainable? Should the interventions be changed? This is part of your critical decision making grade; which is a part of your clinical grade.