View
213
Download
0
Category
Preview:
Citation preview
1
The University of Jordan
School of Nursing
Adult Health Nursing (2) clinical
first semester 2016/2017 Clinical Objectives
Write youre objectives from the following list
Clinical Rotations and Objectives
Students will be divided into groups with two rotations. Clinical settings will be: The University of Jordan Hospital, Prince Hamzeh hospital, Al-
Salt Governmental hospital, and Al-Basheer Governmental hospital. Students will be guided in each area by specific clinical objectives for that
area.
ICU Objectives:
1- Identity unit equipment ,machines capacity& health team members
2- Review pathophysiology of common diseases in the unit
3- Ascertain professional behavior in dealing with client, their families' instructor, and health team members.
4- Interpret full intake and output charting interpret results and take appropriate Nursing interventions.
5- Interpret ECG for critically ill clients
6- Demonstrate hemodynamic monitoring for client with cardiac alterations critically
7- Operate different machine in the unit ( cardiac monitor, infusion pump & ECG )
8- Demonstrate suctioning through (oral, ETT, and TT),
9- Analyze arterial blood gases (ABG) readings for critically ill clients
10- Apply pre-post operative care for client with surgical intervention
11- Apply full physical assessment for assigned client
12- Assess level of consciousness using GCS for critically ill clients
13- Care for client on a mechanical ventilator.
14- Report accurately the condition of one assigned patient.
15- Handle medications appropriately in the units
16- Initiate and effectively assist in resuscitation.( CPR )
2
17- Provide post- mortem care
17 - Formulate Nursing Care Plan (NCP) for critically ill clients in order of priority.
CCU Objectives:
1- Identity unit equipment ,machines capacity& health team members
2- Review pathophysiology for cardiovascular alterations common in the unit
3- Ascertain professional behavior in dealing with client, their families' instructor, and health team members.
4- Interpret full intake and output charting interpret results and take appropriate Nursing interventions.
5- Interpret ECG for critically ill clients
6- Demonstrate hemodynamic monitoring for client with cardiac alterations critically
7- Apply full physical assessment for assigned client
8- Report accurately the condition of one assigned patient
9- Operate different machine in the unit ( cardiac monitor, infusion pump & ECG )
10- Handle medications appropriately in the units
11- Formulate Nursing Care Plan (NCP) for critically ill clients in order of priority
12- Initiate and effectively assist in resuscitation.( CPR )
13- Provide post- mortem care
Neuro ICU Objectives:
1. Identity unit equipment ,machines capacity heath team members
2. Review neurological alterations common in the unit.
3. Ascertain professional behavior in dealing with client, their families' instructor, and health team members.
4. Operate different machine in the unit ( cardiac monitor, infusion pump & ECG)
5. Assess level of coconscious through GCS
6. Apply full physical assessment for assigned client
7. Provide nursing care for assigned client
8. Report accurately the condition of one assigned patient
9. Provide pre and post operative care for clients with neuron surgery procedure
10. Handle medications appropriately in the units
11. Formulate Nursing Care Plan (NCP) for critically ill clients in order of priority
ER Objectives:
1- Identity emergency equipments, locates them, and how to operate them
2- Clarify the triage system used in emergency department
3
3- Describe pathophysiology of common emergency conditions.
4- List anticipated complications of the patient and intervenes accordingly
5- Ascertain professional behavior in dealing with client, their families' instructor, and health team members.
6- Handle correctly a client arriving to the ER.
7- Apply full physical assessment for assigned client within a reasonable period.
8- Complete the routine paperwork for accidents suicide cases.
9- Provide support to the patient's family.
10- Formulate appropriate presentation for the case of assigned client.
11- Assist in patient resuscitation( CPR)
12- Assist in transferring the client to their units
13- Handle medications appropriately.
14- Provide health education for clients and their families according to their needs
HEMO DIALYSIS UNIT Objectives:
1- Identify hemodialysis process.
2- Review the pathophysiology of renal failure.
3- Recognize the types of the machines used.
4- Differentiate between types of access as AV. fistula graft and subclavian access.
5- Ascertain professional behavior in dealing with client, their families' instructor, and health team members.
6- Assist nurses in the initiation & termination of hemodialysis for client
7- Apply full physical assessment for assigned client
8- Report accurately the condition of one assigned patient
9- Handle medications appropriately
10- Provide nursing care for client during hemodialysis process
11- Provide health education for clients and their families according to their needs
objectives )Recovery ( ostanasthesia care unitP
1. Identity unit equipment ,machines capacity heath team members
2. Discuss the components of an initial postanasthesia assessment
3. Describe nursing role in receiving patient from operating room
4. Ascertain professional behavior in dealing with client, their families' instructor, and health team members.
5. Assist nurses in receiving patient from operating room
6. Apply initial postanasthesia assessment (airway patency, breathing, circulation & level of consciousness.
7. Explain the potential complications for client in the postanasthesia care unit
4
8. Perform nursing care for client in the postanasthesia care unit (surgical drain, wound dressing ,suction ,position & vital signs
monitoring)
9. Handle medications appropriately
10. Report accurately the condition of one assigned patient
11. Assist nurses in transferring client from postanasthesia care unit.
Cardiac Catheterization Unit Objectives: 1- Identify various tools and instruments used during the catheterization procedure.
2- Review the indication for cardiac catheterization
3- Determine the steps of cardiac catheterization after attain the procedure
4- Describe nursing role for client pre, during & post cardiac catheterization.
5- Ascertain professional behavior in dealing with client, their families' instructor, and health team members.
6- Apply full physical assessment for assigned client
7- Assist nurses in providing care for client pre, during & post cardiac catheterization
8- Report accurately the condition of one assigned client
9- Handle medications appropriately
10- Assist nurses in transferring client from cardiac catheterization
5
The University of Jordan
School of Nursing
Adult Health Nursing (2) clinical
first semester 2016/2017
Orientation Paper
Student name: ………………………………………………
Instructor name: …………………………………………..
Clinical Area /Rotation no.: ……………………………………………….
Student signature items No
Medical, nursing staff, and clerk 1-
Unit capacity 2-
Patient room(oxygen-suction-bed- ambu-bag) 3-
Linen cupboard 4-
Emergency trolley 5-
Defibrillator 6-
Dressing trolley 7-
Procedure sets (dressing set-cath set-cvp set-LP set) 8-
Narcotics 9-
Store supplies and IVF 10-
Refrigerator content 11-
ECG machine 12-
Cardiac monitor and central monitor(with all cables and
alarm system)
13-
Infusion pump-I vac- vascular decompression device 14-
Medical records 15-
Code system (CPR-Fire) 16-
laryngoscope 17-
Stylet 18-
Megil forceps 19-
Mouth gag 20-
Stethoscope 21-
Torch 22-
Waste disposable (sharp container) 23-
Computer system 24-
6
The University of Jordan
School of Nursing
Adult Health Nursing (2) clinical
first semester 2016/2017
NCP FORM
Instructions
1. This is the form of NCPin Adult (2)course & is the only allowed form for this course
2. Only hand writtingusing dark ink pen , allowed Don’t type NCP ( you will get zero mark)
3. Using appreviations not allowed
4. Using symbols not allowed (- ,_ ,/ , X )
5. Heath assessment describe finding don’t use normal , good bad ,abnormal terminology )
6. Diagnostic Evaluation (Lab results, MRI, CT, ECG, etc….) according to the hospital polices
7. Add References for medications profile
8. Write at least (5) nursing diagnosis completlywith Functional Health Pattern, Evidenced By/Defining
Characteristics, goal planned interventions ,actual interventions &out com
9.Only one week allowed for filling NCP
10.Submit in the due date as mentioned in the time table
*First rotation
NCP due date(24/10) Monday
NCP due date ( 25/10)Tuesday
*Second rotation
NCP due date (5/12 ) Monday)
NCP due date(6/12 ) Tuesday)
11.Submission late from due date student will lose marks ( one mark out of ten for each late day )
12. Submission late for more than three clinical dates not allowed you will get (zero mark
7
UNIVERSITY OF JORDAN
School of Nursing
Adult Health Nursing (2) clinical
first semester 2016/2017
NCP FORM
Student Name : Date :
Clinical Area /rotation no. : Evaluator:
Student mark out of 10 ( )
*****************************************************
Nursing Admission Data Base (5%)
Client ........................................... Age : ................ Sex: ..........................
Date of Admission (Transfer) : ..........................Via : .................................
Condition on arrival : Wheelchair.............. Walking............ Stretcher..........
Source of Data:
Spoken language:
Patient education: (1 Mark)
Reasons for Hospitalization : (0 . 5 mark)
Confirmed Diagnosis : ( 1 Mark )
Medication taken at home : ( 0.5 Mark)
Past medical history : (0 .75 Mark)
Past surgical history : ( 0 . 75 Mark)
Family history ( genogramfor 3 generations ) : (0 . 5 Mark)
8
ASSESSMENT ( Describe ) (15%) 1. Health Maintenance - Perception Pattern . ( 0 . 75 Mark )
A : Smoking :
B : Alcohol :
C : Allergies (drugs, food, tape, dyes):
2. Activity / Exercise Pattern (Describe activity, feeding, bathing, dressing, toileting, mobility, & using assistive
devices): - ( 1.5 Mark)
3. Nutrition / Metabolic Pattern (Describe): ( 2 Mark)
A : Typical diet at home :
Prescribed diet :
B : Appetite :
C : Nausea :
D : Vomiting :
F : Dysphagia:
G : Weight changes within last 6 months:
H : Dentures :
9
4. Elimination Pattern : ( 2 Mark)
A : Bowel habits, ostomy, bleeding, assistive devices etc.. :
B : Urinary Habits :-
5. Sleep / Rest Pattern: ( 1.25 Mark)
6. Cognitive / Conceptual Pattern :- ( 2 Mark)
A : Hearing :
B : Vision :
C : Vertigo :
D : Discomfort / pain :
7. Coping Stress/ Self Perception Pattern: ( 1 . 5 Mark)
A : Major concerns regarding hospitalization of illness :
B : Major loss / change : No ............., Yes (specify)
C : Coping mechanisms :-
10
8. Value - Belief Pattern :- ( 1 Mark)
A : Religion:
B : Spiritual Habits:
9. Role - Relationship Pattern :- ( 1 . 5 Mark )
A : Occupation:
B : House - hold members:
C : Family concerns regarding hospitalization:
10. Sexual / Reproductive Pattern :- ( 1 Mark )
A. Female patients:
Menstruation :
Use of contraceptives :
Vaginal bleeding :
Vaginal discharge:
Self-Breast Exam:
B. Male patients
Testicular exam:
11
PHYSICAL EXAMINATION : ( OBJECTIVE DATA) :- (10%)
1. General Survey: ( 1.25 Mark )
Level of consciousness:
Orientation:
Height Weight Temperature
General Appearance:
2. Nutritional - Metabolic Pattern (Describe) : ( 4 Mark )
A : Skin :
B : Oral Cavity :
C: Neck:
D: Abdomen:
12
3. Activity- Exercise Pattern: ( 3 Mark )
A: Lung and Thorax
B: Cardiovascular:
C: Musculoskeletal:
4. Cognitive- Perceptual Pattern:- ( 1 . 75 Mark )
A: Mental status: (able to calculate, thinking abstractly, memory, etc..):
B: Neurological status:
13
MEDICATION PROFILE ( 10% )
Allergies : ................................................................................................
Drugs and
Classification
( 1 Mark )
Indication for
my Patient
( 2 Mark )
Dose /Route/
Frequency
(1 Mark )
Contra-Indications
( 1 Mark )
Expected side effects
( 2 Mark ) Nursing Implications
( 3 Marks )
References:
14
Diagnostic Evaluation
(Lab results, MRI, CT, ECG, etc….)
Date Test Performed
( 1 Mark ) Normal Value
( 2 Marks ) Patient Value
( 2 Marks )
Interpretations & Nursing
Implications
(5 Marks)
References:
Nursing Care Plan
15
Functional Health Pattern
Nursing Diagnosis
( 10 Marks)
Evidenced By/Defining
Characteristics
( 10 Marks )
Short-Term Goals
(5 Marks)
Planned Intervention
(With Rationale )
(15 Marks)
Actual Intervention
(5 Marks)
The Outcome
(With Rationale)
( 5 Marks)
References:
16
ts Instructor commen
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………
NCP Mark out of 10 submitted once only
Student mark *10/100= total mark
Instructor signature : ………………. Student signature : ……………………
Course coordinator
Tagreed shawashi
17
The University of Jordan
School of Nursing
Adult Health Nursing (2) clinical
first semester 2016/2017
Health Education Form
Name of Student: ………………………………… Evaluator:…………………………...
Clinical Area:/rotation no.……………………………………... Date: /
Items Student Score
3 2 1 0 NA
Health Education
1 Assess clients’ learning needs
2 Written information(brochures) in Arabic language
revised by instructor
3 Use appropriate teaching and learning principles when
implementing the health education
4 Develops and implements a teaching plan according to
assessment findings, and level of understanding
5 Provides patient education related to disease,
Medications, lifestyle changes that needed to achieve
optimal health
6 Presents information in a clear, professional manner
7 Estimated time for health education about 10-15
minutes
8 Evaluate clients’ attainment of learning outcomes.
18
Instructor comments
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………\
Mark out of 3 added to the evaluation form (interpersonal relationship) in both rotations
Student mark *3/24= total mark
Instructor signature : ………………. Student signature : ……………………
Course coordinator
Tagreed shawashi
19
The University of Jordan
School of Nursing
Adult Health Nursing (2) clinical
first semester 2016/2017
Weekly Objectives
Clinical area /rotation no.: ……………………………….Clinical instructor: …………
Student’s Name:
Objectives No Date:
Weekly Objectives:
1- ………………………………………………………………………
………………………………………………………………………
2- ……………………………………………………………………………………………………………………………
…………………
3- ……………………………………………………………………………………………………………………………
…………………
4- ……………………………………………………………………………………………………………………………
…………………
20
Planned and unplanned learning activities:
1 - ………………………………………………………………………
………………………………………………………………………….
2- ……………………………………………………………………….
………………………………………………………………………….
3- ………………………………………………………………………..
…………………………………………………………………………..
4-………………………………………………………………………..
………………………………………………………………………….
5- ………………………………………………………………………..
Client condition :
Initial :…….. age: ……….. gender:………..
Chief complaint :……………………………………………….
Confirm medical diagnosis:…………………………………….
Past medical and surgical history :……………………………..
Vital sign ………………………………………………………
21
Abnormal lab test : ……………………………………………..
…………………………………………………………………..
…………………………………………………………………..
…………………………………………………………………..
Abnormal physical exam : ……………………………………...
…………………………………………………………………...
…………………………………………………………………...
…………………………………………………………………...
…………………………………………………………………...
…………………………………………………………………...
One nursing diagnosis and goal :
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
………
Student's impression:
…………………………………………………………………………
…………………………………………………………………………
……………………………………………………………………
22
Instructor’s feedback / Clinical performance :
Knowledge :
Nursing process :
Interpersonal relationship :
Professional behavior :
Psychomotor skills:
Instructor signature : ………………. Student signature : ……………………
1
The University of Jordan
School of Nursing
Adult Health Nursing (2) clinical
first semester 2016/2017 CLINICAL EVALUATION TOOL
zero: objectives met 0-20% of time, unsafe, continuous assistance.
1: objectives met 21-40% of time, occasional unsafe, occasional assistance.
2: objectives met 41-70 % of time, frequently unsafe, frequently assistance.
3: objectives met 71-100% of time, safe, rarely assistance.
I . Knowledge Base and cognitive skills : ( ….../18) II . Nursing Process:
A – Discusses the pathophysiology/medical diagnoses involved:
Defintion of disease process
Provide concise summary of pathophysiology
Pertinent assemssment of diagnostic criteria
Risk factor , manifestation
A-Collects a complete nursing data base via physical assessment &
complete history.
Chief complain ( initial, age , gender reason for the medical
help )
History of present illness ( description of chief complain)
Medical and surgical history
Subjective and objective data
B – Discusses the rationale for therapy e.g., medication; it's action, side
effect, nursing implications . B-Identifies nursing diagnoses a according to NANDA.
C- Compares the client's condition/pattern of recovery with that
associated with the diagnosis.
C- Derives nursing diagnoses through date analysis in order of
priority.
D- Recognizes and interprets changes in the client's condition:
Labratory data
vital signs,
physical exam,
diagnostic (CT SCAN, ERCP….).
D- Formulate short-term goal for each nursing diagnosis.( using
smart criteria)
E- Discusses the potential complications associated with the Patient's
diagnoses and describes preventive measures.
E- Formulate an appropriate planned intervention for his/her clients
with rational
F- Link the patient's condition with the evidence based practice. F- Implements the plan of care
G- Document the patient’s responses to care using appropriate
medical terminology.
1
III . Interpersonal Relationships: IV . Professional behavior and sense of responsibility:
A- Introduces self to client and family, and establish therapeutic relationship with
them.
A-Presents evidence of preparation for clinical
assignments to
Instructor e.g. Preclinical sheets, medication assignment.
B- Adhere to clinical training rules (see attached papers). B-Take initiative for independent learning activities.
C- prepare the weekly clinical objectives using SMART method, including the 4
aspects of care.
C-Identifies strengths and learning needs with the
instructor.
D-Provides patient education (teaching) related the disease process, therapy, life
style modifications. D-Participates in learning activities during discussions.
E-Initiates collaboration with instructor, peers, and health care members. E- Carries out all delegated responsibilities.
F. Controls emotions despite stressful situations. F- Accepts instruction and uses suggestions to improve
performance.
G- Notifies instructor or nurses in the unit of tardiness or
absence.
V . Psychomotor skills:
A-Prepares the environment privacy, clean surrounding, proper lights, patient positioning, ...etc.
B-Prepares equipment correctly and adequately
C- Adhere to safety measures such as infection control(hand washing, sterility, proper disposal of
equipment).
D-Uses equipmentcorrectly and safely before, during and after the procedure
E-Document procedures appropriately using documents forms.
F- Report abnormal findings to assigned staff.
2
The University of Jordan
School of Nursing
Adult Health Nursing (2) clinical
first semester 2016/2017
Clinical Examination Form
Name of Student: ………………………………… Evaluator:…………………………...
Clinical Area / rotation no. :……………………………………... Date: / /20
Items Student Score
3 2 1 0 NA
I Medical diagnosis and Pathophysiology
1 Discusses the client's medical diagnoses, Verbalizes accurate
information regarding Medical Diagnosis and/or surgical procedure
2 Discusses the Pathophysiology involved
3 Relates Pathophysiology of disease(s) to patients’ assessment findings,
medications, diagnostic test results, and medical and nursing
interventions
II Assessment
1 Perform comprehensive client assessments including history,
subjective and objective data. in a systematic manner
2 Demonstrates correct techniques for physical assessment based on
patient characteristics
3 Recognizes abnormal client data
4 Clusters data to identify patient/nursing problems
III Medication
1 Recall client medication information including classification,
indication, action, dosage, side effects.
2 States the nursing implications of the medications
3 Discusses the rationale for therapy e.g., medication procedures (Relate
clients’ medications to their health status)
3
4 Calculate drug dosages correctly
5 Perform appropriate assessments prior to, during, and after medication
administration
IV Diagnostic tests
1 Recognize normal and abnormal data
2 Interprets significance of lab and diagnostic tests
3 States the nursing implications of the diagnostic tests
V Needs and diagnosis
1 Formulates appropriate ND (Psychosocial, Developmental,
Nutritional, Values & Beliefs) for client needs (Develops
comprehensive list of ND)
2 Writes ND correctly, Supports ND with problem statement and
appropriate etiology (NANDA approved)
3 Establishes priorities of care in meeting identified needs of patients
VI Client Goal
1 Goal stem congruent with problem
2 Goal stem contains all components (SMART criteria)
VII Nursing interventions
1 Prepare clients for interventions
2 Interventions are appropriate, specific and related to parameters
or lab & diagnostic tests
3 Gives rationale for intervention
Comments:……………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………
4
……………………………………………………………………………………………………
Rating Scale *
3. Exceptional performance - consistently exceeds expectation
2. Performs as expected for this level
1. Needs Improvement
0. Unsafe clinical practice
N/A Not applicable or Performance Criteria not appropriate for this clinical setting
Student score *10/69 = student scor out of 10
Clinical Instructor’s Signature:………………………………………….
Recommended