ASHEVILLE BUNCOMBE TECHNICAL COMMUNITY COLLEGE PRACTICAL NURSING EDUCATION HANDBOOK

Transcription

1 Revised 01/13/ ASHEVILLE BUNCOMBE TECHNICAL COMMUNITY COLLEGE PRACTICAL NURSING EDUCATION HANDBOOK Please carefully read the following pages and ask for further explanation of points you feel need clarification. The material in the Handbook will be reviewed during orientation and during the Fall Semester as a part of NUR 101 Practical Nursing I. You will be asked to sign a statement which verifies your understanding of the content of the Program Handbook. Information in this handbook describes the Asheville-Buncombe Technical Community College Nursing Program at the time of publication. Unless otherwise indicated by a parenthetical statement containing effective date all terms, conditions, policies, practices, stated directives and information contained within this handbook is effective on the publication date as listed in the Table of Contents. However, changes may be made in policies, the calendar, curriculum or costs. Such changes will be announced by ABTCC approved methods and practices.

2 Revised 01/13/ TABLE OF CONTENTS Welcome... 5 A-B Tech s Vision, Mission and Values... 6 A-B Tech Catalog and Student Calendar... 7 SECTION I: LICENSED PRACTICAL NURSING PROGRAM College and Program Accreditation... 8 Mission and Philosophy... 8 Student Learning Outcomes... 9 Documents and Forms... 9 Faculty and Staff... 9 SECTION II NURSING PROGRAM CODE OF CONDUCT NCBON Administrative Rule 21 NCAC (students) Establishing and Changing Policy NCBON Administrative Rule 21 NCAC (faculty) Progression ANA Code of Ethics Chain of Command Communication Clinical Absences General Clinical Expectations Lab Rules Clinical Dress Code and Appearance Rules Mission Hospital Expectations Consequences of unprofessional behavior SECTION III NURSING PROGRAM POLICIES Academic Advising Academic and Performance Counseling Appointments Audiovisual Policy Background Checks/Drug Screen Certified Nursing Assistant Certified Professional Rescuer Change of Contact Class Officers Clinical Affiliates Confidentiality Statement Degree Awarded and Licensure Eligibility Employment in the Clinical Affiliates Faculty Meeting Representation Faculty Supervised Medication Administration... 30

3 Revised 01/13/ Grading Policy Assignments/paperwork Projects Exam and Quiz Grading Exam Administration Exam Review Making up a Missed Exam Medication Administration and Calculation Competency Exam Clinical and Lab Skill Competency Testing Evolve (HESI & SimChart) Workplace Readiness Service Learning Attendance Post Exposure Follow-Up Procedures Readmission/Transfer to the Nursing Program LPN to ADN Advanced Placement Option Skills test for readmission/transfer Scholarship Information Skills Requiring Certification Social Media/Networking Policy Student Health Expectations Student Responsibilities for Safe Patient Care Student Supervision in Clinical Settings Technical/Physical Standards for the Student Nurse SECTION IV - LICENSED PRACTICAL NURSING PROGRAM CURRICULUM DESIGN Conceptual Framework Core Competencies Curriculum Organization Conceptual Model Maslow s Hierarchy of Needs Erikson s Developmental Tasks Nursing Process SECTION V FORMS General Incident Report Form A-B Tech Readiness Skills Rubric Student Health Assessment Form Readmission/Transfer Physical Assessment and Medical Skills Form Self-Improvement Plan Action Plan Monitoring Academic Progression Plan... 71

4 Revised 01/13/ Conference Form Student Practice Event Evaluation Tool Agreement... 74

5 Revised 01/13/ WELCOME Welcome to the Licensed Practical Nursing program at Asheville-Buncombe Technical Community College. Your selection of the Practical Nursing as a program of study carries with it several important responsibilities. First, the Practical Nursing student must be committed to the profession. Being a nurse requires self-discipline, physical, mental, and emotional stamina. As you give to others, you must often give of yourself. Therefore, commit yourself to lifelong learning and do not be reluctant to give, for you often receive much more in return. Second, the Practical Nursing student must strive for excellence. The importance of providing good health care is paramount. When we as health care providers fail in our performance, the patient becomes the loser. Therefore, strive for excellence, for our patients deserve our best. Third, begin even now to plan for your continuing education growth. Nursing is an ever-changing science. Advances in the field require new learning and a plan for your education growth. Therefore, learn now what you can, but never expect to reach the summit of all knowledge in this field. The Practical Nursing student should not become so overpowered by the technologies and complexities of nursing that he or she forgets the focus of the profession quality health care for the patient. It is in giving of yourself to your patients and to your profession, that you will reap the fullest pleasure from your practice. Numerous and varied opportunities await the nurse as health-care provider, making personal goals almost unlimited. Enjoy the time you spend with each patient now as a student, and later as you practice as a Practical Nurse. Allow them to be the highlight of your day. -The Nursing Faculty of ABTCC

6 Revised 01/13/ A-B Tech Vision, Mission and Values Vision Locally Committed Regionally Dynamic World-Class Focused Mission A-B Tech inspires, nurtures and empowers students and the community toward a better quality of life through progressive teaching, bold innovation and supportive collaboration. Values A-B Tech s core beliefs guide behaviors, decisions and interactions towards accomplishing the mission and achieving the vision. A-B Tech is dedicated to student and community success through: Excellence To practice the highest levels of professionalism and performance in providing a quality education for our diverse community. We commit to superior personal, academic and professional standards as we strive for distinction in all aspects of our learning and work. Learning To foster a love of learning and to empower individuals to succeed in our local and global community. To be the #1 resource for college and career readiness, transfer education, enrichment, workforce development and life-long learning. Supportive Environment To create a safe, nurturing, appreciative, compassionate atmosphere of mutual respect and collaborative partnerships among all individuals. Innovation To actively seek creative solutions and cutting edge initiatives that lead to best practices. Inclusiveness To embrace the diversity of cultures, ideas, wisdom and points of view that make people unique and adds quality to our lives and vitality to the college. Continuous Improvement To continually assess the effectiveness of our programs, services and processes to assure that we are doing our best every day and that over time our best gets better.

7 Revised 01/13/ A-B Tech Catalog and Student Calendar This handbook has been designed as a guide to provide you with the necessary information regarding your classroom and clinical education experiences. This handbook is a SUPPLEMENT to all other ABTCC-published materials including the College Catalog and Student Calendar. You are responsible for obtaining these materials from Student Services and reviewing them along with this Program Handbook. Click HERE to access the college catalog Click HERE to access the student handbook Report broken links to the nursing program

8 Revised 01/13/ SECTION I LICENSED PRACTICAL NURSING PROGRAM College and Program Accreditation Recognized and Approved by: North Carolina State Board of Education North Carolina Community College System N.C. State Approving Agency for the Use of Veterans Military and Education Benefits A-B Tech is accredited by the Commission on Colleges of the Southern Association of Colleges and Schools to award associate degrees. Mission The Licensed Practical Nursing program supports the mission of the North Carolina Community College System and the mission of Asheville-Buncombe Technical Community College. The faculty is committed to providing accessible high quality nursing education to meet the diverse and changing health-care needs of the service area and to promoting the development of qualified students prepared for the professional role of practical nurse at the entry level. Graduates of this program meet the education requirements to take the National Council Licensure Examination (NCLE-PN). Philosophy The philosophy of the Licensed Practical Nursing program is derived from statements about the health, quality of life, achievement of potential, the individual, environment, health, nursing, the practice, and education of the Licensed Practical Nurse. Within this mission, the goal of nursing faculty is to promote the highest quality of nursing care to the individual, families and significant persons, and the community. The aim is to facilitate optimum health, quality of life and achievement of potential for the individual. The Licensed Practical Nurse The graduate of the Licensed Practical Nursing program at Asheville-Buncombe Technical Community College is prepared to meet the educational competencies as defined by Southern Association of Colleges and Schools, the North Carolina Nursing Practice Act and the Licensed Practical Nursing program outcomes. The practice of nursing is directed toward meeting the health care needs of individuals throughout their lifespan. The graduate s role is characterized by evidence-based clinical practice with the provision of care for individuals and families in structured settings. The Licensed Practical graduate demonstrates the competencies identified by the National League of Nursing (2000) and the Institute of Medicine (2004) to provide nursing care.

9 Revised 01/13/ Student Learning Outcomes Upon completion of the Practical Nursing Program, the graduate will upon licensure: 1. Students will demonstrate skills necessary for transition to professional nursing practice. 2. Students will demonstrate knowledge necessary for transition to professional nursing practice. 3. Students will demonstrate behaviors necessary for transition to professional nursing practice. 4. Students will demonstrate cultural competency within nursing. 5. Students will utilize informatics and evidence based data to provide nursing care to clients. Documents and Forms All Nursing Program documents and forms are accessible via Moodle course shells or the ABTCC Nursing Web site Faculty and Staff Address instructors by surname (last name): Faculty contact information If you have problems with the course or material covered, please contact your instructor during office hours or call and arrange an appointment. Full-time faculty office hours are posted on office doors in Rhododendron building. Clinical supervision will be provided by both full-time as well as adjunct and part-time instructors. Should you need to reach a part-time clinical instructor, please contact: Nursing Department, Room 443, Rhododendron building nmarkhoff@abtech.edu

10 Revised 01/13/ SECTION II NURSING PROGRAM CODE OF CONDUCT North Carolina Board of Nursing Administrative Rule 21 NCAC STUDENTS (a) Students in nursing programs shall meet requirements established by the controlling institution. Additional requirements may be stipulated by the nursing program for students because of the nature and legal responsibilities of nursing education and nursing practice. (b) Admission requirements and practices shall be stated and published in the controlling institution's publications and shall include assessment of: (1) record of high school graduation, high-school equivalent, or earned credits from a post-secondary institution; (2) achievement potential through the use of previous academic records and preentrance examination cut-off scores that are consistent with curriculum demands and scholastic expectations; and (3) physical and emotional health that would provide evidence that is indicative of the applicant's ability to provide safe nursing care to the public. (c) The number of students enrolled in nursing courses shall not exceed the maximum number approved by the Board as defined in 21 NCAC (f) and 21 NCAC (k) by more than 10 students. (d) The nursing program shall publish policies in nursing student handbook and college catalog that provide for identification and dismissal of students who: (1) present physical or emotional problems which conflict with safety essential to nursing practice and do not respond to treatment or counseling within a timeframe that enables meeting program objectives. (2) demonstrate behavior which conflicts with safety essential to nursing practice. Establishing and Changing Policy All student policies of the Asheville-Buncombe Technical Community College Nursing Program are developed and approved by the faculty. Approved policies are contained in the Nursing Student Handbook, which is available to all students on the ABTCC website. Prior to each fall semester, new and returning students will read the Nursing Student Handbook and sign an acknowledgement form. Input from students will be considered a part of data gathering regarding policy changes. New policies or those needing revision will be reviewed and approved, modified, or denied during a faculty meeting by a majority vote of all faculty. Approval, modification or denial will be by vote of the faculty, with a majority being required. New and revised policies will be incorporated into the Nursing Student Handbook, to be published the following fall semester. Students will be notified by individual course faculty of any policy revisions that go into effect before the next scheduled fall handbook revision

11 Revised 01/13/ The effective date will be determined by faculty when the policy is approved and will be announced to students. Prior to the next scheduled handbook revision, students will be provided with any policy changes in writing, and sign an acknowledgement of receipt. North Carolina Board of Nursing Administrative Rule 21 NCAC Nurse faculty members shall have the authority and responsibility for: (1) student admission, progression, and graduation requirements. You are responsible for the completion of your academic program, for familiarity with all requirements of the ABTCC catalog under which you are eligible to graduate, for maintaining the grade point average required, for knowing your academic standing, and for meeting all other degree requirements. Advisors and counselors are available to assist all students, but final responsibility for meeting program and graduation requirements remains with you. Student responsibilities include asking for help, attending open skills lab, communication with students, faculty and staff and knowledge of policies outlined in the student handbook and the college catalog. Progression in the nursing program is contingent upon Following policy set forth in the Nursing program handbook and ABTCC student calendar and catalog Adhering to guidelines found in the course syllabus, calendar and description Demonstration of clinical skills commensurate with progress in the program and supportive of safe nursing practice Professional behaviors as outlined in the ANA code of ethics and handbooks Meeting all requirements as per clinical agency contract to remain in the nursing program. Purchasing and maintaining all required materials A-B Tech and the Nursing Program believe that professional behavior is an integral part of each student s nursing education. You are expected to behave with the professionalism of a nurse as outlined by the American Nurses Association (ANA) Code of Ethics, the ABTCC student handbook and the nursing program handbook upon entering the program. You are expected to behave with professionalism whether you are in the classroom, lab, or clinical setting. Professional behavior is reinforced by use of the Workplace Readiness Rubric. The Program asks each student to acknowledge the importance of personal integrity in nursing, including the standard set by the AB-tech Student Code and the commitment to the public trust made by the Nursing Program. Nursing is a profession which has earned the public s trust. The importance of student integrity, trustworthiness and honesty are very serious concerns due to the implications to patient safety. A faculty member may

12 Revised 01/13/ refuse to have a student continue in their course, and the college may dismiss a student from the program, if the student s character does not uphold the professionalism of nursing. This is a serious matter for both the program and the student. The Nursing Program identifies unprofessional behavior as a cause for an academic dismissal. An academic action may be overturned on an appeal only if the academic action was arbitrary or capricious (i.e., all of the important facts were not considered). The ANA Code of Ethics defines professionalism, as follows: 1. The nurse in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual unrestricted by consideration of social or economic status, personal attributes, or the nature of health problems. 2. The nurse s primary commitment is to the patient, whether an individual, family, group, or community. 3. The nurse promotes, advocates for, and strives to protect the health and safety and rights of the patient. 4. The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse s obligation to provide optimum patient care. 5. The nurse owes the same duties to self as to others, including responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth. 6. The nurse participates in establishing, maintaining, and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action. 7. The nurse participates in the advancement of the profession through contributions to the practice, education, administration and knowledge development. 8. The nurse collaborates with other health professionals and the public in the promoting community, national and international efforts to meet health needs. 9. The profession of nursing as represented by associations and their members is responsible for articulating nursing values, for maintaining the integrity of the profession and its practice, and for shaping social policy. ( Chain of Command For concerns regarding issues with students, faculty and staff while in the program, follow the chain of command. Document your concerns in writing using date, time, place, name and description of incidents or issues. Examples include classroom conduct, fellow student or instructor behaviors and clinical staff issues. Document the steps you take as you go through the chain of command as well. Always address the

13 Revised 01/13/ person you have issues with first if appropriate. If you are unsure who to talk to, you can ask your advisor or department chairpersons. 1. Person(s) exhibiting the conduct 2. Direct instructor (clinical, lab or classroom) 3. Lead instructor (and Clinical Liaison if the issue is clinical) 4. Associate Chairperson 5. Chairperson 6. Dean of Allied Health 7. Vice President of Instructional Services/Vice President of Student Services 8. President 9. Board of Trustees When contacting anyone please include your full name, contact information and your program as well as expected date of graduation this information will be useful in providing specific feedback. For a grade appeal students may obtain the appeal form from student services, have the faculty and chair sign it and take it to the Vice President of Instructional Services Communication All nursing courses are web enhanced through the ABTCC website. Students must have access to a computer and are expected to check Moodle and daily for updated course information, assignments, inclement weather, schedule changes and attendance records. Students should not check Moodle on unsupported platforms such as those on smartphones or tablets. Click here for more information and to set up your computer for Moodle use. Attempting to complete assignments on unsupported devices may result in failure of that assignment. Give prior notification in writing and/or voice mail to faculty when you are unable to meet commitments, detailing how and when you will make up requirements. When communicating with an instructor introduce yourself and include the name of your program. When ing, also include your student ID.

14 Revised 01/13/ For clinical absences complete all of the following steps: 1. notify the Clinical Instructor a minimum of one hour before the start time of the clinical experience (by or phone as directed), and 2. if your clinical site requires notification, call the unit and obtain the name of the person you spoke with; note the time that you called Exceptions: 3. If your clinical instructor has directed you to do so, notify the clinical liaison by or phone (nitamkirkpatrick@abtech.edu, (828) ) a minimum of one hour before the start time of the clinical experience. In all communications identify yourself and your program, the reason for your absence/tardy, and the names and times of the other persons you contacted (if is not available to you, leave a voice mail General Clinical Expectations The following guidelines are published to aid the student in determining proper professional conduct. Students are expected to: 1. Know that removal of supplies/articles from clinical affiliates is considered theft. 2. Maintain a professional attitude when in the presence of other students, staff nurses, program faculty, physicians, patients and families, or other health-care providers. Use of profane or obscene language will not be permitted during any nursing class, clinical, or lab activity. 3. Eat only in areas specifically designated for that purpose. Breaks and lunch schedules will be assigned at the discretion of the Clinical Instructor at each Clinical Affiliate. The student is reminded that with the nature of the professional responsibilities of nursing it is often impossible to predict a schedule of meals and breaks in advance. The student is provided the equivalent of a half-hour lunch break during each full day s clinical rotation and will be given the opportunity for other breaks during the day as the work schedule allows. Students are allowed to eat away from the campus of the facility only when directed to do so by nursing faculty. 4. Remain at clinical facility unless specifically dismissed by the nursing faculty. 5. Turn off cell phones and pagers upon entering the class, lab and clinical setting. Students who might need to be contacted in the event of an emergency should ask that their families contact the nursing clinical liaison at

15 Revised 01/13/ Accept assignments from the clinical instructor commensurate with the student s capabilities or take direction from an individual designated by the clinical instructor 7. Provide direct patient care without any form of compensation (gratuity or tip). 8. Discuss how to perform clinical skills with the Clinical Instructor prior to the implementation of the procedure. 9. Refrain from revealing personal information outside the realm of professionalism. Personal life of the student or his or her peers should never be discussed in front of a client. 10. Make every effort to make a client comfortable. 11. Have supervision when performing clinical skills. 12. Perform all skills available to them during the clinical day. If a student has not had the opportunity to perform a given skill in the clinical setting, the student is responsible for alerting the instructor prior to initiating any procedure. Students should recognize clinical weaknesses and advise course faculty to arrange for additional laboratory practice sessions. Failure to take responsibility for learning experiences will result in an unsatisfactory clinical evaluation and failure to meet the course objectives. The faculty acknowledges that true life emergencies do exist and will work with you in these situations if they arise. Note: True life emergencies do NOT include: 1. Scheduling work or vacation during class or clinical, or final exam times. (Missing class in order to work is not an excused absence.) 2. Non emergent doctor or dental appointments. 3. Being fatigued due to your own actions. 4. Planning special events that interfere with class or clinical time. Lab Rules Students participating in lab activities will: 1. Dress as instructed for lab activities: for lab activities such as simulation that are counted as time spent in clinical, the clinical dress code applies. 2. Bring lab kits and designated equipment to all assigned labs or the student will be dismissed from the lab. Any time missed will count as an absence. 3. Use only equipment designated for use by the instructor. 4. Wash hands before any lab assignment that uses mannequins or lab models. 5. Operate or move mannequins only under direct instructor supervision. 6. Remove shoes if they must occupy a bed during a lab activity. Beds are only to be used during assigned activities. 7. Refrain from eating or drinking in the lab. 8. The computer lab in the Rhododendron Building is primarily for the use of Allied Health and Public Service programs and students who are currently enrolled at

16 Revised 01/13/ Asheville-Buncombe Technical Community College (A-B Tech). Shut down all computers in the computer lab when finished. Students will assist faculty with the following if necessary please ensure the lab is in appropriate condition before leaving: 1. All chairs and tables are returned to the original classroom set up. 2. Mannequins and models are cleaned, with dressings, IV s, and any invasive lines removed. 3. Any equipment that can be reused is repackaged and replaced in the appropriate storage cabinet. 4. Any equipment that cannot be reused is properly disposed of in either the trash or sharps container. 5. Bedside tables and medication carts have been cleared and wiped with a disinfectant. 6. All beds are made, in the low position and side rails are raised. Linens are changed if soiled. Any student guilty of any infraction of the Code of Conduct will be counseled by the Program Faculty. Each infraction will be handled by the faculty according to the seriousness of the situation and in accordance with the published current policies in the Student Catalog and the Nursing Department Corrective Action and Discipline Policy. Clinical Dress Code and Appearance Rules The personal appearance and demeanor of the nursing students at ABTCC reflect both the College and Program standards and are indicative of the student s interest and pride in the profession. While in the clinical setting, all students are required to maintain standards of dress, grooming, and conduct that are consistent with good hygiene, safety and professionalism. Individuals not following this policy will be sent home to change clothes or correct the problem. If this occurs, time away from clinical will count as hours absent. The A-B Tech photo ID badge is considered part of the uniform; it should include first name, last name, and the title Nursing Student. Students may only wear the ABTCC nursing uniform and badge while participating in approved (for credit) activities such as Service Learning. Volunteer work or other work done outside these boundaries should be performed in alternate, appropriate dress.

17 Revised 01/13/ Male and female students will purchase program-approved uniforms from Read s Uniforms. It is the responsibility of the student to obtain the required uniform pieces in adequate time to have them available for the first clinical rotation. The web site for Read s Uniforms is and the phone number is Item Female Male Burgundy scrub top; two front pockets; A-B Tech Logo embroidered onto the top 2 tops Style # Style # 0103 Style # Style # 4153 Burgundy scrub pants 2 pairs Style # 4232 Style # 0203

18 Revised 01/13/ Style # 4245 ****Optional**** White Lab Coat - similar to those in the sample images to the right. The A-B Tech logo will be embroidered in burgundy on the white lab coat or warm up jacket (as they are called at Read s Uniforms). Style # 4430 Style # 0912 Style # 3414 Style # 29122

19 Revised 01/13/ REQUIRED - ALL STUDENTS Bandage scissors, stethoscope (with bell and diaphragm), penlight, and a watch with a second hand are required. A white round neck, V-neck, turtleneck, or long or short sleeved shirt, may be worn under the scrub top. A long-sleeved white undershirt must be worn if tattoos are visible on the forearms. White leather shoes, or shoes made of a non-porous, non-penetrating, water-resistant material must be worn (closed toe, closed heel, must cover top of foot); NO canvas shoes. Shoes must be clean and polished at all times; white shoe polish may need to be applied periodically if shoes become discolored, or scuffed. White socks or hose must provide coverage for skin. Socks will be of sufficient length to ensure skin coverage during all clinical activities, including kneeling and squatting. Uniforms should be clean, wrinkle free, and display program-approved name tag. Practical Nursing Lab Pack Additional Dress Code Guidelines: 1. No sweaters, hoodies, wraps or other cover-ups are allowed to be worn over the required uniform during clinical. For this reason, the purchase of a white lab coat is encouraged. Obviously, the student may wear weather-appropriate outer wear when traversing to the clinical site. During clinical, the student may wear a white lab coat when necessary. 2. Hair will be neat, clean, dry at all times and well groomed. Extremes in style or color are not acceptable in clinical. When in clinical, hair will be secured to prevent patient contact with the care giver s hair. Discreet clasps or barrettes are acceptable. Facial hair, such as moustaches and beards must be kept neatly trimmed and clean. A student should be able to cover facial hair completely with face mask or shield. 3. Make-up should be discrete and well-applied. Strong odors including tobacco, perfumes, scented lotions and powders, after shaves or strong body odors are not allowed. Antiperspirant or deodorant (not strongly scented) must be used daily. Visible tattoos must be covered (see uniform information above). 4. Students may wear wedding, class, or other small ring, Rings will be limited to one per hand. No other jewelry is allowed. Visible body piercing displaying jewelry will not be allowed. 5. White or flesh colored full coverage undergarments should be worn at all times; no undergarments should rise above the waistband of the scrub pants, especially when bending over. 6. Sunglasses may be worn only when prescribed by a physician or optometrist. 7. Fingernails must be kept short, clean, and neat for reasons of proper hand washing and patient safety. Colored nail polish is not acceptable. No artificial fingernails or extenders are allowed (i.e., acrylic nails, tips, wraps made of silk,

20 Revised 01/13/ linen, fiberglass, gels, glues, and mixtures of these products). Natural fingernail tips are to be kept less than 1/4 inch in length. 8. While in uniform, students may not chew gum or smoke except in designated areas. Many clinical affiliates do not allow ANY SMOKING IN OR ON THE GROUNDS OF THE FACILITY. It is the student s responsibility to adhere to the policies of each facility. Failure to follow such policy may result in the student no longer being allowed to continue in clinical at this facility, and may jeopardize the student s continuation in the Nursing Program. Student clinical uniforms should smell clean and be free of cigarette smoke odor or discoloration. 9. Students may be required to adhere to a specific clinical agency dress code when agency policy is more stringent than the policy of this nursing program. 10. Some courses may require alterations in the uniform policy. Course syllabus will outline the details. Read s Uniforms 123 Sweeten Creek Rd Suite D Asheville, NC (828) Monday-Saturday 10am-6pm Directions to Asheville Location: Take I-40 to exit 51. Make a right onto Sweeten Creek Road (25-A). Proceed approximately one-half of a mile, then turn right onto Sweeten Creek Crossing, which will take you into the main parking lot for Read s Uniforms, behind the building. Mission Hospital Expectations Expectations of Students 1. Students will wear their school uniform while on Mission campus. Exceptions: a. If a student is in a non-clinical area they may wear business attire b. If the student is in an area that requires changing into hospital scrubs. 2. Students must wear their school identification badge at all times. 3. Cell phones or personal electronic devices should be silenced or placed on vibrate 4. Text messaging or other cell phone functions will only occur during breaks in non-patient areas. 5. Use of cell phone camera function is prohibited. Clinical Expectations of Students 1. Be present and listen to report. 2. Demonstrate a basic knowledge of the patient s condition and diagnoses and have a prepared plan of care. 3. Keep the nurse informed at all times of patient status.

21 Revised 01/13/ Be knowledgeable about medications for the assigned patients including rationale and side-effects. 5. Medications may be given under the direct supervision of the instructor. This should be arranged between the instructor and the nurse in charge of the patient. 6. Give report to the nurse before leaving the unit. 7. Document according to unit policy. 8. Complete documentation before leaving for the day. Student Practice Guidelines - Faculty and Student: Emergency Medical Science and Nursing Policy, 2NR.NSA.0112 (1.12) Nursing students, faculty and Paramedic students cannot be assigned to care for patients: 1. On airborne isolation 2. On suicide precautions 3. In violent restraints Nursing students, faculty and Paramedic students cannot perform the following procedures: 1. Admission, transfer, or discharge of a patient 2. Administration of blood or blood components 3. Advanced Cardiac Life Support (ACLS); Pediatric Advanced Life Support (PALS); may perform Basic Life Support (BLS) 4. Advanced competencies (e.g. defibrillation, cardioversion) 5. Consent process 6. High alert medications requiring independent double check ABTCC Students MAY administer Subcutaneous Heparin, Lovenox and Insulin (per communication with Karen Lundberg, May, 2013) 7. Non-violent restraints (application, documentation) 8. Point of Care testing (Capillary Blood Glucose, Hemocult) 9. Telephone, verbal orders and critical result reporting 10. Titratable intravenous (IV) medication including preparation of IV admixtures 11. Bladder irrigation 12. Care of central lines, peripherally inserted central catheters (PICC) and implantable intravascular access devices 13. Complex wounds and treatments 14. Venipuncture or IV catheter insertion Exceptions to above restrictions: 1. Paramedic and precepted nursing students may perform venipunture or peripheral IV catheter insertion under the direct supervision of the preceptor or RN with appropriate competencies. 2. Precepted nursing students can care for patients receiving chemotherapy and those on neutropenic precautions.

22 Revised 01/13/ Consequences of unprofessional behavior A continued pattern of unprofessional behavior is not tolerated in the nursing program. If you witness anyone engaging in unprofessional behavior as outlined above, document the behavior with the time, date, place and name of the person and follow the chain of command. Those with a documented history of unprofessional behaviors will be counseled as per program policy. Students agree to comply with the stated rules and regulations outlined in the handbook, with the AB-Tech Student Handbook, and with the Course Catalog and to stay abreast of handbook information as it is revised and distributed. If you violate the policies set forth in the Nursing Program Handbook, the AB-Tech Student Code of conduct, or the ANA code of ethics, you will be counseled and documentation will be placed in your file. In addition, the faculty member will notify other faculty as deemed appropriate (lead instructors, adjunct clinical instructors, chairpersons). When problem behaviors are identified, the involved faculty member will counsel you on the unacceptable behavior and indicate the type of behavioral change that is expected, and within what time frame. Unacceptable behavior and counseling will be documented by the faculty in your file using a self-improvement plan, action plan or conference (see below). In addition, the faculty member will notify other faculty as deemed appropriate (lead instructors, adjunct clinical instructors, chairpersons). You will be given a copy of the documentation which was submitted to your file. 1. Self-Improvement Plan (SIP) If faculty find you need to demonstrate a change in behavior, it is appropriate to fill out a SIP. You may meet with the faculty member to design a SIP that involves self-reflection of the performance or behavior that is of concern. A copy will be placed in your folder (if applicable). It is up to you to ensure that follow up documentation is placed in your folder, however no further action is required by the faculty if they judge you have successfully completed the SIP. 2. Action Plan (AP) An Action Plan defines specific objectives developed by nursing faculty to address student behaviors or performance concerns. An unresolved action plan will progress to a conference with Nursing Department Chairpersons and may lead to failure of the course. The AP will be created by the faculty member or by chairpersons as delegated. You will meet with the designated staff member to discuss the AP. Follow up with the faculty or staff member is required. A copy of all Action Plans initiated will be placed in the students folder. Lead instructors and chairpersons will be notified as well. Faculty will then follow up on the AP. All documentation is to be placed in your folder, including supporting s, written records, attendance record etc Dismissal is a possibility.

23 Revised 01/13/ Monitoring Academic Progression Plan (MAPP) If faculty observe that you would benefit from faculty intervention, but a SIP or AP is not required, then a MAPP may be generated. Faculty may inform you of interventions available such as tutoring, one-on-one sessions, student mentoring, open labs, test reviews etc Completed forms will be placed in your folder. In the event you do not follow up on a suggested MAPP, a notation will be made on the form and it will be placed in your folder. 4. Chairperson Conference If faculty observe behavior or academic performance that violates student handbook policies and/or constitutes a threat to personal safety, you will conference with faculty and chairpersons. These situations will be handled on a case by case basis and require documentation. If you are to remain in the program, an Action Plan will be generated and followed. If you have demonstrated a documented threat to the safety of others, or repeated disregard for handbook policy you may fail a course and be dismissed from the program. Students may reapply for admission as per handbook policy. 5. Student Practice Event Evaluation Tool Just Culture provides a mechanism for nurse employers, educators, and regulators to come together to promote a culture that promotes learning from practice errors while properly assigning accountability for behaviors, consistently evaluating events, and complying with mandatory reporting requirements for licensed nurses. The NC Board of Nursing is committed to working with Nursing Education Programs interested in using Just Culture principles in addressing practice events occurring with students in their clinical practice settings. Just Culture in Nursing Programs uses a Student Practice Event Evaluation Tool (SPEET) developed by the NCBON for evaluating practice events and determining whether the actions of the individual student warrant consoling, coaching, counseling, remediation, or disciplinary action. This tool can be used by program directors and faculty, in collaboration with board consultants as needed, to evaluate student practice events with consistency and fairness, while providing the opportunity to learn from mistakes and enhance patient safety. If behaviors do not change within the given time frame, the faculty member will document the incidents and the attempted interventions. The documentation will be reviewed by department chairpersons and documentation will be placed in your permanent file. If unprofessional behavior continues, the faculty has the right to fail you with further documentation being completed and placed in your file. The department chairpersons will ultimately evaluate your situation. Dismissal is also a possibility. The chairpersons may make a referral to the Dean of Allied Health.

24 Revised 01/13/ SECTION III NURSING PROGRAM POLICIES Academic Advising Each student will be assigned to a program faculty member who acts as the student s advisor for academic or other purposes throughout all semesters. It is important for students to communicate with their assigned program advisor at mid-semester to assess progress in class and in clinical/lab. An education plan for the next academic semester can be completed at this time. The faculty also expects that the student will seek assistance and counseling at the first sign of any problem, academic or otherwise, that may jeopardize success in the program. Academic and Clinical Performance Counseling Counseling Conference A counseling conference provides an opportunity for the instructor, student or Nursing chairperson to raise and discuss issues of concern. A counseling conference can be initiated or requested by a student, faculty member or Nursing Chairperson. A third person/neutral party may be asked to participate in counseling conference. Attendance of a third party is to be accepted by all participating. Students may be counseled regarding academic and/or clinical performance. Violations of any program standard or policy as stated in course syllabi, the program handbook, the ABTCC catalog and/or student handbook are also reasons for which counseling is initiated. Academic Counseling Conference If a student s academic performance indicates potential for not completing the course, a conference may be held at the request of the student or instructor. The instructor will provide the student with theory grades in writing. Recommendations for corrective action to assist the student in improving performance can be made at this time using a Monitoring Academic Progression Plan (MAPP). The instructor will put a copy of the conference documentation in the student s file. Clinical Performance Conference Instructors have the right and responsibility to ensure safe and satisfactory behaviors in the clinical setting. The instructor may impose any restriction upon the student deemed necessary in relation to the occurrence. This includes removal from the clinical setting immediately. The instructor will then document behaviors/occurrence objectively. All specific data including date, time and place of occurrence is to be included. When student clinical behaviors do not meet satisfactory standards, the instructor will initially inform the student verbally (verbal warning) and if necessary a written warning will follow. The verbal discussion should occur as close to the time of the occurrence as possible.

25 Revised 01/13/ The instructor will discuss with the student acceptable behavior/performance and establish a Self-Improvement Plan (SIP) Written warning will generally follow a verbal warning as necessary for unsatisfactory clinical behavior. An Action Plan (AP) will be provided if deemed necessary by the instructor. A counseling conference may be held. The student has the opportunity to respond to the instructor s warning and recommendation on the Action Plan. The student and instructor s signatures are required on the AP. The student s signature does not necessarily indicate agreement. The signature represents that the student has been apprised of the occurrence in writing and has read the information. Should a student refuse to sign the form, a note will be made on the form. An area for student comments is provided on the form. The instructor will put a copy of the conference documentation in the student s file. Appointments Medical, dental, and other appointments should not be scheduled during didactic, lab, or clinical times. Faculty have scheduled office hours during which they may be able to see you on short notice; however if you require a conference with a faculty member or chairperson, you must schedule a meeting by calling or ing in advance. Audiovisual Policy Audiovisual recordings/photographs may be obtained while you are a student in the Nursing Department for the purpose of education and may be used for in-group debriefing sessions. Recordings will be destroyed after review. Background Checks / Drug Screen A required component of the allied health division is the student s participation in the clinical placement at area hospitals, clinics, and offices. Successful completion of clinical rotations is necessary to meet program graduation requirements. Allied health students will not be conferred a degree, diploma or certificate unless they can successfully complete the clinical placement and all other aspects of the program. Clinical affiliates hold patient care at a high level of responsibility. They must insure there is no risk to their patients before allowing an individual to participate in providing healthcare. Accordingly, clinical affiliates have their own standards in determining who may participate in a clinical program at their location. The College does not play any role in determining whether a student satisfies the standards set by the clinical affiliate. Admission into an allied health program is a two phase process. A student is not admitted into the allied health program until each phase is completed.

26 Revised 01/13/ The prospective student must be admitted conditionally to the program. 2. The prospective student must be accepted into the clinical placement. Individual clinical placements have their own acceptance requirements separate from the college (e.g. drug testing, criminal background, etc ) If a prospective student is denied acceptance for clinical training privileges at any healthcare institution, for any reason, that student is ineligible to proceed with the course of study in the allied health division. a. Once a student is conditionally admitted, a background check and drug screening will be conducted by a third-party entity chosen by the College. Prospective student shall deal directly with the third-party entity and will be responsible for all financial costs. b. The third-party entity will report all results directly to the clinical affiliate. Prospective student may also obtain a copy of the report for their personal review. The healthcare institution will then inform the College whether the prospective student s clinical privileges are approved or denied. If denied, the student will not be admitted into the program. LOSS OF CLINICAL PLACEMENT WHILE IN AN ALLIED HEALTH PROGRAM At any time after acceptance into an allied health program, if clinical privileges are revoked for any reason, the student must withdraw from the allied health division. Certified Nursing Assistant After successful completion of NUR-101, you may obtain your CNA II. To obtain this certificate, your CNA I must be current. The department chair will ask for those who are interested to submit their names in late fall. Obtaining a CNA II can give you better job opportunities as you progress towards Licensure as a Nurse. In addition, Mission Hospital has a competitive nurse extern program that requires a current CNA II. Though you are required to have certification as a nursing assistant for admission to the nursing program, while you are in the nursing program you do not need to maintain your CNA. For information on how to keep your CNA I current, visit the NCAR site Certified Professional Rescuer Documentation of current CPR (or BCLS) certification for the Professional Rescuer or Health Care Provider the due date will be as indicated in the new student orientation session. It includes the following components: adult, infant, child, one man rescue, two man rescue, choking, use of mask/artificial airways/ automatic external defibrillator (AED). Certifications for one or two years are acceptable. CPR courses must contain

27 Revised 01/13/ face-to-face content. The nursing program will not accept CPR courses with online content only. CPR must remain current while in the program. Updates must be dropped into the blue box in the Rhododendron building one week prior to expiration. You cannot attend clinical with expired CPR certification. Change of Contact Information Any change of name, address, or telephone number should be reported to the division administrative assistant as well as to the Student Success Service Center in the Bailey Building as soon as possible. Class Officers During the first semester, officers will be chosen (President, Vice President, Secretary, Treasurer). These officers will also serve as student government representatives. The officers will coordinate class activities and serve as class representatives to the faculty and Student Government Association. Clubs approved to operate on campus must have their charters renewed each fall. The officers may schedule to meet with the entire faculty on an as needed basis. Scheduling is done through the assigned Faculty Advisor. The faculty will be available to discuss any concerns any individual class may have. Class meetings should be held a minimum of once per semester. Minutes of class meetings are to be recorded and kept on file, with an additional copy directed to the Department Chairperson. All nursing students are expected to participate in class meetings. Clinical Affiliates The nursing faculty at Asheville Buncombe Technical Community College are continuously engaged in seeking new clinical sites to afford students the best opportunities for clinical experiences to enhance their nursing education. The Program Faculty reserve the right to change clinical times and locations from schedules offered at registration. This is necessary to accommodate the needs of clinical affiliates and still provide the best educational experience for the student. The clinical affiliates reserve the right to refuse admission to any Nursing Student who is involved in any activity not considered professional or conducive to proper patient care. Any student refused admission to any clinical affiliate is subject to recommendation for dismissal from the Program. Confidentiality Statement All clinical affiliates and patient records are confidential in nature. Students are expected to maintain the confidentiality of all hospital records in a professional

28 Revised 01/13/ manner. If a student is found guilty of willfully violating patient confidentiality, he or she will be recommended for appropriate disciplinary actions and also could be disciplined by the clinical institution. Students needing access to client charts after discharge from a clinical affiliate in order to complete in-depth study of the record for care plans, may request the Clinical Instructor to sign appropriate forms allowing student access to the medical records for the specific client. Health Insurance Portability and Accountability Act ( HIPAA ) The College acknowledges that clinical affiliates, as health care providers, are subject to the provisions of HIPAA, a federal statute which, in part, governs disclosures and uses of protected health information ( PHI ). PHI is defined in 45 C.F.R , and includes health information received or created by a health care provider that relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present or future payment for the provision of health care... and identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual. Clinical affiliates shall have the right to educate each student on the proper uses and disclosures of PHI. Clinical affiliates shall have the right to require each Participant to sign a written confidentiality agreement. Any failure on the part of the student to abide by the requirements of HIPAA or agency policies and procedures implementing HIPAA shall constitute a material breach of this agreement and can be grounds for dismissal from the Nursing Program. Maintaining confidentiality of this information is the direct responsibility of each student with clinical privileges. This includes social networks (see social networking policy) Each student will complete individual site requirements as needed Degree Awarded and Licensure Eligibility All program graduates are eligible for the Associate of Applied Science Degree in Nursing and upon meeting all other requirements, to sit for the NCLE - PN. One who passes this national exam and meets all of the other requirements will become a Registered Nurse and can use the initials, P. N. after his/her name.

29 Revised 01/13/ Effective January 1, 2002, a mandatory criminal background check is required for all applicants seeking initial licensure in North Carolina. Licensure Applicants with Prior Convictions and/or Disciplinary Action As the regulatory agency, the Board of Nursing does not become involved in reviewing the applicant s conviction record until such time as application is made to take the national examination. In the application, the question is asked whether or not the applicant has ever been convicted of a misdemeanor/felony/dui. If the response is yes, a certified copy of the criminal record must be submitted. A detailed written explanation is also required if the conviction occurred less than 5 years ago. In addition, as of January 1, 2002, criminal background checks including fingerprints are required. In accordance with guidelines established by the Board, board staff reviews the record. The applicant may take the exam as scheduled; however, the license may or may not be issued upon passing the exam. After the Board staff reviews the record, one of several actions may occur. 1. There may be a request for additional information 2. The license may be issued once the exam is passed 3. The applicant may be notified it will be necessary for him/her to appear before the Board Licensure Committee. This may be necessary if: - A felony conviction occurred after the applicant entered the nursing program - The conditions of the conviction have not been satisfied - The type and/or number of convictions bring into question the applicant s ability to safely and competently practice nursing If an appearance before the Licensure Committee is required, the committee will make a decision and one of several actions may be taken: 1. The license is issued when the applicant is successful on the exam 2. The license is issued with probation when the applicant is successful on the exam 3. The license is withheld. If this should occur, the applicant will be told the reason and will have the right to address the Board concerning the decision. Referenced 6/20/ Employment in the Clinical Affiliates A student will not be covered under the ABTCC liability insurance when working as an employee.

30 Revised 01/13/ Faculty Meeting Representation Student representatives will be selected from ADN1, ADN2, and PN classes to be responsible for communicating information to the entire class. The student will also represent their class at the annual Regional Advisory Meeting. After class officer elections, students will elect a representative and an alternate to attend the faculty meetings. Interested students will volunteer. Representatives will serve a one semester term. If more than two students per class are interested, then the students will write a letter of intent to the elected class officers. The letter should include why the student desires this opportunity and how they will demonstrate commitment to this responsibility. The student government officers will choose the representative and alternate and shall provide the names to their faculty advisor before the first faculty meeting following the selections Faculty Supervised Medication Administration o Medications must always be prepared and administered only under the direct supervision and presence of the AB-Tech nursing instructor in a faculty supervised clinical experience. Students are expected to follow each of the six rights of medication administration. Students evaluated as "unsafe" in medication preparation and administration by the AB-Tech nursing faculty will be removed from the clinical environment for the protection of the public. The student can continue to attend class and/ or labs. A final course grade of "F" is earned for the course. o Medications which require additional PN training and certification are not to be administered by the student at ANY time or under ANY circumstance.

31 Revised 01/13/ Grading Policy To assist in the understanding of content and in achieving program outcomes leading to licensure as a health care provider, faculty will utilize the following policies. After the syllabus agreement has been signed, instructors may not add, remove or change point values for assignments without having students sign a new agreement. 1. Assignments/paperwork Assignments and paperwork and are designed to prepare the student for class, lab and clinical experiences. No student is permitted in the faculty mail room at any time. 1. Written assignments should include the following information a. Student s written name b. Instructor s written name c. Name of assignment 2. All Written assignments and paperwork should be stamped with the time clock and placed in the large blue drop box located just outside room 443. Sign submissions in on the clipboard. Failure to follow this procedure may result in lost paperwork, delayed clinical experiences, action plans and point deductions. 3. Online assignments will be turned in per instructor directions 4. Late work will be accepted as per individual assignment instructions 2. Projects: individual and group projects may be assigned as part of your grade. Assignments will be included in the syllabus with clear expectations for point values to be awarded (use of a grading rubric is required, to be presented to students at the beginning of the term). 3. Exam and Quiz Grading Policy A Quiz is defined as a short evaluation tool completed independently by a student. Worksheets, presentations, and/or group projects do not meet the definition of a quiz and will not be included as quiz grades. Unannounced quizzes of varying formats may be administered in any class, lab or online. Students not present at start of a quiz will earn a 0. Online quizzes will not be accepted after the established due date/time resulting in a grade of 0. Any student exceeding the allotted time for an online quiz will have points deducted as stated in the quiz instructions.

32 Revised 01/13/ Faculty will utilize the NCLE exam plan in the planning of exams. An Exam is a more comprehensive evaluation tool covering material introduced over several class/lab periods. An exam typically consists of questions with final exams typically consisting of questions. Exams may be administered in class, lab or online. Students are encouraged to take all exams at the scheduled time. No exam may be taken before the scheduled date and/or time. Students will make up missed exams. Students scoring below 70% on any unit exam are encouraged to re-mediate with faculty to correct deficiencies. This may take place during faculty office hours or during open lab practice sessions. Exams will be primarily multiple choice questions but may contain alternate format items similar to those on the national licensure exam. Students will have 1 ½ minutes allotted per question. Students who arrive late to class on exam day may choose to take the exam but will be required to turn in the exam at the designated time along with the rest of the class. No additional examination time will be allotted and the student will be counted absent while not present during the exam. Final scores of 0.5 or above will be rounded up to the nearest whole number. 4. Exam Administration Policy During an exam students are requested to: o Keep exam booklet in a face down position until directed by the instructor to begin the exam o Write their name on both the exam booklet and answer sheet o Mark answers on both the exam booklet and the answer sheet o Place all personal belongings including cell phones along classroom walls or in the back of the room during the exam. Turn off all electronic devices. All answer sheets will be turned into instructor when time is called. Only answers marked on the official answer sheet will be included in the calculated grade. Students completing the exam before time is called turn in their answer sheet to the instructor. Then the student may leave their exam booklet in a face down position on their desk and leave the classroom. Students planning to participate in a collaborative test review may remain in the classroom until the exam is

33 Revised 01/13/ completed or break and remain outside the classroom until the review begins. Should a student fail to complete the exam during the time allowed for examination: o Only those answers completed on the answer sheet will be graded. o Any unanswered questions will be counted as wrong answers 5. Exam Review Policy Faculty may choose from the following options for exam review. No note taking will be allowed during any review. Day-of-exam feedback The instructor may provide the answers to the exam immediately after time is called. Only those students having taken the exam will be allowed to enter the classroom to hear the answers for the exam questions. Students wishing to appeal an exam item must submit the information along with a reference source to the instructor within 2 days of the review. Review time will not be used to debate questions and no note taking will be allowed during the review. OR Scheduled group review The instructor may schedule exam review for the entire class at a specified time and location outside of scheduled class or lab meeting times. Students wishing to appeal an exam item must submit the information along with a reference source to the instructor within 2 days of the review. Review time will not be used to debate questions. OR Collaborative exam review does NOT apply to FINAL exams; the number of points given will be determined by the Lead Instructor, but should not exceed 2 points at any given time. Upon completion of the exam, all individual answer sheets will be collected by the instructor. Students will then be separated into small groups and each group given a clean answer sheet. Student participation in collaborative exam review is optional, but strongly encouraged. Students will then have 20 minutes to collaboratively retake the exam. Students may not interact with members of other groups or the instructor during this process. Students may not refer to textbooks or other reference material during the group review. Assigned groups should work together to come to a decision on each exam question. If the instructor elects to award points based on group performance during the collaborative process, scores of 90 or greater would qualify for 2 points, scores of qualify for 1 point and scores less than 80 will receive no additional points.

34 Revised 01/13/ The size and composition of the groups will be determined by the instructor and may vary with each exam. Collaborative exam review for students taking the exam in the Testing Center. The nursing faculty may schedule a collaborative exam review immediately after all seated students have completed the exam. No note taking will be allowed during the review. Students testing in the Testing Center may choose to participate in the collaborative exam review if they complete their prior exam prior to the scheduled collaborative exam review by completing the following steps: - Students will obtain their completed exam booklet and scantron answer sheet from the testing center staff in a specially sealed envelope prepared and stamped by the testing center staff for nursing students. - Student will give the specially sealed envelope prepared by the testing center staff to the nursing faculty leading the collaborative exam review. - The nursing faculty conducting the collaborative review will return the student s exam booklet to them for use during the review. The nursing faculty will keep the student s scantron form. - Exam booklets and scantron answer sheet not returned in the properly sealed envelope will not be allowed to be used during this exam review and a grade of 0 will be earned for this exam. Individual review Arrangements to review the exam must be made with the administering instructor within one week of exam completion by all students. Exams will not be available for review after the designated time period 6. Making up a Missed Exam Students are encouraged to take all exams at the scheduled time. No exam may be taken before the scheduled date and/or time. Missed exams will be made up according to the following guidelines. The student must contact the instructor administering the exam within 24 hours of return to school or clinical to arrange for make-up of a missed exam. If arrangements are not made within 24 hours and the exam is not taken as scheduled, a 0" will be recorded. Make up exams may vary in format from the original exam. Make up exam completion dates will be determined by the administering instructor and may vary case by case. Students will be referred to Testing Lab in the Academic Learning Center to complete the exam. 7. Medication Administration and Calculation Competency Exam During the first semester of instruction, a medication administration and calculation competency exam will be administered as part of the clinical preparation as outlined in the course syllabus or calendar.

35 Revised 01/13/ After the first semester, the Medication Administration and Calculation Competency Exam will be administered by the date stated in the syllabus or calendar. Only calculators provided by the ABTCC Nursing Department may be used during the exam. Students who score less than 90% will have two additional opportunities for repeating the exam. Students who score less than 90% must contact the course instructor in writing within 24 hours after notification of exam 1 score to schedule remediation and exam 2. A MAPP form will be generated to track the progress of the student. Students may not take exam 2 unless they have remediated. Remediation may include online tutorials, worksheets and time with instructor. The student must attempt exam 2 by the date stated in the syllabus or calendar. Students who score less than 90% on exam 2 must have their MAPP updated, with additional remediation. Students will be referred to mandatory tutoring sessions. Students will not be allowed to pass medications in the clinical setting until successfully passing the medication exam. If a student is unable to score 90% or greater by the date stated in the syllabus or calendar, the student has not demonstrated competency to administer medications safely in the clinical setting and will not be allowed to attend clinical. This will lead to failure of the course. 8. Clinical and Lab Skill Competency Testing The student must receive a satisfactory clinical performance evaluation for all clinical components of the course, and in lab competencies. Clinical and Competency testing will be graded as Pass or Fail. Competency testing is required throughout the nursing curriculum and may also be implemented as a tool to evaluate safe clinical performance. Competency testing may vary in length and time. Each student is expected to be able to demonstrate competency in all required skills, but actual testing may only include a portion of the required skills. Each student s competency testing may not be identical, but will be equivalent in scope for all students in the course.

36 Revised 01/13/ Students will have a maximum of 2 chances to pass any skill competency. Failure to pass the skill competency will result in a failing grade for the course which will impede progression in the nursing program. Upon initial failure of any skills test, a MAPP will be generated to track the progress of the student. Students may not take the second skills exam unless they have remediated. Remediation may include, but is not limited to online tutorials/videos, open lab and time with instructor. The student must successfully take the skills test by the date stated in the syllabus or calendar. The second skills test must be administered by two instructors, one of whom should not be involved in the student s first attempt. 9. Evolve: HESI, SimChart/SLS HESI provides a comprehensive and adaptive learning system to assist in preparing students with what they need to know to pass the NCLE licensure exam and become skilled nurses. Purchase includes standardized testing and on-line remediation tools which correlate with class and clinical experiences. HESI exams will be administered during the appropriate semester. Research has shown that students prepared using testing programs are more successful in passing the state board licensure examination. The raw score you receive on your HESI will be divided by 10 and entered into the grade book. If more than one HESI exam is given, an average of the exams will be calculated. Failure to take HESI exams will result in a zero. SimChart/SLS will be used throughout the program using an electronic health record system that combines practical, real-world experience in electronic documentation with fully integrated educator support to incorporate EHR practice into the curriculum and give students a competitive edge in today's rapidly changing health care environment 10. Workplace Readiness The Workplace Readiness Skills Certificate Program (WRS) is a College-wide effort at Asheville Buncombe Community College. The purpose of this initiative is to produce graduates who demonstrate academic skills, as well as soft skills, that will allow students to not only obtain, but maintain, jobs. Employable work skills associated with this class include: Attendance, Time management, Professionalism, Communication, Quality of work, Participation/teamwork, Effort and Critical thinking). This course incorporates a point system into the final

37 Revised 01/13/ course grade that will reflect the students understanding and display of these specific employable work skills. Students must achieve a minimum grade of B combined with a minimum of 32 on the available assessment points for this course to qualify towards their Workplace Readiness Skills Certificate. This skill set, when present, translates into successful students in the classroom as well as the workplace. The Readiness Skills Rubric (See FORMS) is intended to evaluate student s demonstration of these skills. 11. Service Learning Program Description Service-Learning encourages students to undertake service projects, to reflect on what they learn, and to draw connections between what they learn in the community and what they learn in the classroom. Some of the benefits students acquire while participating in Service-Learning are: exploring careers, networking, community involvement, improving learning by getting more involved, improving diversity awareness, preparing for future employment, understanding of civic responsibility, building self-confidence and self-esteem, increasing retention, and strengthening resumes. In some nursing courses, students are required to undertake a service-learning project that is specific to the course objectives. Students may choose from specific lists of Service learning opportunities available in the community, or choose an alternative service to an individual which is approved by faculty. Each student will be responsible to contact the agency/ individual and provide faculty with a verification letter of agreement with the person/person s signature. Each student is responsible to provide proof of service by completing the Service Learning Verification Form included in the syllabus. 12. Attendance Policy Students are required to keep a record of their attendance and to communicate discrepancies with the attendance keeper as soon as they are discovered; it is inappropriate to wait until the end of the semester. Online attendance will be updated by faculty on a weekly basis. Absences in excess of 10% will be handled on a case by case basis and may result in failure of the course. Previous professional behavior patterns will be considered. Students may not make up missed clinical hours. Students may be given permission in extreme circumstances to participate in alternate clinical hours at the

38 Revised 01/13/ discretion of the faculty and chairpersons. Student absences in excess of 10% will be assessed by an ad hoc attendance review board. The review board is to be requested by the lead instructor within 24 hours of the student passing the 10% mark, but not in advance. The review board will include the following three voting members: 1. At least one but no more than two faculty with administrative duties (Dept. chair, associate chair, clinical liaison) 2. At least one but no more than two instructors who do not currently have the student in class The review board will be conducted as follows: 1. To convene within 1 week of the date of referral 2. Permission to audio record will be obtained from all members 3. Presentation of case by lead instructor (to be no more than 10 minutes times may be extended by board as necessary) to include a summary of absences and recommendation of outcomes. 4. Presentation of case by student (to be no more than 10 minutes) to address the absences and provide background or additional information to allow the board to make an informed decision. 5. Questions to lead instructor and student (to be no more than 5 minutes) 6. Student and lead instructor will step out 7. The board will discuss the presentations and a vote will be made The student may continue to attend class, lab and clinical until a decision has been made. The student will be notified within 24 hours of the meeting of the board with one of the following options: 1. Student will remain in the program, signing a contract outlining future attendance plan. 2. Student will withdraw by last date of withdrawal (may continue in class and lab, but not attend clinical) or student will receive a grade of F for the course. Appeals to the decision of the board will follow due process as outlined in the ABTCC student catalog. Post-Exposure Follow-Up Procedures for Off Campus Incident/Student Accident Claims In the event of a needle stick or other body fluid exposure incident at a clinical site, student may be tested in the emergency room of the clinical site. Your instructor will notify OccuMed to report the incident If student was not tested in the emergency room at the clinical site, he or she should go to OccuMed, Mission s Outpatient Service Center for testing within 1-2 hours of incident. OccuMed is located at 2 Medical Park Drive, Suite 102.

39 Revised 01/13/ Testing is covered by student accident insurance provided that student has seen Shelby Burnette, Administrative Assistant in the Simpson Building within 48 hours of exposure to activate claim. Student will need the name of the source patient for the claim form. If student choses to go to another source for care, payment of the claim will be more complicated. OccuMed has an agreement with AB Tech to process student incidents. Readmission/Transfer to the Nursing Program Any student who has attended an Associate Degree Nursing or Practical Nursing Program may apply for advanced standing in these curriculum programs at A-B Tech. Readmission and transfer into the nursing programs is contingent upon space available. The number of available spaces will correlate with the withdrawal of regularly admitted students. In some years, no slots may be available. Credit granted for previous coursework will be determined on an individual basis. Students transferring from another college or university nursing program to A-B Tech must complete > half of the credit hours required for the specific nursing program of study at A-B Tech. If transferring into the Associate Degree Nursing Program, a student must complete > 36 credit hours. If transferring into the Practical Nurse Education Program, a student must complete > 24 credit hours. Eligibility for Readmission or Transfer Readmission with advanced standing: Students are defined as individuals who have successfully completed nursing courses at A-B Tech. All NUR prefix coursework must have been successfully completed within a 1 year period of the date of readmission. LPN to Associate Degree Nursing Advanced Placement Option: The specific requirement of this option can be found HERE. This option allows qualified, selected LPN candidates to join the ADN students in the summer semester. Applications will be accepted every year in the previous fall; seating is limited and subject to space available. You must have an unrestricted LPN license in North Carolina to apply. In addition, completion of NUR 117 (Pharmacology) or the equivalent is a prerequisite along with those listed in the LPN to ADN Advanced Placement Option admission criteria. Applicants will be ranked according to TEAS composite scores and residency status (additional points are awarded if applicant resides in Buncombe or Madison county).

40 Revised 01/13/ If a student has failed the ADN program twice, that student is not eligible for readmission or admission to the Bridge Program. Transfer: Transfer students are defined as individuals who have successfully completed nursing courses at other colleges or universities. All NUR prefix course work must have been successfully completed within a 1 year period of the date of transfer. The following dates have been established for readmission/transfer: Semester for reentry Letter/ of intent received between the dates of: Interview: Before start of prior term (allows for re-entry by auditing to be an option) Exams completed: 6 weeks before start of term Fall March 1 Memorial Before Summer session July 1-1 st term Day begins Sept 1 2 nd term Spring June 1- Labor Day Before fall 2 nd term Dec 1-1 st term begins Oct 15th Feb 1 2 nd term Summer Jan 10 Mar 10 Before 2 nd spring term April 1st begins March 12 Skills completed: 4 weeks before start of term July 15 th -1 st term Sept 15 th -2 nd term Dec 15 th -1 st term Feb 15 th -2 nd term April 15 th The process for readmission or transfer is as follows: 1. These items must be received by the application deadline: Letter of intent to the Chairperson of the Department of Nursing, no earlier than three months prior to the application deadline. Schedule an interview with the chairpersons (part of the selection process, may require a remediation plan and/or auditing lower level courses; may audit lower level course(s) in lieu of 6A-6D, as below, with permission of chairpersons). At a minimum, students must score 90% on the medication calculation test, 70% on the final exam, and receive a satisfactory on the clinical component of the course audited. Test Scores meeting the minimum requirements for admission into the nursing cohort into which the student wishes to transfer or be readmitted. Applicants with disabilities should contact the Coordinator of Disability Services/ Counselor at (828) , ext. 141, at least three weeks prior to testing to receive special accommodations for the Accuplacer. 2. Readmission students from A-B Tech will be given priority consideration over transfer students. 3. Nonresidents of North Carolina will be considered only in the event vacancies exist after the consideration of North Carolina residents. 4. A student will be readmitted only one time to any program. Exceptions by department chair approval.

41 Revised 01/13/ When multiple students apply for readmission or transfer to the same course, student will be readmitted by TEAS test score and satisfactory evaluation of skills and theory. 6. Incoming students must demonstrate skills and/or theory commensurate with the knowledge level of the currently enrolled students in the course being entered. a. Students scoring 90% on the (written) pharmacology component must complete remediation and retesting no more than two additional times. b. Students scoring between 70% and 90% on the theory component will be required to complete remediation prior to the skill practicum. c. A skill practicum will be administered to the student by three or more instructors in the Department of Nursing. The skill practicum must be evaluated as satisfactory. It is the student s responsibility to make an appointment with the Department Chair before the application deadline to arrange a time for completion of the practicum requirement. d. Remediation consists of correcting the written test using the textbook. A 90% must be achieved upon remediation. 7. Transfer applicants: Submit the following documents to the nursing department: Official high school transcript from a valid institution or GED Official copy of a transcript from every college or university attended Copies of syllabi for each nursing course taken at a college or university other than A-B Tech. Schedule an appointment with the nursing department chair. After the conference with department chair, if the applicant is still interested in transferring, Applicant must take the Accuplacer computerized placement test in Reading, Sentence Skills and Arithmetic or submit SAT/ACT scores (taken within the last three years). The following minimum scores are required for transfer: ACCUPlacer Score SAT Score ACT Score Reading 80 Reading 500 Reading 18 Sentence 86 Writing 500 English 21 Skills Arithmetic 55 Math 500 Math 20 Documented completed college level transfer courses with a C or higher may substitute for Accuplacer testing. Transfer students (continued): If you meet the minimum Accuplacer scores and you are accepted as a transfer student, Schedule and take the TEAS test to be considered.

42 Revised 01/13/ Official TEAS Version 5 (V) scores from other institutions may be submitted from ATI directly to nursing department chair. Applicant may use TEAS Version V composite/total adjusted score from previous test sessions if the score is three years or newer. TEAS test scores from older/other versions of the TEAS exam will not be accepted. TEAS exam fees will be paid for by the student at the time of online registration on the ATI site. TEAS exam composite (total adjusted score) score will be used to rank applicants within their selected program cohort. 8. The A-B Tech catalog in effect at the time of readmission or transfer will be followed for graduation requirements. All students must contact the clinical liaison to determine what vaccinations and training are needed. You must have your background check and drug screen as well as your physical updated before you can be readmitted or transfer. Skills test for Readmission/Transfer to the Nursing Program Instructions: The student seeking to be re-admitted or transferred into the nursing program will be asked to perform the following skills Adult physical assessment Complete head to toe physical assessment will be completed on an adult client. Student should bring an adult on which to perform the exam. Reproductive exam will be deferred. A maximum of thirty minutes will be allowed. Medication Administration Administration of medications commensurate with level of program (may include PO, SQ, IM and IV), observing medication administration safety guidelines will be performed. Time allowed to be determined by skill level being assessed. Evaluation: Student will be observed by a minimum of 3 nursing faculty. Faculty will individually evaluate the students performance of all demonstrated skills as satisfactory or unsatisfactory. Comments will reflect the rationale for the grade awarded. The student s performance may also be taped. Two of the three faculty must evaluate the student s overall performance as satisfactory to achieve a passing evaluation. The student s performance must be at the level of the student expectations for the course in which the student desires to enroll.

43 Revised 01/13/ For example, a student seeking admission to NUR 102 is held to a lesser standard of performance but must still provide demonstration of safe nursing skills and techniques as compared to a student wishing to enter NUR 103. Skills demonstration for a student wishing to enroll in NUR 103 may include greater analytical and critical thinking. Students should expect to answer questions from the evaluators while demonstrating the medication skills and the assessment exam covering knowledge of previous nursing courses already completed. All skills demonstrated must be performed in a safe and timely manner, just as is expected in the clinical environment. If a student should perform the skill accurately, safely, yet not within an appropriate time frame, then the student s performance would not be considered satisfactory. All students must contact the clinical liaison to determine what vaccinations and training are needed. You must have your background check and drug screen as well as your physical updated before you can be readmitted or transfer. Scholarship Information AB Tech College Foundation Scholarship Application apply online: College Foundation of North Carolina Forgivable Education Loan Scholarship (FELS): The Great 100 Scholarship Program Mission Healthcare Foundation, Inc. 980 Hendersonville Rd., Suite C, Asheville NC Skills Requiring Certification and/ or Additional Training Students are never to perform any nursing skill which requires the nurse provider to have completed certification and / or specialized training even if requested to do so with the supervision and assistance of the nurse provider. Provider is defined as: Any A-B Tech Community College nursing faculty, clinical agency nurses or other healthcare personnel Social Media/Networking Policy Patient privacy is a number one priority. No photos, social networking, etc. will relate directly or indirectly to the clinical experience or clinical facilities. No photos of any type will be made in a clinical setting. Students should refrain from posting on social networks such as Facebook during course hours. Before posting, consider the permanent nature of such postings, and that faculty and staff may see such postings. Please note that Libel is defined as defamation by written or printed

44 Revised 01/13/ words, pictures, or in any form other than by spoken words or gestures. A breach of this policy may result in disciplinary action and/or expulsion from the program. The American Nursing Association s Principles for Social Networking: 1. Nurses (nursing students) must not transmit or place online individually identifiable patient information. 2. Nurses (nursing students) must observe ethically prescribed professional patient nurse (student) boundaries. 3. Nurses (nursing students) should understand that patients, colleagues, institutions, and employers may view postings. 4. Nurses (nursing students) should take advantage of privacy settings and seek to separate personal and professional information online. 5. Nurses (nursing students) should bring content that could harm a patient s privacy, rights, or welfare to the attention of appropriate authorities. The nursing student is responsible for reading a document entitled White Paper: A Nurse s Guide to the Use of Social Media ; it may be viewed at: This document details professional standards regarding patient privacy and confidentiality in social networking. Also, students are required to log onto to view a video produced by the National Council of State Boards of Nursing, entitled Social Media Guidelines for Nurses. Student Health Expectations Prior to entry into the first nursing class, a student must submit reports from a licensed health care provider based upon examinations by that licensed healthcare provider which include the results of any tests listed on the health forms available from the Nursing Department. Students requiring special considerations for disabilities must submit official documents prior to entry into the first nursing class and updated as necessary. Until completed health forms are received, the student remains under Conditional Admission Status and will not be allowed to attend any clinical. Health forms will not be returned or copied. They are discarded after completion of the nursing program. The required health forms must indicate that the applicant possesses the acceptable physical and mental health indicative of ability to provide safe nursing care to the public. These reports must include evidence that all required immunizations have been completed. The Hepatitis B vaccination series shall be started or the declination form completed prior to student clinical assignment. Students are expected to meet all requirements as per clinical agency contract to remain in the nursing program. A student who presents problems in physical or mental health which do not respond to appropriate treatment and/or counseling within a reasonable period of time will be subject to dismissal from the Nursing Program.

45 Revised 01/13/ Any student who sustains a physical injury or has an illness or emotional problem which interferes with the ability to provide safe care to patients or threatens the safety or health of the student or patients will be counseled by the instructor and Chairperson, Department of Nursing. Health reassessment by a qualified health care provider may be required. 2. Additional consultation with the Vice President, Students Services of Special Needs Coordinator may be required. 3. All documents will be considered when a decision is made related to allowing continued study in the Nursing Program. Nursing faculty will make the final decision. Students are required to maintain current annual PPD testing and flu vaccinations while enrolled in the Nursing Program. Updates must be dropped into the blue box in the Rhododendron building on the counter outside of room 443 prior to expiration. You cannot attend clinical with expired immunizations. This may impede your progression in the program. Student Responsibilities for Safe Patient Care One of the most widely believed myths is that students practice off their instructor s license. This is not true. Every student is legally responsible for his or her own actions while providing patient care. It is general principle of law that persons who undertake the activities of a professional will be held to the standards of that professional. Thus, students enrolled in practical nurse or registered nurse programs will be held to the same standards of practice, even though they are not yet licensed themselves. It is therefore incumbent upon the student to undertake only those activities of the licensed nurse that he or she has been prepared to perform safely via classroom or learning laboratory instruction. On the other hand, there is no reason for the student to fear being held to the licensed professional standard. For example, in administering intramuscular medication, the student can know the same principles of administration as the licensed nurse does. Conversely, students would be foolhardy to undertake intramuscular medication administration without knowing these principles, since the law will judge them as if they did know them. Being a student is not a legally recognized excuse, since the law does not recognize a lesser standard of care for students. The law will not preclude patients from successfully suing for injuries because the injury was caused by a student rather than a licensed professional. Doing so would be bad public policy. More patients could be expected to refuse care by students if they knew that by accepting student care they were accepting a lesser standard of care. Patients should not be penalized with substandard care

46 Revised 01/13/ because they agree to assist in educating future nurses. The law will not allow patients to be forced to accept lesser standards. Student Supervision in Clinical Settings The following information is provided to prevent misconceptions concerning student supervision by nursing faculty while in clinical sites. Some students seem to think I ve done this before or the staff nurse asked me to do this, so it s OK for me to do without an instructor present. This misconception is potentially dangerous not just for the health-care client but for the student as well. All students should be supervised on a continuous basis in clinical settings. Students having successfully performed a skill on one or more occasions under a specific instructor s supervision may be allowed to perform the skill independently for the remainder of the clinical day or for the remainder of the particular rotation, ONLY IF THE INSTRUCTOR GIVES APPROVAL for this independent action. (Example: Student performs a CBG correctly on multiple occasions during the past two clinical days. The student is given permission to continue to perform CBG testing without direct instructor supervision during the remainder of this rotation with this instructor. When this same student rotates off to another unit, under supervision of a different instructor, the student must first be supervised by this new clinical instructor. Only with the new clinical instructor s approval should the student independently perform CBGs during this new rotation.) Students are not to assume just because a staff nurse requests the student perform an activity, that it is OK to perform this action independently. Students MUST ALWAYS check with the instructor prior to engaging in activities requiring supervision. Technical/Physical Standards for the Student Nurse To enter into and to complete the nursing program, nursing students must be able to meet the emotional, cognitive, and physical requirements listed below: Emotional Requirements: The nursing program is rigorous, both in academic study and in the acquisition and practice of clinical skills. You must have sufficient emotional stability to perform under stress and provide safe nursing care to clients in the clinical setting while being observed by instructors and other health care professionals. Cognitive Requirements: You have sufficient cognitive ability to listen, speak, read, write, reason and perform mathematical functions (addition, subtraction, multiplication, division, percentages, and fractions with or without a calculator) at a level that allows processing and understanding of materials and information presented either verbally or in written format.

47 Reaching e Balanc Lifting Revised 01/13/ Physical Requirements: Nursing students are required to travel to clinical facilities (i.e., outpatient, acute care settings, skilled facilities) and to have the endurance to adapt to a physically demanding program. Job Requirements Occasional Frequent Constant For 50 lbs: 1 lift every 30 minutes 1 lift every 2 minutes 1 lift every 15 seconds Static knuckle x height Bench height x Ankle height x Shoulder x height Dynamic bench x height To the left x From the x center To the right x Carrying x Cart Pushing x height Pulling x Shoulder Pushing x height Pulling x Frequency 0-33% 34-66% % Sitting x Standing/walking (lab) (clinic) Clim Stairs x bing Ladder x Erect posture Stooping Kneeling Crouching Crawling Job Requirements Occasional (0- Frequent (34- Constant (67-33%) 66%) 100%) Forward Overhead Bended reach Handling Fingering

48 Temperature Revised 01/13/ Feeling Talking Hearing (Type: low and high sounds with instrumentation) Seeing near (corrected to 20/20) Seeing distant Reading Calculating Compiling Indoors Outdoors Hot/Cold Moderate Constant Humid/Damp Dust Hazardous Chemicals Steps, ramps, stairs Slippery or uneven surfaces Communicating Interpreting Investigating Explaining Planning Supervising Teamwork Constant supervision

49 Revised 01/13/ SECTION IV - LICENSED PRACTICAL NURSING PROGRAM CURRICULUM DESIGN Conceptual Framework -- Licensed Practical Nursing Education Nursing education at the Licensed Practical level, in the North Carolina Community College System, is a process that facilitates changes in behavior, the acquisition of knowledge, skills, and attitudes necessary to function in the role of the entry-level practical nurse. The conceptual design defines the essential elements as the environment, quality of life, achievement of potential, and health. The organizing framework contains content related to the individual, the health care system and nursing. The Licensed Practical nursing program at Asheville-Buncombe Technical Community College provides an education that is flexible, progressive, and sensitive to the changing needs of the individual, significant support person(s), and community. Through these educational experiences, students will have the opportunity to develop critical thinking and problem solving skills. Learning is a continuous process that results in a change of behavior and occurs when the individual is challenged and motivated to enhance personal knowledge. Teaching and learning is an interactive process between teacher and learner. The responsibility of the faculty of Asheville-Buncombe Technical Community College Licensed Practical Nursing Program is to facilitate the student s understanding and ability to meet the competencies for nursing practice through the design and evaluation of learning experiences. The nursing student is responsible for actively participating in learning experiences and develops the knowledge, skills, and attitudes necessary to provide quality individual centered nursing care. The conceptual model provides a mental scaffold or framework to prepare learners for new instruction and motivates by making a meaningful connection for the learner. The learner must attain mastery of each part of the framework; the individual, the healthcare system and nursing in order to understand the complete curriculum. (Knowles, 2005). The domains of the individual, the healthcare system, and nursing provide the conceptual framework guiding the associate degree nursing curriculum. Concepts are organized within each these domains and learning occurs from simple to complex. Individual The faculty of Asheville-Buncombe Technical Community College believe that each individual is a complex, multidimensional, unique, and significant being possessing inherent value and worth, and a member of a family, community, and culturally diverse society. All individuals have dynamic bio-physical, psychological, socio-cultural, spiritual, and developmental needs that contribute to health, quality of life, and

50 Revised 01/13/ achievement of potential. Adaptation to the environment requires the individual to change throughout the lifespan. Each individual has a right to healthcare and to information that will assist him or her to participate actively in his or her health care in order to achieve the highest level of wellness possible. All individuals should be cared for, respected, nurtured, understood, and assisted. In order to provide and manage care, nurses must view the individual at the center of any nursing activity. Healthcare System According to von Bertalanaffy (1968) a system consists of the coming together of parts, the power comes from the energy of the interconnection and the way the parts come together. The community healthcare system is a macrosystem and consists of a variety of parts or microsystems. Clinics, hospitals, pharmacies, laboratories, long term care and Internet sites are microsystems that are connected by patients and information to improve health. (IOM, 2001) Environment The individual is in constant interaction with a changing environment that consists of both internal and external forces that varies throughout the lifespan and has the potential to cause stress in the individual. The nurse can assist the individual to alter aspects of the environment and to utilize his/her innate and learned coping mechanisms to adapt to these stressors. Health Health is a dynamic, ever-changing state of mental, physical, and spiritual well-being, which exists on a continuum from optimal wellness to illness and ending in death. The individual s needs for healthcare are determined by his/her position on the continuum. Each individual s health is based on his/her cultural perceptions and beliefs of health and illness and the ability to adapt to internal and external environmental forces. The individual is responsible for and capable of identifying, learning, and practicing health behaviors that can promote wellness, prevent illness, restore or maintain wellness, or achieve a dignified death. Nursing Nursing is a science and the art of integrating and assimilating knowledge and skills derived from biological, sociological, and behavioral sciences and information technology to deliver client-centered, culturally competent, holistic care. Through caring, empathy, ethics, and the development of a therapeutic relationship with the individual and significant support person(s), the nurse integrates the art of nursing with the scientific foundation for nursing practice that utilizes the nursing process. Incorporating evidence-based practice, the nurse functions autonomously and collaboratively with the interdisciplinary team to assist individuals to reach their maximum health potential through assurance of quality client outcomes, promotion of wellness, prevention of illness, and restoration of health or assistance in achieving a dignified death.

51 Revised 01/13/ Quality of Life Quality of life involves five domains including physical, functional, psychological, social, and spiritual well-being. The individual s perception of and satisfaction with activities of daily living contributes to their worth, meaning, or satisfaction. This empowers the individual to cope successfully with the full range of challenges encountered in the real world. (Ignatavicius: Med-Surg Nursing 5th Ed p.5) Achievement of Potential Achievement of potential is the individual s growth toward attaining one s utmost ability and quality of life. It is based on the individual s choices, perceptions, personal goals, life experiences, and holistic health. Core Competencies NLN Core Competencies For the practical nurse, applicable NLN core competencies are: professional behaviors, communication, assessment, clinical decision-making, caring interventions, teaching and learning, and collaboration. The concepts are used to define nursing and prepare graduates to pass the NCLE-PN and function as practical nurses. Institute of Medicine Competencies The five core competencies identified by the IOM for healthcare providers are; patient centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. (IOM, 2005) Professional Behaviors Professional behaviors within nursing practice are characterized by a commitment to the profession of nursing. The graduate of an Licensed Practical nursing program adheres to standards of professional practice, is accountable for his/her own actions and behaviors, and practices nursing within legal, ethical, and regulatory frameworks. Professional behaviors also include a concern for others, as demonstrated by caring, valuing the profession of nursing, and participating in ongoing professional development. Communication Communication in nursing is an interactive process through which there is an exchange of information that may occur verbally, non-verbally, in writing, or through information technology. Those who may be included in this process are the nurse, client, significant support person(s), other members of the healthcare team, and community agencies. Effective communication demonstrates caring, compassion, and cultural awareness, and is directed toward positive outcomes and establishing a trusting relationship. Therapeutic communication is an interactive verbal and non-verbal process between the nurse and client that assists the client to cope with change, develop more satisfying interpersonal relationships, and integrate new knowledge and skills.

52 Revised 01/13/ Assessment Assessment is the collection, analysis and synthesis of relevant data for the purpose of appraising the client s health status. Comprehensive assessment provides a holistic view of the client which includes dimensions of physical, developmental, emotional, psychosocial, cultural, spiritual and functional status. Assessment involves the orderly collection of information from multiple sources to establish a foundation for provision of nursing care, and includes the identification of available resources to meet client needs. Initial assessment provides a baseline for future comparisons that can be made in order to individualize client care. Ongoing assessment and reassessment are required to meet the client s changing needs. Clinical Decision Making Clinical decision making encompasses the performance of accurate assessments, the use of multiple methods to access information, and the analysis and integration of knowledge and information to formulate clinical judgments. Effective clinical decision making results in finding solutions, individualizing care, and assuring the delivery of accurate, safe care that moves the client and support person(s) toward positive outcomes. Evidence based practice and the use of critical thinking provide the foundation for appropriate clinical decision making. Caring Interventions Caring interventions are nursing behaviors and actions that assist clients in meeting their needs. These interventions are based on knowledge and understating of the natural sciences, behavioral sciences, nursing theory, nursing research, and past nursing experiences. Caring is being with and doing for that assists clients to achieve desired results. Caring behaviors are nurturing, protective, compassionate and personcentered. Caring creates an environment of hope and trust, where client choices related to cultural values, beliefs and lifestyle are respected. Teaching and Learning Teaching and learning processes are used to promote and maintain health and reduce risks, and are implemented in collaboration with the client, significant support person(s) and other members of the health care team. Teaching encompasses the provision of health education to promote and facilitate informed decision making, achieve positive outcomes, and support self-care activities. Integral components of the teaching process include the transmission of information, evaluation of the response to teaching, and modification of the teaching based on identified responses. Learning involves the assimilation of information to expand knowledge and change behavior. Collaboration Collaboration is the shared planning, decision making, problem solving, goal setting and assumption of responsibilities by those who work cooperatively, with open professional

53 Revised 01/13/ communication. Collaboration occurs with the client, significant support persons(s), peers, other members of the healthcare team, and community agencies. The nurse participates in the team approach to holistic, client-centered care across healthcare settings. The nurse functions as advocate, liaison, coordinator and colleague as the participants work together to meet client needs and move the client toward positive outcomes. Collaboration requires consideration of client needs, priorities and preferences, available resources and services, shared accountability, and mutual respect. Curriculum Organization The remainder of the model represents the organization of the curriculum including class, lab and clinical experiences to address those elements of the department philosophy that are necessary to develop the critical thinking skills required by the graduate nurse. The student masters knowledge and skills within each of the represented elements. The triangles represent the foundational domains of the curriculum. Within each domain are concepts that provide learning opportunities that are initially simple and become more complex as the curriculum progresses. The domains represented include the three pillars of knowledge on which our curriculum concepts and exemplars are built: the individual, nursing and the healthcare system. The circles represent those dynamic elements (health, achievement of potential and quality of life) that are found within the curriculum. They include the factors that may continually change as the individual interacts with the health care system. Students master nursing skills needed to evaluate, interpret, and assist the individual to achieve their goals. The environment is the sum of all forces that impact all individuals. The student can use knowledge gained regarding the foundational domains and the dynamic elements of health to reduce the stress on the individual and provide culturally competent, individual centered nursing care.

54 Revised 01/13/ The Conceptual Model of the North Carolina Community College System ADN Programs can be applied to the Licensed Practical Nurse

55 Revised 01/13/ Maslow s Hierarchy of Needs from basic to highest levels includes: 1. Physiological needs 2. Safety or security needs 3. Needs for love or belongingness 4. Esteem needs 5. Self-actualization needs SELF- ACTUALIZATION SELF-ESTEEM LOVE AND BELONGING SAFETY AND SECURITY PHYSIOLOGICAL

56 Revised 01/13/ Erikson s Developmental Tasks from birth through death include: 1. Basic trust versus mistrust 2. Autonomy versus shame and doubt 3. Initiative versus guilt 4. Industry versus inferiority 5. Identity versus role confusion 6. Intimacy versus isolation 7. Generativity versus stagnation 8. Ego integrity versus despair The five step nursing process is a systematic means of analyzing the patient s needs, developing a nursing diagnosis, developing a plan, implementing the plan, and then evaluating its effectiveness. By utilizing the five phases of the nursing process, the student gains the knowledge to progress from being a provider of care for one client with common alterations to providing care to clients with increasingly complex alterations in human functioning across the life span. As each semester evolves, the student learns the role of the Licensed Practical Nurse coordinating and collaborating with other health team members within the discipline of nursing. Each student will learn to assume responsibility and accountability for nursing practice and professional growth, within the professional, ethical, and legal framework.

57 Revised 01/13/ Nursing Process Practical Nursing Maslow & Hierarchy of Needs Erikson s Developmental Stages Nursing Framework 3. Planning. Nursing Framework Communication Related Content

58 Revised 01/13/ Page 1 of 2 ASHEVILLE-BUNCOMBE TECHNICAL COMMUNITY COLLEGE GENERAL INCIDENT REPORT FORM TO BE FILLED OUT BY THE INSTRUCTOR OR SUPERVISOR DIRECTLY RELATED TO THE INCIDENT FILL IN ALL BLANKS Reporting Supervisor Incident Date/Time Date Occurred Location Time Occurred Victim Name Phone Address City/State Zip Student Yes N If yes, SS Number Curriculum If no, Position/Title VICTIM S NARRATIVE (briefly describe what happened include the type and brand of device involved in the incident) Signature

59 Revised 01/13/ Page 2 of 2 INSTRUCTOR S/SUPERVISOR S NARRATIVE (Include all information related to the incident including the department or work area where the exposure occurred and an explanation of how the incident occurred.) Signature FIRST AID RENDERED Yes No whom. If yes, give details of aid given and by Medical Treatment Needed Yes No If yes, transported to By IF TREATMENT RECOMMENDED AND VICTIM REFUSES, COMPLETE NET SECTION MEDICAL TREATMENT REFUSAL (To be read to victim) The victim has been informed of the need to seek medical treatment. The options available are: emergency room, personal physician, health department, and if applicable, follow-up care. If there is Bloodborne or Communicable Disease exposure it is recommended that the person seek his/her choice of follow up care promptly within 1-2 hours of exposure. Care may be obtained from among the following: OccuMed Coordinator at Mission Health System (2 Medical Park Drive, Suite 102). If they are closed, the emergency room at Mission Health System or other appropriate medical facility if the exposure incident occurs outside of Buncombe County. VICTIM REFUSAL, refuse medical treatment and/or transportation to a medical facility and understand that by refusing treatment, I accept full responsibility for my actions. Victim s Signature Witness Signature Date and Time

60 Revised 01/13/ Attachment II Post-Exposure Follow-Up Procedures Step 1 ON-CAMPUS INCIDENT Assistance Step 1 OFF-CAMPUS INCIDENT Assistance Step 2 Medical Treatment Follow-Up A-B Tech Student - Activate Student Accident Claim - Obtain testing Follow-Up A-B Tech Employee - File Worker s Compensation - Obtain testing Instruct a bystander on how to call for assistance while you stay with the victim. Security Extension Medical Emergency Dial 9 (to get an off campus line) and then dial 911. Immediate medical assistance should be requested if victim is bleeding profusely, not breathing, no heart beat, severely injured. Manage medical emergency situation, if applicable. Follow standard procedure of the respective clinical site or OccuMed. Proceed to Step 2. For eye, mouth, and other mucous membrane exposures, employees should flush/rinse the exposed area thoroughly with running water. For needle sticks, other puncture wounds, or contamination of any body part with blood, employees should wash thoroughly with soap and water. Instructor should confirm that the student has: - Activate Student Accident Insurance claim by calling within 48 hours of exposure - If student was not tested in emergency room, he or she should go to OccuMed, Mission s Outpatient Service Center at 2 Medical Park Drive, Suite 102, for testing within 1-2 hours of incident. Testing is covered by student accident insurance provided that student has seen Shelby Burnette to activate claim. - Chair should file a Worker s Compensation form on the incident in the Human Resources Office within 48 hours. - Employee should go to OccuMed, Mission s Outpatient Service Center at 2 Medical Park Drive, Suite 102, for testing within 1-2 hours of incident. Testing will be paid by

61 Revised 01/13/ Step 3 Incident Report Worker s Compensation. Contact OccuMed to report the incident. If on campus, complete an Incident Report Form, in conjunction with a Security Officer. If off campus, instructor or supervisor should contact Security upon returning to campus to complete Incident Report. Security Director should review Report with appropriate administrator and Human Resources officer within 24 hours. Step 4 Source Individual - Testing - Purchase Requisition Instructor should explain situation to patient. If in hospital setting, arrange for testing of source patient according to Hospital policy. If in non-hospital setting, arrange for patient to go to OccuMed, Mission s Outpatient Service Center at 2 Medical Park Drive, Suite 102, for OccuMed testing, Instructor should call clinical liaison who will authorize A-B Tech to be billed for source patient testing. Chair should complete a purchase requisition within 24 hours of incident. Requisition should include the source patient s and employee s or student s name. Fee for testing will be billed to the department s supply budget. Post-Exposure and Follow-Up Procedures for Extraordinary Occurrences If exposed to a known Hepatitis B antigen positive person or a known HIV positive person: 1. Individual should report immediately to an emergency room. 2. Comply with the Post-exposure and Follow-Up Procedures listed on the previous pages.

62 Revised 01/13/ A-B Tech Readiness Skills Rubric Goal: Employers have identified a set of soft skills desired in new employees. This skill set, when present, translates into successful students in the classroom as well as the workplace. This rubric is intended to evaluate student's demonstration of these skills. Assessment Levels Criteria Exemplary Acceptable Unacceptable Points Attendance Class Attendance (demonstrates selfmanagement) Attends 100% of classes; notifies instructor prior to absence due to extraordinary circumstances Rarely misses class; notifies instructor prior to absences Attends class less than required amount of time Time Management punctual attendance; turns in work on time Always on time for class; no late work; demonstrates selfresponsibility Is not on time for class or does not turn in work on time 3 or fewer times Is not on time for class or does not turn in work on time more than 3 times Professionalism behavior, attitude, personal presentation always demonstrates positive attitude, selfcontrol, good personal presentation and traits of life-long learning consistently positive; embraces life-long learning; and demonstrates appropriate personal presentation resists new ideas and skills; rarely positive; demonstrates poor personal presentation; Communication listening; oral & written; creator vs. victim language always uses clear, organized language; effectively exchanges ideas and information; uses Creator language consistently uses clear/organized language for exchanging ideas and information; consistent use of Creator language poor demonstration of communication and listening skills; rarely uses Creator language Quality of Work class academic performance consistently gives best effort; quality work usually gives best effort and consistently completes work demonstrates minimal effort, work is sometimes incomplete Participation/ Teamwork working with others, class discussion, Interdependence self-confident; demonstrates selfawareness in accepting responsibility for own choices consistently accepts responsibility for own choices; often demonstrates strong interdependence rarely accepts responsibility for own choices; makes poor choices when working with others

63 Revised 01/13/ Effort Exhibits strong work ethic; preparedness consistently comes to class prepared; maximizes class time available almost always prepared; frequently uses class time effectively frequently does not come to class prepared; poor use of class time Critical ThinkingStrong problem solving skills; adaptation to change always thinks through problems; selects strategy; finds way to solve consistent use of problem solving strategies consistently avoids problem solving; rarely seeks assistance Victim vs. Creator Language Victims believe that their outcomes and experiences are determined by forces beyond their control, such as powerful others and luck. They believe they are merely pawns in the chess game of life. Their language is characterized by blaming, complaining, and excusing. Creators believe that their outcomes and experiences are the natural consequences of their choices. They believe they are chess masters who CREATE, PROMOTE, or ALLOW all that happens in their lives. Their language is characterized by ownership and action plans.

64 Lifting Revised 01/13/ Student Health Assessment Form Technical/Physical Standards for the Student Nurse To enter into and to complete the nursing program, nursing students must be able to meet the emotional, cognitive, and physical requirements listed below: Emotional Requirements: The nursing program is rigorous, both in academic study and in the acquisition and practice of clinical skills. You must have sufficient emotional stability to perform under stress and provide safe nursing care to clients in the clinical setting while being observed by instructors and other health care professionals. Cognitive Requirements: You have sufficient cognitive ability to listen, speak, read, write, reason and perform mathematical functions (addition, subtraction, multiplication, division, percentages, and fractions with or without a calculator) at a level that allows processing and understanding of materials and information presented either verbally or in written format. Physical Requirements: Nursing students are required to travel to clinical facilities (i.e., outpatient, acute care settings, skilled facilities) and to have the endurance to adapt to a physically demanding program. Job Requirements Occasional Frequent Constant For 50 lbs: 1 lift every 30 min 1 lift every 2 min 1 lift every 15 sec Static knuckle height Bench height Ankle height Shoulder height Dynamic bench height To the left From the center To the right Carrying Cart Pushing height Pulling Shoulder Pushing height Pulling x x x x x x x x x x x x x Frequency 0-33% 34-66% % Sitting x Standing/walking (lab) (clinic) Climbing Stairs x Ladder

65 Temperature Reaching Balance Revised 01/13/ Erect posture Stooping Kneeling Crouching Crawling x x Job Requirements Occasional Frequent Constant Frequency 0-33% 34-66% % Forward Overhead Bended reach Handling Fingering Feeling Talking Hearing (Type: low and high sounds with instrumentation) Seeing near (corrected to 20/20) Seeing distant Reading Calculating Compiling Indoors Outdoors Hot/Cold Moderate Constant Based on my assessment of this student s physical health he/she appears to be able to participate in the activities of a health profession in a clinical setting. Yes: No: If no, please explain: Signature of Physician/Physician Assistant/Nurse Practitioner Print Name of Physician/Physician Assistant/Nurse Practitioner Date: Area Code/Phone Number: Office Address:

66 Revised 01/13/ Readmission/Transfer Physical Assessment and Medication Administration Evaluation Form Name Date Score P NP Physical Assessment Area Criteria Met Not Met I. Approach to the client II. Mental status III. Head V. Neck 1. Assembles all nursing equipment in advance 2. Introduces self 3. Washes hands 4. Explains procedure in concise, understandable terms 1. Level of consciousness 2. Orientation to person, place, time 3. Mini mental exam (verbalize only what test is for) 1. Inspect and palpate skin for color, lesions, temperature, moisture, edema as appropriate 2. Inspect external ear 3. Inspect for gross hearing (CN8) 4. Inspect tympanic membrane (verbalize what see) 5. Inspect for patency of nares. 6. Inspect mouth, lips, teeth, tongue, oral mucosa (ah and gag reflex CN9&10) (verbalize only) 7. Test for CN II 8. Test for CN V, motor and sensory 9. Test facial CN VII 10. Inspect external structures of eyes-eyelashes, eyelid 11. Inspect for gross vision (CN2) 12. Inspect for visual fields (CN2) 13. Inspect for EOM=s (CN 3,4, 6) 14. Inspect for pupillary responses (PERRLA) (CN 3) (verbalize what you see) 1. Inspect for shoulder shrug (CNI) 2. Inspect ROM of cervical vertebrae 3. Inspect for JVD (verbalize only) 4. Palpate lymph nodes 5. Palpate carotid pulses 6. Auscultate carotid arteries

67 Revised 01/13/ Area Criteria Met Not Met V.Upper Extremities VI. Chest VII. Abdomen 1. Inspect and palpate skin for color, lesion, temperature, moisture, edema as appropriate 2. Inspect and palpate nails 3. Inspect for ROM shoulder, elbow and wrist 4. Palpate radial pulses 5. Assess hand grasps strength 1. Inspect and palpate skin for color, lesions, temperature, moisture, edema as appropriate 2. Inspect for A-P diameter 3. Inspect for rate, rhythm, depth of respiration 4. Inspect for spinal alignment 5. Palpate for fremitus 6. Auscultate all lung fields (verbalize normal sounds) 7. Inspect for rate, rhythm and PMI 8. Auscultate the 5 areas of the heart (verbalize normal sounds) 1. Inspect skin for color, lesions, temperature, moisture, edema as appropriate 2. Inspect contour 3. Auscultate for bowel sounds 4. Light palpation (verbalize only) 5. Palpate femoral arteries (verbalize only) VIII Lower extremities I. Skill in use of equipment and selection of method of exam 1. Inspect and palpate skin for color, lesions, temperature, moisture, edema as appropriate. 2. Inspect and palpate toe nails. 3. Inspect popliteal, posterior tibial and pedal pulses. 4. Inspect for ROM, hip, knee, ankle. 5. Assess leg strength. 1. Proceeds in a logical, orderly manner from one assessment area to another 2. Includes all 4 components as appropriate (inspection, palpation, percussion, and auscultation) 3. Utilizes methods and instruments appropriately

68 Revised 01/13/ Medication Administration Medication Oral Medication Intramuscular injection (may include mixing of a powder or breaking an ampule) Subcutaneous administration of insulin Intravenous medication (may include IV push, setting up and priming primary and/or secondary IV line Criteria Met Not Met 1. Check physician s orders 2. Identify and research unfamiliar drugs 3. Review client chart for allergies, lab data, any contraindications 4. Hand hygiene 5. Observes 6 rights (right client, right time, right route, right medication, right dose, right documentation) 6. Check for expiration date 7. Perform needed calculations 8. Prepare medication as indicated 9. Selects correct supplies for administration 10.Answers questions about medication administration or knows where to find answer Student Date Nursing Instructor Date Nursing Instructor Date Nursing Instructor Date

69 Revised 01/13/ Self-Improvement Plan Student Name: Program: Nursing Instructor: Work Place Readiness categories - circle all that apply : attendance time management Professionalism communication quality of work participation/teamwork effort critical thinking. Assessment: Describe the event or incident that has created a problem for you during nursing course work. Diagnosis: What do you think was the cause of the problem? Plan for Improvement: What plan can you put into place to correct this problem? Implementation: what will you do to prevent this from occurring again? Set a time frame for completion of your plan and describe very specific actions that you will take to develop these skill(s)? I propose this as my plan to improve my clinical performance. Signatures: Student: Date: Approved by: Nursing Faculty: Date: Follow-Up Notation: Outcomes met: Yes No Evaluation: Did you meet your goal? Describe why you are better prepared to be successful in your nursing education. Student signature: Date:

70 Revised 01/13/ Action Plan Student Name: Program: Nursing Instructor: Description of Problem or Performance Concern: Expected Outcome: Plan: A. Skills, knowledge, performance and behaviors that must be demonstrated to meet expected outcomes: B. Suggested resources and activities: C. Dates and times of follow up activities (conferences, presentations etc ) Signatures Student: Date: Nursing Faculty: Date: Follow-Up Notation: Outcomes met: Yes No Date: Signatures: Student: Date: Nursing Faculty: Date:

71 Revised 01/13/ Monitoring Academic Progression Plan (MAPP) Student Name: Program: Date MAPP Intervention Initiated: Instructor: Student Response: See below Declined Did not respond Identify the problem(s) or barrier(s) to my success; why am I not succeeding in this course? What actions may I take to assist in overcoming these problems or barriers? (Outline a plan indicating the students personal commitments to this course) How may I evaluate my progress within this course? (Provide measurable outcomes, if possible; i.e. I will make an 80% or above on my next test.) What are my goals for this course? (Outline student goals; i.e. I want to pass with a grade of B ) Document meeting dates and times: If a follow-up meeting is required, document dates and times and the outcomes of the meeting: Faculty Comments:

72 Revised 01/13/ Conference Form Student Name: Program: Nursing Instructor: Final Warning Performance Improvement Period: From to Conference Referral: Dean of Allied Health & Public Service Vice President of Student Services Description of Behavior or Performance Concern: Nursing Student Comments: Signatures: Student: Date: Nursing Faculty: Date: Nursing Department Chairperson: Date:

73 Revised 01/13/ Double click on the image to open the SPEET tool