LOYOLA UNIVERSITY CHICAGO NIEHOFF SCHOOL OF NURSING COURSE TITLE AND NUMBER: MSN 485 ADVANCED PRACTICE ACUTE CARE NURSING PRACTICUM CREDIT HOURS: 1-12 credit hours (670 clinical hours) PLACEMENT: Last semester(s) of program FACULTY: Nursing School Faculty T. Digate & J.Jennrich COURSE DESCRIPTION: This clinical practicum is designed to guide the student toward the development of scientific knowledge and advanced practice skills in the area of acute care nursing. The attainment of this advanced practice mastery involves the synthesis of concepts, knowledge and skills gained in the previous courses applied to the care of the acutely ill adult patient. Course content focuses primarily on the advanced practice of acute care nursing and guides the student toward an actualization of the role of the acute care practitioner. The student will care for the acute care patient from admission to the tertiary care center through discharge/rehabilitation when possible. Through the use of nursing frameworks, nursing diagnosis, the nursing process, application of advanced knowledge, and advanced practice skills, the student will develop strategies for the nursing management of the critically ill patient. Legal, cultural and ethical implications are presented. The practicum offers the student opportunities to work with the interdisciplinary team and to develop skills necessary for advanced practice nursing, advanced management, and exploration of research in the area of acute care nursing. Clinical seminars will include discussion of concepts that have been introduced in previous courses and will be built upon with added depth. A grand rounds/case study approach will be utilized with cases cared for by students in the clinical arena. Other possible topics include: implementation of the advanced practice nursing role, social support, patient advocacy, vulnerable populations, cultural diversity, contracting, credentialing, privileging, etc. Seminars will also include identification of ethical issues in the students practice, application of research findings, applying a Jesuit philosophy in the care of the acutely ill individual or family, and individual development of a philosophy of advanced practice nursing. Seminars will include student and faculty-led discussions. Instructional Methods: A variety of teaching/learning methods will be used. The course may include guest speakers, seminar discussions, case reviews, implementation of a teaching plan/project, and preceptor-supervised clinical experiences. Course Format: This variable credit clinical course will strongly emphasize the attainment of acute care nurse practitioner competencies based on the most recent American Association of Critical Care Nurses Scope
2 and Standards for Acute Care Nurse Practitioners and the Emergency Nurses Association Scope and Standards of Emergency Nurse Practitioners. Students will successfully complete at least 670 clinical hours prior to graduation. The practicum will consist of two supervised clinical experiences with assigned preceptors within selected clinical sites chosen to optimize attainment of specific clinical outcomes. Students will meet with preceptor and faculty to develop individual objectives based on self assessment of strengths and learning needs prior to each semester as well as throughout the semester to determine expectations and progress relevant to the registered credit hours. Policy on Academic Honesty Academic honesty is an expression of an ethic of interpersonal justice, responsibility and care applicable to Loyola University faculty, students and staff, which demands that the pursuit of knowledge in the university community be carried out with sincerity and integrity. Academic dishonesty is characterized by the failure to apply this ethic, i.e., any action whereby faculty, student or staff misrepresents the ownership of academic work submitted in his or her name. Student failure to practice academic honesty will, depending upon the seriousness of the misconduct, result in a sanction ranging from the grade of "F" for the assignment to expulsion from the University. COURSE OUTCOMES: At the conclusion of this course the student will be able to: 1. Synthesize and apply knowledge from nursing, behavioral and natural sciences as they relate to the management of acutely ill patients. 2. Demonstrate the ability to collaborate with interdisciplinary health professionals in providing care to acutely ill patients in primary, secondary and tertiary health care settings. 3. Implement components of the advanced practice role including: advanced practice, case management, consultation, research and education. 4. Demonstrate the ability to provide competent and comprehensive advanced practice nursing management to acute care patients. 5. Apply a nursing model to the care of the acutely ill patient and family. 6. Identify research problems and critique research for application in acute care management. 7. Incorporate teaching-learning principles in meeting the educational needs of patients, their families and the community at large. 8. Appreciate the cultural, spiritual, ethical, legal, financial, psycho/social impact of acute care advanced practice role while practicing in the clinical environment. 9. Exemplify personal and professional growth in the functional role of the advanced practice nurse
3 COURSE REQUIREMENTS: 1. Supervised clinical practice with a designated preceptor successfully completing a minimum of 670 clinical hours based on course and personal clinical objectives. Pre, mid and final meetings/evaluations with preceptor, student and faculty. 2. Submission of weekly evidence-based clinical practice paper and journal entries along with skills checklist record. This includes such content as personal and role reflection, selected patient history, physical etc, evidence based guidelines utilized and a spread sheet with technical skills. Participation at clinical seminars including written and oral case presentations and seminar discussions. The powerpoints and the best reference on the topic will be posted in course content. 3. Completion of a scholarly written proposal for a prevention project the first semester of clinical and implementation and evaluation of the project in writing, along with an oral presentation of the project to peers during the last semester of clinical. 4. Updated professional e-portfolio review with course faculty at end of each semester by apt. COURSE EVALUATION: **The letter grade for the course will be based on satisfactory clinical performance with achievement of course objectives. Additional requirements listed below will also contribute to the final course grade. Students must receive a grade of B- or better to successfully pass this course. 1. Clinical practice evaluated by preceptor and faculty by observing clinical competencies, overall patient management, clinical decision making, and completion of clinical evaluation forms (60%). 2. Mandatory participation in clinical conferences, including clinical case presentations or ethical and legal issues (10%). 3. Clinical Logs: Evidence based practice weekly clinical critiques and journal entries one journal due every 24 hours of clinical (25%). (12-14) 4. Community prevention project (5%). Semester one is the formal lit review, proposal and outline for project and semester two is the evaluation and final write up try and make suitable for publication and replication in your role as ACNP. 5. Written final self-evaluation regarding achievement of objectives; preceptor and site evaluations. 6. Up to date e-portfolio at the end of semester with demonstration on progression in profession.
4 Clinical Case Presentations (for seminar): each 24 hours or weekly (12-14 will be due); rubric attached At the monthly clinical seminars each student will be expected to present a case that they encountered during their clinical. The case should be presented in a teaching format using the following guide: 1. Age, gender, race 2. Chief Complaint 3. Onset 4. Vital signs 5. Differential Dx 6. Labs/x-rays/tests (bring x-rays to class if available) 7. Results of above 8. Final Dx 9. Evaluation 10. Learning points 11. References and key articles/ebr related to case Clinical Logs: 1 log required for every 24 hours of clinical. Students will e-mail the clinical log to the faculty following each 24 hour clinical. Records more than 1 week late will not be accepted and a zero grade will be assigned for that record (see attached rubric). Prevention Project: A clinical prevention project is required of each ACNP student. The first semester the clinical project proposal must be submitted. The second semester the project is implemented and evaluated in a written formal paper and presented to the class (see attached). Required Texts and Mobile Drug Data Base and Reference Tool Godara, H., Hirbe, A., Nassiff, M., Otepka, H/, Rosenstick, A. (2013). The Washington Manual of Medical Therapeutics, Thirty-Fourth Edition, Philadelphia: Lippincott-Raven. Pepid: purchased through Loyola University bookstore. PCP and Emergency Suite (http://www.bkstr.com/webapp/wcs/stores/servlet/helpstoreinfoview?langid=- 1&catalogid=1001&storeid=95904&demoKey=d) Epocatrates: 20% discount thru August 29 for all new subscriptions. (https://www.epocrates.com/referral.do?p_r_name=misericordiauniv01 2013
5 Recommended Texts: Bache, J. (2003). Handbook of emergency department procedure (2 nd Ed), St. Louis, Mo. Mosby-Year Book, Inc. Barclay, T. & Myers, C. (2008). Practice Guidelines for acute care nurse practitioners, 2 nd edition. Philadelphia: WB Saunders. Benner, P. (1984). From novice to expert. Menlo Park, California: Addison-Wesley Publishing Co. Bongard, F. & Sue, D. (2009) Current essentials of critical care (3 rd Ed,) also free download. NY, NY: McGrawHill/Appleton & Lange. Campos, T., Lafferty, K (Eds), (2011) Essential procedures of emergency, urgent and primary care settings: A clinical companion. NY, NY: Springer Ferri, F. (2011). Practical guide to the care of the medical patient (9th Ed). St Louis: Mosby- Year Book, Inc. (online) Flynn, M., Whalen, E., VonRueden, K., Harstock, R. (2010). Trauma Nursing: from resuscitation through rehabilitation (4th edition). Philadelphia: Saunders. Henry, JB (2011). Clinical diagnosis and management by laboratory methods (22 nd ED). Philadelphia: Saunders. Keough, V. (Ed) (2003). Advanced practice nursing: Current practice issues in emergency care (2 nd Ed.). Dubuque, Ia.: Kendell- Hunt Publishing Co. (just because!) Marino, P.L. (2008). The ICU book (3rd Ed) Baltimore: Williams & Wilkins. McPhee, S., Papadakis, M., Rabow, M. (2012) Current medical diagnosis and treatment (51 st Ed).NY, NY: Lange, McGraw Hill. Merckmedicus.com Rakel, R and Bope, E (2012). Conn s current therapy: Expert consult. Elsevier. Springhouse Corporations. (2001). Procedures for Nurse Practitioners. Springhouse Pennsylvania: Springhouse. (always cheap on line) Tintinalli, JE, Kelen, GD, & Stapczynski, JS. (2010). Emergency Medicine: A Comprehensive Study Guide, 6 th Ed. NY, NY: McGraw Hill. ACNP Certification Exam Review book. (Todd, Miller, Fitzgerald, Barkley etc.) 485syl813
6 Loyola University Chicago Niehoff School of Nursing MSN 485 Advanced Practices Acute Care Nursing Practicum Clinical Logs Student Name: Log# Date: Clinical Dates for this log Hours for this log Total Hrs thus far Total Number of patients seen for this record: Total 0-13 Total 14-64yo Total >65 List Primary Dx of patients seen: Reflection on past 24 hours of clinical experience: (What was the best experience and why. What additional preparation do you need to do for the next experiences?) Review of an interesting case. Written in the format of a formal note on the patient s chart: Pt Initials, age, gender, race Chief complaint HPI (onset, quality, duration, context, modifying factors, S&S Review of Systems (include PMH, FH, SH, Meds/allergies) Vital Signs Physical Exam Pertinent labs, diagnostics tests Diagnosis, Differential dx Management plan including meds Evaluation Final Diagnosis Patient, family education Comment specifically on the care your provided to this patient and learning points from this case. Review of a journal article pertinent to this case: Choose an evidence based article that answers a question that is pertinent to the case discussed above. Review the article and discuss the following points. Author, date, title, journal name, volume number, page number. (Attach as PDF) Summary of purpose and findings Reason for selection Applicability of findings to improve this patient s outcomes