Adult-Gerontology Acute Care Nurse Practitioner Preceptor Manual

Transcription

1 Visin INSPIRE INNOVATE EXCEL Missin T imprve the health f the cmmunity by inspiring change in health care thrugh innvatin and excellence in nursing educatin, schlarship, practice, and service. COLLEGE OF HEALTH PROFESSIONS SCHOOL OF NURSING Graduate Prgrams Adult-Gerntlgy Acute Care Nurse Practitiner Preceptr Manual Philsphy The Graduate Prgram prepares students fr advanced rles in nursing and t be accuntable fr clinical and rganizatinal decisin making based n schlarly evidence, principles f ethics, relevant theries and health care plicy. Upn cmpletin f the Graduate Prgram, the MSN and DNP graduates are prepared t prvide leadership in the analysis f factrs influencing health and the subsequent implementatin and evaluatin f strategies fr imprving health in an interprfessinal, glbally aware, culturally sensitive manner. (revised 03/02/2009)

2 The Master f Science in Nursing and the Dctr f Nursing Practice degrees prepare students fr advanced clinical practice as an Acute Care Nurse Practitiner. Acute Care Nurse Practitiner Scpe f Practice Care f adults and lder adults acrss the acute care cntinuum, including thse with acute and cmplex illnesses Histries & physicals Medical and nursing therapeutics Health prmtin, Health screening & maintenance Diagnsing & managing unstable and cmplex health care prblems Teaching & cunseling Cllabrating with Physicians and ther Health Care Prfessinals The Adult-Gerntlgy Acute Care Nurse Practitiner (ACNP) is a RN prepared at the Master's r Dctral level as a nurse practitiner whse fcus is the care f acutely and critically ill adult patients. The ACNP is educated t prvide cntinual and cmprehensive care, in a variety f settings, t adults wh are chrnically, acutely r critically ill. Acute Care Nurse Practitiners seek t imprve patient care and help return the patients t an ptimal state f wellness by: 1) perfrming histry and physical exams; 2) determining differential diagnses; 3) wrking cllabratively with physicians and ther healthcare prviders t develp a therapeutic plan f care; 4) health prmtin and health educatin; 5) case managing patients with a fcus n cst-effective utcmes. The ACNP has skills that can assist the patient with chrnic, acute and critical cnditins t ptimize healthier utcmes in utpatient and inpatient settings by prviding patient teaching, early detectin and treatment f exacerbatins and in cllabratin with physicians prvide treatment when intensive care is warranted. Practice patterns fr the ACNP have included a Nursing Based Mdel where the ACNP is placed in a unit r service based prgram f care, r a Jint Prfessinal Practice Mdel in cllabrative practice with a physician practice r grup and fr reimbursement. The graduates f the ACNP specializatin is eligible t take the Adult-Gerntlgy Acute Care Nurse Practitiner exam administered by the American Nurses Credentialing Center and the certificatin exam fr Adult- Gerntlgy Acute Care Nurse Practitiners administered by the American Assciatin f Critical Care Nurses. In sme states, certificatin is required fr licensure as a nurse practitiner. ACNP graduates are eligible t apply fr recgnitin as an Advanced Practice Registered Nurse (APRN) as a nurse practitiner thrugh the Kansas State Bard f Nursing. Fr the nurse practitiner student, there is a strng emphasis n clinical practice and skill develpment, including advanced health assessment, management f patients, technlgies, and supervised clinical experiences. Cre curses required fr all students are: evidence based practice, theretical fundatins, advanced nursing practice rles, healthcare plicy systems and plitics, advanced pathphysilgy, advanced pharmaclgy, and management f clinical data and utcmes. The verall benefits f the nurse practitiner track are: cmprehensive cst-effective care

3 prvided t patients and families; cntinuity f patient care; and the develpment f cllegial relatinships with physicians and ther health care prfessinals. The faculty f WSU's Schl f Nursing supprts bth the Clinical Nurse Specialist (CNS) and the Nurse Practitiner (NP) rles t meet the needs f patient care delivery and the health care team. Therefre, the curriculum reflects bth the ACNP and CNS specialties, and sme didactic cursewrk is shared, while ther curses are specifically designed fr the nurse practitiner student. Faculty Elaine Steinke, RN, PhD, ARNP, CNS, Prfessr (316) Elaine.Steinke@wichita.edu Karen Hayes, RN, PhD, ARNP, ACNP, CNS, Assistant Prfessr (316) kshayes@cx.net Terri Cre, MSN, ARNP, ACNP, Instructr (316) Terri.Cre@wichita.edu Jennifer Rdgers, RN, MSN, ARNP, ACNP, Lecturer (316) jen@jenniferrdgers.net

4 ACNP Curriculum Prerequisites fr the prgram are statistics and an undergraduate nursing research curse apprved by the Schl f Nursing. The ACNP track is 49 credit hurs. Cre Curses Cre Curse Credit Hurs 24 N 701 Advanced Health Assessment 2 N 702 Advanced Health Assessment Lab 1 N 703 Theretical Fundatins f Advanced Nursing Practice 3 N 715 Advanced Nursing Practice Rles 1 HS 711 Pharmaclgical Management f Acute/Chrnic Diseases 3 N 793 Advanced Pathphysilgy I 4 N 801 Health Care Systems: Plicy and Plitics 3 N 806 Evidence Based Nursing Practice/Outcmes f Care 3 N 826 Evidence Based Nursing Prject I 2 N 828 Evidence Based Nursing Prject II 2 Specializatin Curses Specializatin Credit Hurs 25 N 728 Advanced Practice Technlgy and Skills 3 N 874 Adult/Older Adult ACNP Practicum I 4 N 840 Pathphysilgy & Management f Adult/Older Adult Acute Care Prblems I 3 N 842 Transitin t ACNP Advanced Practice Rle I 1 N 909 Pathphysilgy & Management f Adult/Older Adult Acute Care Prblems II 3 N 910 Adult/Older Adult ACNP Practicum II 4 N 911 Transitin t ACNP Advanced Practice Rle II 1 N 912 Management f Acute & Critical Prblems f Adult/Older Adult Ppulatins 3 N 952 Advanced Nursing Practice Preceptrship 3 Cmprehensive Examinatin 0 ACNP Curse Descriptins Curse Number & Title: N728, Advanced Practice Technlgy and Skills (3 cr hrs) Curse Descriptin: A curse that fcuses n applicatin f clinical skills, advanced health assessment, and interpretatin f technlgies utilized in a variety f clinical settings. Students practice these skills in labratry and clinical settings. Students practice histry-taking and physical examinatin, with emphasis n differentiatin, interpretatin and dcumentatin f nrmal and abnrmal findings A 40- hur precepted experience is included. Prerequisite: Cmpletin f the cre curses r departmental cnsent; admissin t ne f the NP ptins. Curse Objectives: The student will: 1. Analyze data frm health histries, physical exam, and psychscial assessment f clients. 2. Enhance skill in using varius techniques and equipment fr client management. 3. Differentiate between variatins f nrmal and abnrmal assessment data.

5 4. Dcument health assessment findings in an rganized manner. 5. Demnstrate a develpmentally apprpriate apprach t histry and physical examinatin f clients acrss the lifespan. 6. Demnstrate cultural awareness in interviewing and examining clients. 7. Cmmunicate effectively in verbal and written instances. Curse Number & Title: N840, Pathphysilgy & Management f Adult/Older Adult Acute Care Prblems I (3 cr hrs) Curse Descriptin: This is the first f tw curses that examines pathphysilgy and management f acute, chrnic, and multisystem health prblems in adult/lder adult ppulatins. Emphasis is n the scientific underpinnings fr clinical decisin-making and practice issues. The majr themes address nrmal physilgy, pathphysilgy, age-related changes, assessment, diagnsis, and management f acute, critical, and exacerbatin f chrnic disease states. Health prmtin and disease preventin are emphasized. Prerequisites: NURS 793 and admissin t ACNP r Adult CNS specializatin E. Curse Objectives: The learner will be able t: 1. Evaluate the epidemilgy, etilgy, pathgenesis, and clinical and labratry manifestatins f specific acute, critical, and exacerbatin f chrnic health prblems f the adult/lder adult. 2. Discuss the genetic basis f selected diseases and related genetic issues. 3. Describe the pathlgic mechanisms and management f pain and inflammatin in the adult/lder adult. 4. Examine strategies fr disease preventin and health prmtin acrss the adult lifespan. 5. Analyze relevant research, established prtcls, and natinal standards f practice fr selected acute, critical, and exacerbatin f chrnic disease states. 6. Develp and evaluate a management plan that includes pharmaclgic and nnpharmaclgic appraches fr acute/critical health prblems in the adult/lder adult. 7. Discuss the psychlgical, cultural, scial, ecnmic, and ethical-legal cnsequences f majr disease states fr the individual, family, and sciety. Curse Number & Title: N909, Pathphysilgy & Management f Adult/Older Adult Acute Care Prblems II (3 cr hrs) Curse Descriptin: The secnd f tw curses that examines pathphysilgy and management f acute, chrnic, multisystem health prblems in adult/lder adult ppulatins. Emphasis is placed n the scientific underpinnings fr clinical decisin-making and practice issues. Majr themes

6 address nrmal physilgy, pathphysilgy, age-related changes, assessment, diagnsis, and management f acute, critical, and exacerbatin f chrnic disease states. Health prmtin and disease preventin are emphasized. Prerequisites: N793 and N840 Curse Objectives: The learner will be able t: 1. Evaluate the epidemilgy, etilgy, pathgenesis, and clinical and labratry manifestatins f specific acute, chrnic, and multisytem health prblems f the adult/lder adult. 2. Discuss psychscial respnses t illness, stress respnse, and end-f-life issues. 3. Examine strategies fr disease preventin and health prmtin. 4. Analyze relevant research, established prtcls, and natinal standards f practice fr selected acute, critical, multisystem, and exacerbatin f chrnic disease states. 5. Develp and evaluate a management plan that includes pharmaclgic and nnpharmaclgic appraches fr acute, critical, and multisystem health prblems in the adult/lder adult. 6. Discuss the psychlgical, cultural, scial, ecnmic, and ethical-legal cnsequences f majr disease states fr the individual, family, and sciety. Curse Number and Title: N912 Management f Acute and Critical Prblems f Adult/Older Adult Ppulatins (three credit hurs) Curse Descriptin: Examines advanced nursing interventins fcused n client stabilizatin and management f cmplicatins in the acutely/critically ill adult/lder adult ppulatins. Emphasis is placed n diagnstic reasning and the management f the adult with cmplex health prblems. Interventins fcus n applicatin f advanced practice nursing care t the restratin f health/well-being. Prerequisite curses: N909 and N910 Curse Objectives: The learner will be able t: 1. Design physical and psychscial interventins fr the critically ill adult/lder adult using diagnstic reasning. 2. Analyze the effectiveness f advanced practice interventins based n current research and practice guidelines. 3. Select pharmaclgic and nn-pharmaclgic therapies fr the critically ill adult/lder adult. 4. Analyze the advanced practice rle in establishing and mnitring standards f practice. 5. Examine ethical-legal, cultural, scial, and ecnmic issues relevant t the rle f the acute care nurse practitiner.

7 Practica and Transitin Curses Curse Number & Title: N874, Adult/Older Adult ACNP Practicum I (4 cr hrs) Curse Descriptin: A clinical experience that builds n pathphysilgy and clinical management cursewrk, emphasizing evidence-based practice. Students participate in a medical rtatin that is supervised by an ACNP r physician preceptr in the acute care setting. Emphasis is placed n physical assessment, interpretatin f data, differential diagnsis, develpment and implementatin f management plans, and perfrming relevant prcedures with adult/lder adult ppulatins. Patient and family educatin, health prmtin, and preventin are emphasized. Pre-requisite: N728 C-requisite: N840 and N842 Curse Objectives: The learner will be able t: 1. Perfrm cmprehensive and fcused physical and psychscial assessments f adults/lder adults with acute, critical, and exacerbatin f chrnic health prblems. 2. Analyze patient data t develp differential diagnses, select diagnstic tests, and develp a management plan fr adults/lder adults with acute/critical medical cnditins. 3. Prescribe apprpriate diagnstic and therapeutic mdalities (pharmaclgic, nnpharmaclgic) in the management f acute/critical health prblems. 4. Demnstrate integratin f thery and research while prviding care t patients and families. 5. Implement patient educatin strategies fr health prmtin and disease preventin. 6. Integrate established prtcls and natinal standards in the care f adults/lder adults with acute/critical health prblems. 7. Recgnize situatins requiring cnsultatin and/r referral f individuals in the acute care setting. 8. Cmmunicate effectively in verbal and written frms with patients, families, peers, and ther health care disciplines. 9. Incrprate ethical-legal principles in practice settings. Transitin Seminar Curse Curse Number & Title: N842, Transitin t the ACNP Rle I (1 cr hrs) Curse Descriptin: This curse fcuses n the applicatin f theretical mdels f practice, ACNP rle, evidence-based nursing practice, utcmes f care, and practice issues. Case discussins emphasize the applicatin f physilgic principles and clinical management f acute, critical, and exacerbatin f chrnic health prblems f adult/lder adult ppulatins. C-requisite: N840 and N874 Curse Objectives: The learner will be able t: 1. Apply theretical mdels f practice t clinical situatins in the acute care setting. 2. Analyze the ACNP rle using relevant literature and practice standards.

8 3. Evaluate diagnstic and management plans using adult/lder adult case scenaris. 4. Analyze an evidence-based practice guideline and apply t a case scenari. 5. Discuss practice issues related t the ACNP rle. Practicum Curse Number & Title: N910, Adult/Older Adult ACNP Practicum II (4 cr hrs) Curse Descriptin: Advanced clinical experience that is a cntinuatin f N874. Students participate in surgical and/r emergency department rtatins supervised by an ACNP r physician preceptr in the acute care setting. Emphasis is placed n physical assessment, interpretatin f data, differential diagnsis, develpment and implementatin f management plans, and perfrming relevant prcedures with adult /lder adult ppulatins. Patient and family educatin, health prmtin, and preventin are emphasized. Pre-requisite: N874; C-requisite: N909 and N911 Curse Objectives: The learner will be able t: 1. Perfrm cmprehensive and fcused physical and psychscial assessments f adults with acute and chrnic health prblems. 2. Analyze patient data t develp differential diagnses, select diagnstic tests, and develp a management plan fr adults/lder adults with acute surgical r emergency medical cnditins. 3. Prescribe apprpriate diagnstic and therapeutic mdalities (pharmaclgic, nnpharmaclgic) in the management f acute and chrnic health prblems. 4. Demnstrate integratin f thery and research while prviding care t patients and families. 5. Implement patient educatin strategies fr health prmtin and disease preventin. 6. Integrate established prtcls and natinal standards in the care f adults/lder adults with acute and chrnic health prblems. 7. Recgnize situatins requiring cnsultatin and/r referral f individuals in the acute care setting. 8. Cmmunicate effectively in verbal and written frms with patients, families, peers, and ther health care disciplines. 9. Incrprate ethical-legal principles in practice settings. Transitin Seminar Curse Curse Number & Title: N911, Transitin t the ACNP Rle II (1 cr hrs) Curse Descriptin: Fcuses n cllabrative practice, utcmes f care, practice issues, and case discussin. Emphasis is placed n develping cllabrative relatinships with ther health

9 prfessinals. Case discussins emphasize the applicatin f physilgic principles and clinical management f acute health prblems f adult/lder adult ppulatins. C-requisite: N910 Curse Objectives: The learner will be able t: 1. Apply theretical mdels f practice t clinical situatins in the acute care setting. 2. Evaluate diagnstic and management plan, and utcmes f care using adult/lder adult case scenaris. 3. Discuss the ACNP rle in cllabratin, cnsultatin, and referral with ther health prfessinals. 4. Analyze ethical-legal and ther practice issues related t the ACNP rle.

10 Evaluatin f Student Learning by Preceptrs PRECEPTOR STATEMENT Preceptrs assist curse respnsible faculty and are practitiners wh prvide direct teaching t students apprpriate t the curse and prgram bjectives. Preceptrs fr clinical specializatins may include bth advanced practice nurses (APRNs) and nn-nurse practitiners (usually physicians). Each preceptr must be credentialed and state licensed t practice in his/her specializatin. Natinal certificatin is highly encuraged althugh nt required in Kansas fr APRN status. Preceptrs must have educatinal preparatin and/r extensive practice experience apprpriate t his/her supervisry respnsibility. Newly prepared preceptrs must have at least ne year f practice experience in the specializatin. Orientatin t the preceptr rle, including prgram requirements, expectatins fr versight and evaluatin f students, are prvided fr each specializatin. Student evaluatin is the respnsibility f the faculty with input frm the preceptr. Experiences with preceptrs are evaluated by students and faculty t enhance prgram develpment and student learning activities. Dcumentatin f preceptr qualificatin is maintained in the Schl f Nursing. Alicia Huckstadt, 4/09 SON Graduate Cuncil apprval 5/1/09 Evaluatin f student perfrmance by the preceptr prvides valuable input t bth the student and the faculty member. In additin t the general guidelines presented earlier, please cnsider these areas in yur evaluatin f the student: Reliability Infrmatin gathering ability Physical examinatin techniques Prblem-slving Clinical judgment Patient rapprt and educatin Prfessinal relatinships Knwledge base Recgnitin f limitatins Additinal resurces fr evaluating students can be fund in the links sectin fr preceptrs n this website. These can be helpful if yu have additinal questins r encunter difficulties during the rtatin. Please prvide yur evaluatin f the student n the frm prvided n the fllwing page and return it t the faculty member prmptly upn cmpletin f the student's clinical rtatin. The additin f written cmments is particularly useful fr the student and the faculty member. Thank yu fr supprting ACNP educatin at WSU! Ttal Practicum Hurs: 700.

11 WICHITA STATE UNIVERSITY SCHOOL OF NURSING Preceptr/Instructr Evaluatin f Acute Care Nurse Practitiner Student Semester Student: Preceptr Signature: Key: NA = Nt applicable r nt bserved 2 = Omits task/prcedure, minimal cmpetence even with assistance 4 = Belw average skills, needs a lt f direct supervisin 6 = Perfrms with average skills, needs sme direct supervisin 8 = Perfrms with abve average skills, needs minimal direct supervisin 10= Skills are well develped, wrks independently mst f the time Date: Ttal Pints Pssible = 100 Directins: Place a X in the bx t indicate yur rating f the student fr each item Prcedure/Task Rating NA Is skillful in btaining histries and perfrming physical examinatins in patients as apprpriate fr the setting, including nrmal and abnrmal variatins in lder adults. Recgnizes bth typical and atypical presentatins f cmplex acute, critical, and chrnic illnesses including urgent/emergent physical and mental health cnditins acrss the age spectrum. Selects and recmmends apprpriate diagnstic tests with attentin t safety, cst, acceptability, and efficacy. Develps differential diagnses by pririty fr new r recurring cmplex acute, critical, and chrnic physical r behaviral disrders/prblems. Articulates patient prblems and physical findings, verbally and in writing, using accurate and apprpriate terminlgy. Succinctly frmulates & articulates the apprpriate plan f care; uses clinical data and evidence based literature t supprt the plan f care fr adults acrss the lifespan. Selects and recmmends apprpriate pharmaclgic and nnpharmaclgic interventins with attentin t safety, cst acceptability, and efficacy. Demnstrates an awareness f ethical and legal implicatins f care prvided t patients and families. Implements apprpriate patient teaching, cunseling, and health prmtin strategies with attentin t culture, aging, gender, and health literacy. Cperates and cllabrates with members f the health care team. Demnstrates prfessinal behavir. Cmments: (Yur cmments are particularly valued, s please add a few f yur cmments here r n reverse)