Medical Office Technology Assessment Report Fall 2007

Transcription

1 Department Mission Statement Medical Office Technology Assessment Report Fall 2007 The mission of the Medical Office Technology program is to provide the appropriate instruction, technology, and expertise in preparing students to become competent professionals in the ambulatory health care industry. 1. Intended Learning Outcomes a. Upon completion of the learning process of measuring and documenting blood pressure, students will demonstrate an entry-level competency of clinical and clerical skills i. Preparation for the procedure ii. Use of equipment iii. Communication with patient iv. Procedure v. Documentation b. Methods used to assess Learning Outcomes i. Simulated clinical skills rubric for blood pressure measurement ii. Skills Competency Assessment check list outlining the steps of the procedure to be learned using the manikin arm. The manikin arm allows the instructor to vary the simulated process while allowing the student to learn a wide range of blood pressure readings and heart rates 2. Benchmark a. Over three class periods students will practice patient preparation, blood pressure measurement skills, and documentation with a goal of 98% accuracy in the procedure portion. 3. Historical Context: These measurements were done before the use of the controlled manikin arm as a teaching aid. a. Fall 200 measurements were as follows: Preparation for procedure 9% Use of equipment 93% Communication with patients 98% Procedure 92% Documentation 100% 1

2 b. Summer 200 measurements were as follows: Preparation for procedure 96% Use of equipment 97% Communication with patients 97% Procedure 92% Documentation 100% c. Note: In the Procedure area, a 92% accuracy rate was noted both semesters. 4. Current year data results: a. The blood pressure manikin arm was incorporated into the blood pressure learning process. i. Instructor noted that using the manikin allowed students to hear exactly what she was hearing. By using this technique, students actually scored lower in procedure accuracy. ii. Although somewhat difficult to maneuver, the simulated blood pressure arm gave students an accurate tool for measurement. Since the readings were controlled by the instructor, a large variety of measurements and heart rates could be demonstrated. iii. The manikin is equipped with speakers allowing the entire class to hear instead of one student at a time. iv. Spring 2007 measurements were as follows: Preparation for procedure 77% Use of equipment 80% Communication with patients 9% Procedure 90% Documentation 89%. Analysis: a. instructor commented about the stiffness of the manikin arm and indicated it made the procedure preparation tedious for students to maneuver the blood pressure cuff to the correct position. However, after the training, and trying the technique on each other, students seemed to improve rapidly b. communication with patients remained just slightly lower in score than previous semesters which could be due to a number of variables (student age, experience, shyness, etc.) c. the overall score for the procedure dropped 2% and is probably due to the improved accuracy of the instructor being able to hear exactly what the student hears. 2

3 iv. With the use of the manikin, the instructor felt the somewhat lower accuracy score was a plus rather than a negative d. as the instructor becomes more confident in using the manikin, we look for improvement in student accuracy. i. As technology improves and budget permits, we will continue to look for better tools designed for teaching this technique ii. an additional goal is to incorporate the use of more instructional CD s showing students the proper procedure for this and other patient assessment techniques iii. the purchase of better blood pressure cuffs and stethoscopes for student use has been put into the current budget and is being incorporated this semester 6. Summary a. We will continue to use current rubric with the inclusion of the manikin as part of the teaching process. a. Since learning blood pressure technique is a two-stage process, the initial focus will be on listening and learning sounds with accuracy. This phase will include use of the manikin. b. The second phase of the learning process will transition students into practicing the techniques on each other with alternate use of the manikin to ensure accuracy. 7. Procedures/Methods a. We will continue to strive for a goal of 98% accuracy with a passing grade of no less than 90% in the procedure portion. This Skills Competency Assessment tool will be used to insure student follow and complete each required step of the process. SKILLS COMPETENCY ASSESSMENT (III.C.3.b. 4. b. ) OBTAIN VITAL SIGNS Student's Name: Date: Objective: Conditions: To demonstrate the steps necessary for measuring blood pressure. In a simulated or actual situation and given access to all necessary equipment and supplies, within a four-minute period of time, measure palpatory and ausculatory blood pressure and record findings, following correct procedural technique and observing safety and aseptic precautions. Recorded rate findings must be within 4 mmghg of instructor s measurement using manikin and teaching stethoscope. Time Requirements and Accuracy Standards: 4 minutes. Points assigned reflect importance of step to meeting objective: Important = () Essential = (10) Critical = (1) Automatic failure results if any of the critical tasks are omitted or performed incorrectly. Note time began PROCEDURE STEPS STEP PERFORMED POINTS POSSIBLE 1. Washed hands. 2. Assembled equipment. 3. Cleaned earpieces and head of stethoscope with COMMENTS 3

4 antiseptic. 4. Identified patient.. Explained procedure. 6. Placed equipment within easy reach of patient. 7. Placed patient in a relaxed and comfortable sitting or lying position. 8.a. Positioned arm, palm up. b. Clothing appropriately managed a. Opened valve, deflated bladder completely b. Located center of bladder; assured adequate cuff size 1 c. Applied cuff to upper arm, bladder centered over brachial artery; 1 to 2 above elbow Assured reading dial is in proper view. 11. Closed valve with one hand. 12. Positioned other hand to palpate radial pulse 13. Observing dial, rapidly inflated cuff to 30 mm above level where radial pulse disappears Opened valve, slowly releasing air until radial pulse was detected Observed dial reading Deflated cuff rapidly and completely. Squeezed cuff with hands to empty air. 17. Positioned earpieces of stethoscope in ears with openings entering ear canal; held head of scope in one hand. 18. Palpated brachial artery at medial antecubital space with fingertips Placed head of stethoscope directly over palpated pulse. 20. Closed valve on bulb and rapidly inflated cuff to 30 mm above palpated systolic pressure Opened valve, slowly deflating cuff With eyes directly in line with dial, noted reading at which systolic pressure heard Allowed pressure to lower steadily. 24. Continued to release pressure until all sound disappears. 2. Released remaining air. Squeezed cuff between hands. 26. Recorded accurate systolic and whichever diastolic instructed to read Reevaluated if indicated after a minimum of fifteen sections Removed stethoscope from ears Removed cuff from patient s arm. 0 EVALUATOR: Record B/P EVALUATOR: NOTE TIME COMPLETED (within 4 minutes) 30. Assisted patient with clothing, if necessary Cleaned tips and head of stethoscope with alcohol to disinfect Folded cuff properly and placed with other sphygmomanometers in storage. 33. Washed hands. 34. Recorded and signed procedure on patient s chart (see below) 0 Add points of steps checked TOTAL 130 EARNED POINTS: Signature: Evaluator's Name (print) Comments: 4

5 Documentation Chart the procedure in the patient's record. Date: Charting: Student's Name: PASS b. If students continue to demonstrate continued success with the manikin training arm, additional similar equipment will be considered for teaching future classes. 8. Plan a. In the procedure portion of measuring blood pressure, an accuracy goal of 90% is passing. However, a minimum passing rate of 80% can be demonstrated in the other phases of the process: i. Procedure preparation ii. Use of equipment iii. Communication with patient iv. Procedure (90% pass rate) v. Documentation b. If students continue to demonstrate continued success with the manikin training arm, additional similar equipment will be considered for teaching future classes

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