University of Texas Health Science Center at San Antonio Department of Lifelong Learning 7703 Floyd Curl Drive, MSC 7946 San Antonio, Texas

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1 1 University of Texas Health Science Center at San Antonio Department of Lifelong Learning 7703 Floyd Curl Drive, MSC 7946 San Antonio, Texas Course Syllabus: UTHSCSA RN Refresher Course Full Course: 112-hour Online Course + 16-hour Skills Lab + 80-hour Clinical Practicum Course Description: The UTHSCSA RN Refresher Course focuses on current nursing practice as related to the clinical area of medical-surgical nursing care. The course is designed to meet the educational needs of nurses who have been out of the clinical setting for some time and desire to re-enter the workplace and as part of the Texas Board of Nursing (BON) requirement for licensure reactivation ( Content is based on the Texas BON requirements for nursing refresher courses ( The focus of the course is to expand the nurse s knowledge, skills and attitudes by applying information related to new technology, equipment, current nursing trends, and legal requirements to previously acquired formal education and skills competency. The Texas BON requires an RN supervised clinical component for any nursing refresher course. The Clinical Practicum component of the UTHSCSA RN Refresher course is designed to meet this requirement. Overall Course Objectives: Upon completion of this course the student will meet minimum educational preparation for re-entry into the practice of nursing which is consistent with the standards and protocols outlined in the nursing literature. Specifically, the student will be able to: 1. Employ the nursing process to provide holistic, patient-centered care that reflects an understanding of pathophysiology, pharmacology, medical treatment and nursing management across all healthcare settings. 2. Apply pharmacology in nursing practice to include knowledge of dosages, administration guidelines, therapeutic effects, adverse effects, toxicity management and identifying/reporting adverse events. 3. Employ safe medication administration practices as appropriate for the patient care setting. 4. Use patient care technologies, information systems, and communication devices to deliver safe nursing care. 5. Employ evidence-based practices to facilitate communication and collaboration (inter/ intraprofessional and therapeutic) to deliver safe patient care.

2 2 6. Identify national, state and local laws, regulations and standards that guide nursing practice and continuing competency. 7. Document nursing care that is reflective of the nursing process and current industry standards. Clinical Practicum Objectives: Upon completion of the Clinical Practicum the student will be able to: 1. Employ the nursing process effectively to deliver safe patient care at the practicum site. 2. Employ safe medication administration practices as appropriate for the patient care setting. 3. Document the delivery of nursing care as appropriate for the patient care setting. 4. Use patient care technologies, information systems, and communication devices to deliver safe nursing care. 5. Communicate effectively with patients and other members of the healthcare team. 6. Demonstrate understanding of the Texas Nursing Practice Act and Board of Nursing Rules and Regulations/Position Statements during clinical practicum. Course Organization: The RN Refresher course is provided in a blended format that includes online didactic course work blended with on campus hands-on skills practice/high-fidelity simulation and a clinical practicum with a registered nurse preceptor in a healthcare facility. The primary components of the program will be disseminated on-line via a learning management system. Media formats include: streaming video, on-line testing, on-line activities, on-line student discussion forums, and links to other resource material in Evolve (an online resource companion to the Elsevier textbook). The content is presented in Units with content specific modules. Most modules (but not all) will consist of recommended readings, online lessons, practices and discussion board activities. After completing all the modules in each unit students complete the unit post-test and proceed to the next unit. The course Units should be completed in numerical order. Students will have access to an instructor and other students via and on-line discussion boards. Students will use SimChart (an Elsevier product), an educational Electronic Health Record, for simulated patient care charting. Clinical Skills Laboratory is conducted on campus. Each of the three lab sessions will be offered twice (based on class size). High-fidelity simulation utilizes a SimMan 3G mannequin (a Laerdal product) and a simulated patient care room. The Clinical Practicum is a health-related work-based learning experience that enables the student to apply specialized occupational theory, skills, and concepts. The clinical practicum provides 80 hours of supervised clinical experience (by a registered nurse) in a healthcare setting for the purpose of practicing basic nursing skills.

3 3 An overview of the course schedule is presented in the table below: Week Course Content Assignments #0 Online Orientation to Course Orientation Post Test #1 Unit 1: Professional Nursing Practice/Basic Skills Orientation Meeting: On Campus Orientation Evaluation Unit 1 Post Test Discussion Board #1 Introduction to SimChart #2 Unit 2: Cardiovascular System Unit 2 Post Test SimChart Practice: Vital Signs #3 Unit 3: Respiratory System/Oxygenation Unit 3 Post Test SimChart Practice: Respiratory Assessment Practice #4 Unit 4: Renal/Reproductive System/Elimination Unit 4 Post Test SimChart Practice: Intake & Output #5 Unit 5: Integumentary System/Wound Care Unit 5 Post Test #6 Unit 6: Pharmacology Dosage Calculation Test Dimensional Analysis Post Test #7 Unit 7: Intravenous Therapy Skills Lab Day #1: 9 am 3 pm (On Campus) #8 Unit 8: Endocrine System/Diabetes Mellitus Skills Lab Day #1: 9 am 3 pm (On Campus) #9 Unit 9: Perioperative Care/Pain Management Skills Lab Day #2: 9 am 3 pm (On Campus) #10 Unit 10: Neurological System Skills Lab Day #2: 9 am 3 pm (On Campus) #11 Unit 11: Immune System/Infectious Disease Skills Lab Day #3: 9 am 1 pm (On Campus) #12 Unit 12: Communication/Documentation Skills Lab Day #3: 9 am 1 pm (On Campus) Unit 7 Post Test Unit 8 Post Test Mid-Course Evaluation Unit 9 Post Test SimChart Practice: Pain Assessment Unit 10 Post Test Unit 11 Post Test Unit 12 Post Test Discussion Board #2 SimChart Practice: Health Assessment #13 Unit 13: Gastrointestinal System/Nutrition Unit 13 Post Test #14 Unit 14: Musculoskeletal System/Mobility Clinical Practicum (with Preceptor) Unit 14 Post Test Clinical Journal #15 Unit 15: Hematologic System/End of Life Care Clinical Practicum (with Preceptor) Unit 15 Post Test Discussion Board #3 #16 Unit 16: Psychosocial Care/Addictive Behavior Final Course Week Clinical Practicum (with Preceptor) Clinical Journal Unit 16 Post Test Overall Course Evaluation Clinical Journal All Course Assignments Must be Complete

4 4 An overview of the Clinical Skills Laboratory sessions is provided in the table below: Session #1 Session #2 Session #3 Foley Catheters Intravenous therapy High-fidelity simulation Oxygen Therapy Wound Care/sterile gloving/sterile field Medication Administration Mid-fidelity Simulation: Provide patient care in a simulated environment Mid-fidelity Simulation: Vital signs; heart, lung, bowel sounds; Vital signs; heart, lung, bowel sounds; oxygenation oxygenation 6 hours 6 hours 4 hours Recommended Text Materials: 1. Medical-Surgical Nursing: Assessment and Management of Clinical Problems (current edition). Lewis, S., Dirksen, S., Heitkemper, M., & Bucher, L. Mosby/Elsevier Publishers. 2. Nursing Interventions & Clinical Skills (current edition). Perry A., Potter, P. & Elkin, M. Mosby/Elsevier Publishers. 3. Pharmacology for Nursing Care (current edition). Lehne, R. Saunders/Elsevier Science Publishers. Students will be given ordering information when they are accepted into the course. Prerequisites: Students in this course must complete application requirements: Course application Background check Proof of current immunizations Current American Heart Association Healthcare Provider Basic Life Support training Current health insurance Current T RN license or temporary permit o CAUTION: Contact the Course Coordinator/Instructor BEFORE you apply for a temporary permit. The temporary permit is issued by the Texas Board of Nursing; it is effective for 6 months and is nonrenewable. The refresher course is 16 weeks long and is offered twice a year. You do not want your temporary permit to expire before you are able to complete the clinical practicum. We request that once you are enrolled in the course you ask the instructor when to apply for the temporary permit.

5 5 This course is primarily presented in an online format. Students are required to have a home computer, printer and internet service provider that has high speed broadband Internet access. Applicants are expected to have minimum computer competency which includes use of Internet and . Online tutorials will be provided for navigating in the online learning environment. Specific technical requirements for the learning management system will be provided upon acceptance into the course. Course Requirements: Online Didactic component: Students will be expected to review the recommended readings and complete all required activities within each Unit before moving on to the next unit of study. The course Units should be completed in numerical order. After completing all the modules in each Unit complete the Unit Post Test and proceed to the next Unit. A medication dosage calculation exam will be given in Unit 6 and passing is a course objective. Clinical Skills Laboratory component: Students are expected to be prepared to demonstrate skills during the clinical skills lab. The lab instructor will demonstrate each skill one time prior to student demonstration. Skills will be demonstrated on lab mannequins and training equipment. Students will be fully oriented to the simulated environment prior to the simulation experience. The lab and course instructors will be available for questions during all Clinical Skills Laboratory sessions. Clinical Practicum component: The student will be paired with a registered nurse preceptor to complete the 80-hour Clinical Practicum. The student will follow the schedule of the assigned preceptor at their assigned clinical site. The student will actively participate in the clinical practicum. The student will participate in the delivery of safe appropriate patient care utilizing the nursing process (assessment, planning, implementation, evaluation and documentation) and will be expected to demonstrate successful performance of the skills listed on the "Nursing Skills Completion Checklist". It is the student s responsibility to call and notify (ahead of time if possible) the preceptor, the practicum site and the course instructor when shifts are missed or canceled (either by the student or the preceptor). It is also the student s responsibility to make up any missed shifts in order to complete the 80-hour Clinical Practicum. For students to get the full benefit of the clinical practicum it is required that the Clinical Practicum be completed in 3 to 4 weeks. Students must be flexible, as they will be working the preceptor's schedule. Preceptors work a variety of shifts depending on the patient care setting; night-shift and weekends may be expected. If the student has difficulties with this type of scheduling, the course instructor needs to be made aware as soon as the student is aware and accommodations will be attempted, but will NOT be guaranteed. Students will discuss progress in this clinical practicum with the instructor and preceptor on an on-going basis. The instructor and/or preceptor will make recommendations for areas of practice needing improvement and suggest methods to accomplish this improvement.

6 6 Evaluation: The student s successful completion will be determined by: Didactic (Online) Clinical Skills Laboratory Clinical Practicum Unit post-tests minimum passing score: Attendance at all 3 Clinical Skills Laboratory days Complete 80 hours of clinical at assigned healthcare facility 80% Participate in all 3 Clinical Skills Laboratory days within 3-4 weeks Medication dosage calculation test o Demonstrate skills Complete clinical objectives minimum passing score: 80% Safe, professional practice Complete 80% of Nursing Skills Completion Checklist (in either Dimensional Analysis test minimum o The course instructor, in consultation with clinical skills laboratory OR clinical practicum) passing score: 80% the clinical skills laboratory instructor, Complete online evaluation of clinical site AND preceptor Participation/completion of all Discussion determines safe nursing practice of the Safe, professional practice Board Assignments/Clinical Journals students enrolled in this course. Unsafe or Complete course evaluations: unprofessional practice will be grounds for NOTE: Safe, professional nursing practice is described in the Clinical o Orientation removal from the course Practicum Student Manual and at the Texas BON website at o Mid-course Overall Course 2010.pdf (Differentiated Essential Competencies of Graduates of Texas Nursing Programs). The course instructor and/or clinical preceptors determine safe, professional nursing practice of the students enrolled in this course. Unsafe or unprofessional practice will be grounds for removal from the clinical practicum site and the course. Course Completion Course Options: Students interested in the RN Refresher course have the following options for completing the course Option #1: Students may apply for the full RN Refresher Course Option #2: Students may apply for the Online Didactic Course plus the Clinical Skills Laboratory Option #3: Students may apply for the Online Didactic Course only The information included in this syllabus describes the full RN Refresher Course (Option #1). The full RN Refresher Course is the only option that allows students to complete the required Clinical Practicum with a UTHSCSA affiliated clinical agency. The Clinical Practicum is not offered as a separate component that can be added to Option #2 or Option #3 at a later date. The table below provides the costs and prerequisites for each option:

7 7 Full Course* Didactic & Skills Didactic Only Laboratory Online Didactic Clinical Skills Laboratory (2 Skills Practice + 1 Simulation lab) Clinical Practicum Course Fee $3,000 $2,000 $1,000 Student Prerequisites Application Resume Professional Behaviors Agreement Clinical Placement Survey Certified Background Check Health Insurance Current Immunizations Basic Life Support Telephone Interview Clinical Placement On-campus orientation *This is the ONLY option that allows students to complete a Clinical Practicum with a UTHSCSA affiliated clinical agency. The Clinical Practicum is NOT offered as a separate component that can be added at a later date. Course Completion Determination: Students either complete or do not complete the course based on the successful completion of the activities described above. No partial credit will be offered. Certificate of Completion: Upon successful completion of the course requirements based on the course option selected, the student will be given a certificate of completion. For individuals who need this course as a requirement for receiving a permanent Texas nursing license, the course instructor will complete and send the required Verification of Successful Completion of Professional Registered Nursing Refresher Course/Extensive Orientation/Academic Nursing Course(s) for Texas Board of Nursing to the Texas BON. NOTE: Continuing Nursing Education (CNE) cannot be awarded because this course is considered basic nursing by the Board of Nursing (BON).

8 8 Course Contacts: Kimberly Cox, MS, RN, NE-BC University of Texas Health Science Center at San Antonio 7703 Floyd Curl Drive, MSC, 7946 San Antonio, Texas