VANGUARD UNIVERSITY SCHOOL FOR PROFESSIONAL STUDIES BACHELOR OF SCIENCE IN NURSING DEGREE PROGRAM MULTIDIMENSIONAL ASSESSMENT WITH LAB NURS 325 (4 UNITS-7 WEEKS) Created: 05/07 Revised: 2/12, 8/12, 10/12, 2/2013
VANGUARD UNIVERSITY BSN PROGRAM Course Number: NURS 325 Multi-Dimensional Faculty and Contact Information: TBA Phone: Email: TBA Days/Times: One night per week, 6-10 pm Units: 4 units Pre-requisite: Admission to BSN program COURSE DESCRIPTION The purpose of this course is to provide the student with the opportunity to be equipped with skills necessary to do a multi-dimensional health assessment of their identified client. Emphasis is placed on the concepts of bio-psycho-social, spiritual, cultural, and community health care needs in performing the holistic examination of the individual. Additional emphasis will include the client s health care needs, levels of prevention and growth and development of the individual across the life span using theoretical concepts. Two hours of the required Child Abuse content for the Public Health Nurse certificate (PHN) will be included in this course. COURSE OBJECTIVES After completing this course, the student will be able to: 1. Identify the purpose of the nursing interview in assessing health history data. 2. Perform nursing health interview and document a complete health history in a comprehensive and systematic manner. 3. Describe the purpose and demonstrate the procedure when performing a complete physical examination of different body systems using enhanced bio-psycho-social assessment skills. 4. Document the findings of the client s present and past physical status in an organized manner in the format of Review of Systems and Physical based on systems. 5. Incorporate critical thinking skills into the planning of delivery of nursing care to individuals, families, groups, and communities based on assessment of multidimensional assessment data. 6. Describe the physical, mental, and developmental assessment of the child to adulthood. 7. Identify risk factors and assessment skills to provide early detection of family violence, including child, adult, intimate partner, and elder abuse. 2
8. Demonstrate and/or discuss understanding of health and physical assessment processes of the abused and neglected child including identifying children at risk and early detection. Two hours of required child abuse content for the Public Health Nurse certificate (PHN) will be covered in this course; additional five hours will be covered in NURS 420, Community Health Nursing. STUDENT LEARNING OUTCOMES 1. To provide the student with a variety of health assessment skills and techniques to apply in clinical laboratory setting while demonstrating critical thinking, nursing process, holistic health history and physical examination of clients. 2. To demonstrate clinical nursing skill sets and documentation of findings in an in depth assessment of anatomy, physiology, nursing health history, nutrition, family health history (genogram), spiritual assessment, and community resources of an identified client in a multidimensional health context. 3. To generate an understanding of health and physical assessment of the abused and neglected child including identifying children at risk and early detection. AACN CORE VALUES AND KNOWLEDGE RELATED TO MULTIDIMENSIONAL ASSESSMENT Critical thinking: Develop ability to identify actual and potential health problems while performing an assessment that includes physical, psychological, spiritual health and making a clinical judgment about health care needs. Communication: Develop interview assessment skills to collect data that assesses health needs of individuals including physical, psychological, cultural, and spiritual areas. : Demonstrate ability to perform a physical assessment using subjective and objective clinical data collected with advanced assessment skills Technical Skills: identify disease processes by collecting and evaluating subjective and objective data using various instruments of assessment and developing other advanced assessment techniques. Health promotion, risk reduction, and disease prevention: Build on current strengths to identify clients risk of disease, enhance patient knowledge of disease prevention and develop strategies to reduce health risks. Patient-centered Care Quality & Safety Education for Nurses (QSEN) Competencies 1. Elicit patient values, preferences and expressed needs as a part of a clinical interview, implementation of care plan and evaluation of care. 2. Assess presence and extent of pain and suffering 3
3. Assess levels of physical and emotional comfort Safety 1. Use national patient safety resources for own professional development and to focus attention on safety in care settings. 2. Communicate observations or concerns related to hazards and errors to patient, families and the health care team. COMPETENCIES FOR GERIATRIC NURSING CARE 1. Identify actual or potential mistreatment (physical, mental or financial abuse, and/or selfneglect) in older adults and refer appropriately. 2. Identify and follow standards of care to recognize and report elder mistreatment. Required texts: REQUIRED AND RECOMMENDED TEXTS AND LITERATURE Bickley, L., Palm, M. L., & Hogan-Quigley, B. (2012). 11 th Ed Bates guide to physical examination and history taking. Philadelphia, PA: Lippincott, William & Wilkins. ISBN: 978-1-6091-3762-5 COURSE POLICIES ATTENDANCE AND TARDY POLICY You must be at class on time and remain present until dismissed. attendance is necessary in order to complete the course. The School for Professional Studies relies on the dynamics of class interaction and group processing in order to integrate and apply the learning of academic content. This model also emphasizes the development and practice of interpersonal communication skills and teamwork (e.g., group problem solving and negotiation). The format therefore necessitates class attendance. In practical terms, one course session is equivalent to three weeks of traditional semester course work. Due to the concentrated scheduling and the emphasis upon participatory learning, students need to be in attendance every week. Students who miss more than one class meeting (or more than five class hours) in any given course will automatically receive a failing grade and need to retake the course to obtain a passing grade. If an instructor deems that a student s second absence was under extremely unavoidable and unusual circumstances (i.e., an auto accident), the professor may file an academic petition on behalf of the student to the Dean of SPS. If the academic petition is approved, the instructor may give the student a W (Withdrawal) grade in place of a failing grade. The student will still be required to retake the course. 4
Students who arrive late disturb the class. Students who arrive late will not receive participation points for the unit covered. Students who are habitually late may be asked to withdraw from the course. DEGREE REQUIREMENTS Students must achieve a minimum grade of C for all major course requirements. Any major course in which the student receives a grade below C must be retaken. CLASS PARTICIPATION Students must be prepared and participate in all discussions. Criterion: Is the student engaged in classroom discussions? Does the student demonstrate an ability to handle assigned material with a degree of proficiency? (e.g., ask questions and participate in dialog consistently, and in a manner that reflects familiarity with the assigned material). Participation evaluated according to quality, not quantity, of participation. Attendance will be scored, and no participation points will be awarded if the student is absent from class. LATE PAPER POLICY Students are responsible for submitting assignments on time (by 6:00 pm). Unless authorized by the Professor in advance, no credit will be given for assignments not turned in when due. CELL PHONES AND ELECTRONIC EQUIPMENT Out of consideration for others, please turn your cell phone to the silent mode. If it does not have a silent or vibrate mode, please turn it off. Please do not use computers, cell phones, electronic games (including Facebook), etc. for personal use during class. These items tend to distract the other students during class discussions or study group activities and detract from your own learning experience. ACADEMIC DISHONESTY Work submitted for assessment purposes must be the independent work of the student concerned. Plagiarism, or copying and use of another s work without proper acknowledgment, is not permitted. Nor is it permissible for any former or present student to allow another student to refer to, use as a sample, or in any way copy or review their work. If a student needs guidance, he or she must seek the Professor s assistance. Please refer to page 47 of 2013-2014 Vanguard University Catalog for definitions and consequences of plagiarism: http://registrar.vanguard.edu/catalog/ DISABILITY SERVICES For students with documented medical or psychological disabilities, documented temporary illness that requires missing 1 week of classes, or documented chronic illness please contact the Coordinator of Disability Services, to request reasonable accommodations. The Coordinator of Disability Services is located in the Counseling Center on the second floor of the Scott Academic Center and can be reached at extension 6483 or by email at disability.coord@vanguard.edu. For students with a documented learning disability who would like to request classroom 5
accommodations, please contact Barbi Rouse, the Director of Learning Skills, located upstairs in Scott Academic Center at extension 6478 or by email at barbi.rouse@vanguard.edu. room Diversity Statement As students and faculty at Vanguard University of Southern California, and foremost as Christian believers, we endeavor to communicate with honesty and confidentiality, to speak with encouraging and edifying words, and to create a safe environment where we shelter one another with love when vulnerabilities arise. This classroom intends to foster a Christ-centered community that promotes appreciation and respect for individuals, enhances the potential of its members, and values differences in gender, ethnicity, race, abilities, and generation. Teaching/Learning Methods: Learning Activities 4 units = 60 contact hours in class and online activities Out of Activities 120 hours Total Teaching Learning Methods / Contact hours Lecture (60 hours required) 1. Seven (7) four (4) hour sessions on campus = 28 hours (21 hours lecture; 7 hours lab with demonstration & return demonstration) 2. Planned Moodle online activities, forums, & discussions with faculty = 32 hours Assignments: (120 hours) Case Study = 20 hours IHA Paper = 20 hours Group Presentation = 10 hours Skills Practice: 30 hours Readings & prep for exam & quizzes= 40 hours 4 units = 60 hours of contact 4 units = 120 hours of out of class activities Teaching/Learning Methods include: 1. Online asynchronous forum discussions/case studies 2. Reading assignments 3. Electronic data base search/research 4. Synthesis of knowledge through oral presentations, written papers, classroom discussion, case studies, lab practice 5. Examinations and quizzes OVERVIEW / POINTS AVAILABLE Attendance and Participation = 70 Points Moodle Activities online = 70 Points Case Study = 150 Points Final examination (written & practicum) = 260 Points 5 quizzes (20 points each) = 100 Points Integrated Health Paper = 200 Points Presentation = 150 Points 6
Total = 1000 Points Grading Scale Students must maintain a GPA of 2.0 to continue in the undergraduate program. course in which a grade of C or less has been achieved must be repeated. A required Percentages Points Grade Significance GPA 93-100% 930-1000 A Exceptional 4.00 90-92.9% 900-929 A- 3.67 87-89.9% 870-899 B+ 3.33 83-86.9% 830-869 B Above Average 3.00 80-82.9% 800-829 B- 2.67 77-79.9% 770-799 C+ 2.33 73-76.9% 730-769 C Average 2.00 70-72.9% 700-729 C- 1.67 67-69.9% 670-699 D+ 1.33 63-66.9% 630-669 D Below Average 1.00 60-62.9% 600-629 D- 0.67 00-59.9% 000-599 F Failure 0.00 7
CLASS SCHEDULE Hour Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 6:00 7:00 Introduction To Course Chpt 1-5: Health History, Cultural & Spiritual Review Chapter 8: (Nutrition) Quiz Chpt 18, 19, & 20: Musculoskeletal, Mental Status, Neuro Review Chapter 6: Overview Physical Quiz Chpt 9, 10, 11, 12: Skin & HEENT Quiz Nursing Assess of Special Chpt 13, 14, & 15: Lungs, Heart, Peripheral Vascular Quiz Nursing Assess of Special Chpt 16 & 17: GI, Renal, Breast Abused and Neglected Child Quiz Nursing of Special Putting it all together-lab practice Chpt. 21 & 22: Reproductive & Putting it all together Putting it all together Practice & Testing 7:00 7:30 7:30 9:00 9:00 10:00 Chpt 1-5 Lab Skill practice Skill practice Lab Skill practice Lab Skill practice Nursing Assess of Special Lab Skill practice Nursing Assess of Special Lab Skill practice Case Study due Student Presentations Nursing Assess of Special Lab Skill practice- Putting it all together IHA Paper Due Final Exam: WRITTEN exam & Skills Demo Final Exam NOTE: The Professor reserves the right to make changes to the scheduled classes based on needs of the students 8
STUDENT ASSIGNMENTS Integrated Health Paper (IHA) Putting it all together The purpose of this assignment is to provide students an opportunity to do an integrated health assessment using the head-to-toe format. Information received from your laboratory peer will be collected as assessment skills are practiced in class, and documented as indicated on the IHA form provided. A theoretical framework should assist you in developing this assignment such as Roy, Erikson or another Nursing Theorist. Details of the assignment will be provided in the first class. The example for this paper is in your textbook, Chapter 2. The IHA paper form is uploaded onto Moodle. Please follow this format. The Physical and the Review of Systems sections are to be done as separate typewritten sections, and the example format is included on the IHA form. The due date for the assignment is: Week 6 at the beginning of class. THERE WILL BE NO EXCEPTIONS. This assignment counts for 200 points toward your total grade. The components and the points assigned to the paper are as follows: Nursing History (40 Points) Genogram and Summary (20 Points) Physical (60 Points) o Written separately, not on IHA form o Formatted example provided on IHA form Theoretical Application (10 Points) Review of Systems (60 Points) o Written separately, not on IHA form o Formatted example provided on IHA form Nursing Care Plan (10 Points) Total (200 Points) CASE STUDY The purpose of completing the client case study is to provide students with the opportunity to use critical thinking skills to focus their assessment plan in collecting subjective and objective clinical data. The student will be able to demonstrate knowledge needed to identify potential or real health problems and create an assessment and intervention plan that includes teaching for a hypothetical client. The student will list and describe assessments required to evaluate a client physically, psychologically, spiritually. The components and points (rubric) assigned to the paper will be listed on the case study. TOTAL 150 points 9
CLASS PRESENTATION Each team of students will choose from the list of identified topics. The purpose of the class presentation is to give the student an opportunity to explore and share the health needs of a selected population, including special approaches and assessment findings and techniques seen in each aggregate. The students will present and discuss his/her topic in class starting on week 4. Each team of students will have 15 minutes to present; this time frame will be strictly enforced. The students may use any form of media to present their content. The students should include cultural considerations in each topic to be presented. Please refer to rubrics on each topic at the end of the syllabus. TOPICS: of the Newborn of the Frail Elderly and early detection of abuse of Family systems: of Intimate partner and child abuse of the child from toddler to school age children, development, (physical, mental, psychological), Denver Developmental Screening Test, and special concerns and approaches of the teen to the young adult, including Tanner stages, development (physical, mental, psychological) and special concerns and approaches of the Pregnant woman The class presentation totals 200 points toward your total grade. Please refer to the rubrics on each topic at the end of the syllabus. The components and the points assigned to each student presenter are as follows: Speaker(s) demonstrates knowledge of topic presented with minimal reading of audiovisual material (e.g. ppt slides). Include examples/stories when applicable Content organized, clear, comprehensive (refer to rubrics at end of syllabus for details on each topic) Power Point Slides are organized and professional Speaker engaged and encouraged discussion in class, and remained within the allowed time frame. TOTAL (60 Points) (70 Points) (60 Points) (10 Points) (200 Points) 10