WAYNESBURG COLLEGE.doc

WAYNESBURG COLLEGEDEPARTMENT OF NURSING

GRADUATE AND PROFESSIONAL STUDIESNursing 546

Applied Pharmacology in Clinical Practice

Course Number: NUR 546

Course Title: Applied Pharmacology in Clinical Practice

Course Credits: 3

Faculty: This course will be co-taught by the following

faculty. Faculty for each week is listed in the syllabus in the weekly outline.

Wendy Forrest Edgar, MSN, RN, CRNP-BCCourse Co-ordinatorWendy received her BS in Nursing from Penn State University in 1992. Upon graduation she completed a 6 month critical care internship at Milton S. Hershey Medical Center in Hershey, PA in the Surgical ICU where she worked until 1998. She received her Masters Degree in nursing after completing the Family Nurse Practitioner Program at Widener University in 1998. Wendy is currently employed in the Emergency Department at Jefferson Regional Medical Center where she practices as nurse practitioner. She is also a part-time member of the undergraduate nursing faculty here at Waynesburg College where she teaches physical assessment & pharmacology.Contact information:

e-mail: [email protected]: 724-348-0383

Christine Mitchell, MS, CRNAChris is a 1992 graduate of the nursing

program hereat Waynesburg College. Upon graduation she completed a 6 month critical care internship at

the Milton S. Hershey Medical Center in Hershey,

PA in

N546/Su07, Southpointe1

mailto:[email protected]

the Surgical ICU where she worked until 1995. While

working on her Masters degree she taught leadership

in the undergraduate nursing program here at Waynesburg. Chris received her master’s degree from Laroche College after graduating from the Nurse Anesthetist Program in 1998. She is

currently a Certified Registered Nurse Anesthetist at Saint

ClairHospital. Contact information:

e-mail address: [email protected]

Catalog Description: This course is designed for the graduate nursing student, building on current knowledge of pharmacology. The course

focuses on various strategies for teaching nursing students, nursing staff, and patients and families about medications and safe medication administration.

Course Overview: This course focuses on applied pharmacology for the graduate student who plans a career in nursing education or nursing administration. Basic principles of pharmacology will be examined, and uses of medication for treatment of commonly occurring health conditions will be comprehensively explored. Various sources of medication information will be identified and evaluated. Patient safety issues, from the individual perspective and the healthcare system perspective, will be discussed, including solutions to current concerns. Strategies for teaching patients, students, and staff about medications and safe administration will be described. Techniques for finding the most up-to-date advances and evidence-based practices related to pharmacology will be highlighted.

Course Objectives:


1. Examine basic pharmacological principles and drug classifications.

2. Explore relationships between pharmacologic agents and physiologic/pathologic responses in selected patient populations.

3. Discuss the issues that emerge within various populations/age groups regarding medications, including the effects of single and multiple drug regimens on the client’s health and functioning.

4. Design comprehensive and appropriate client education in relation to prescribed regimens.

5. Identify credible sources and references available to get the most up to date information about new medications and warnings related to administration of medications.

6. Discuss potential ethical issues emerging within the healthcare system related to pharmacologic treatment of patients.

7. Develop strategies for teaching staff, students, and patients/families regarding safe administration of medications.

8. Create system-wide interventions that reduce medication errors.

9. Identify methods of communicating up-to-date pharmacologic information throughout the healthcare system.

Prerequisites: Students are expected to review previous learning regarding basic pharmacology, such as drug classifications, mechanisms of action, generic and trade names.

Access to a computer and the Internet is necessary, and knowledge of the American Psychological Association (APA) style format is essential.Students who lack familiarity with APA style should consider purchasing one of the following:

APA (2005). Concise rules of APA Style. Washington, D.C.: American Psychological Association.

Perrin, R. (2004). Pocket guide to APA style. Boston: Houghton-Mifflin Company.

Students will be required to follow basic principles of spelling, punctuation, and grammar in writing papers and in doing


presentations. Students who lack competence in writing skills or preparing a scholarly paper should consider purchasing any of the following:

Dees, R. (2000). Writing the modern research paper. 3rd Edition. Needham Heights, MA: Allyn & Bacon, Pearson Education Company.

Hacker, D. (2003). A writer’s reference. 5th Edition. Boston: Bedford/St. Martin’s.

Hacker, D. (2000). Rules for writers. 4th Edition. Boston: Bedford/St. Martin’s.

Lutz, G. & Stevenson, D. (2005). The writer’s digest grammar desk reference. Cincinnati: Writer’s Digest Books.

Class Attendance Policy: Refer to the MSN Student Handbook for the Waynesburg College policy regarding class attendance.*Please note that class participation is key in this class and if you miss one or more classes, points will be deducted from the class participation portion of your grade.

Policy for late assignments: No late assignments will be accepted. If an

assignment is not received by the due date the

student will receive a “0” for the assignment,

without exception.

Extra Credit Assignments: None

Grading Policy: A =93-100% B- =81-83%*Graduate courses do not offer A-=90-92% C+=78-80% a Passing grade below a C B =84-86% C =75-77%

Teaching Strategies:LectureGroup discussionCase StudiesWritten assignments


Class presentations (individual & group)

Course Requirements and points/percentages

Class participation 5% Entrance Paper (Needs Assessment) 5% Development of drug calculation test 15% Internet Project 10% Mid-Term exam 15% Medication error case study 5% Individual education project 15% Group education project 15% Comprehensive final exam 15%

Required Text:Lilley, Harrington, & Snyder. Pharmacology and the Nursing Process 5th ed. (2007). Mosby.

Study Guide to accompany Pharmacology and the Nursing Process 5th ed. (2007). Mosby.

Recommended Text:Any nursing drug reference.

Assignment prior to start of first class:Entrance paper (your needs assessment) is due at the first class meeting, answering the following questions:

What is your nursing background? Describe your previous education and professional nursing experience.

What are your pharmacological strengths? (What drugs or class(es) of drugs are you most familiar/comfortable with?)

What are your pharmacological weaknesses? (What drugs or age groups do you feel that you don’t know enough about?)

What new medications do you currently use in your clinical practice area?

Have you participated in or observed any clinical trials? If yes, describe your experience.


What are your learning goals? What do you expect to get out of this course?

Where do you currently obtain medication information and updates?

What is the most commonly utilized drug reference in your current practice? What do you like/dislike about it?

This assignment does NOT need to be in APA format.

COURSE OUTLINE

Session I Tuesday May 8, 2007: Wendy Edgar

Content:Course overview Principles of Pharmacology

Chapter 2Life span considerations

Chapter 3Weight-based drug and drip calculations Teaching drug calculations

Drug classes:Analgesics

Chapter 10Diuretics

Chapter 25

Learning Activities: Review of entrance papers. Review of basic pharmacology principles Review of drug calculations Discussion of medication test you will be developing to

hand in next week.Assignment due week 1:

Entrance paper/Needs Assessment can be brought to class

or e-mailed prior to class to: [email protected].

Session IITuesday May 15, 2007: Chris Mitchell

Content:Pharmacological Physiology


JCAHO National Patient Safety goals for 2006Student issues related to medication errorsIndividual patient issues related to medication errorsStrategies to decrease medication errorsRoot Cause Analysis

Solutions for Resolving Medication ErrorsSystemIndividual

Drug Classes:CNS depressants & muscle relaxants

Chapter 12Local & Genetal Anesthetics

Chapter 11

Learning Activities: Be prepared to discuss the following:

What is your institution doing to address JCAHO National patient safety goals for 2006

How is the process of medication reconciliation implemented?

What are the common causes of medication errors? How does your setting solve problems related to

medication errors? What is the best way to handle medication errors in a

nursing unit? In a hospital? With nursing students Case studies

Discussion of Case studies on Root cause analysis due next week

Assignment due week 2: Drug calculation test

Session IIITuesday May 22, 2007: Wendy Edgar

Content:Finding credible sources of medication informationOff label uses of medicationsHow and where to find information on uses of medicationsExperimental use of medication/Clinical trialsEvaluation of informationLegal issues

Drug classes:Antilipemics

Chapter 28Coagulation modifier agents


Chapter 27Antidiabetic agents

Chapter 31

Learning activities: Exploration of various drug references, including the

internet, discussing the strengths & weaknesses of each. Please bring the most common drug reference that

you currently utilize in your practice. Discussion of internet project due next week.

Assignment due week 3: root cause analysis case study paper

Session IV-Tuesday May 29, 2007: Chris Mitchell

Content:Student issues related to medication errorsIndividual patient issues related to medication errorsPatient Safety and Medication Errors

Chapter 5Strategies to decrease medication errors

Drug classes:Positive Inotropes

Chapter 21Antidysrhythmic agents

Chapter 22Antianginal agents

Chapter 23Learning Activities:

Pharmacology mid-term exam Discussion of direct consumer marketing.

You are reminded to bring an advertisement for a drug or medical product from a consumer magazine and one from a nursing or medical journal for discussion in next week’s class.

Assignment due week 4: none Internet project due week 5

Session V-Tuesday June 5, 2007: Wendy EdgarContent:

Consumer marketingRole of the pharmaceutical sales representative


Role of the nurse educator/nurse managerPatient education: How to help patients and families interpret medication information correctly.

Chapter 6 Drug classes:

AntibioticsChapter 37

Antiviral agentsChapter 38

ImmunizationsChapter 45

Learning activities: Discussion of advertisements for drugs/medical

products from consumer magazines vs. medical/nursing journals

Be prepared to discuss the following: Direct consumer marketing. How much power do

the drug companies have in influencing patients and health care providers? How does that influence occur?

How helpful are drug companies to nurses and nursing students with providing educational materials?

What are the ethical guidelines pharmaceutical companies follow, or should follow? What are the ethical issues (if any) that you see in your practice setting?

Are there some companies that are more helpful/more ethical than others? How do you decide?

What changes have you seen in the past several years, if any, in your interactions with pharmaceutical representatives? Why have those changes happened?

How are pharmaceutical companies regulated? Discussion of US Department of Health & Human

Services Agency for Health Care Research and Quality see Learning activity for week 6 for web address and

assignment for discussion in next week’s class.

Assignments due week 5: Internet project assigned week #3


Session VI-Tuesday June 12, 2007: Wendy EdgarContent:

New medicationsPolypharmacyMultiple drug interactions/adverse drug eventsPrescriptions from multiple healthcare providersDiscussion of clinical practice guidelines

Discussion of US Department of Health & Human Services

Agency for Health Care Research and Quality

Drug classes:Psychotherapeutic agents

Chapter 15Women’s health

Chapter 33

Learning activities: Lecture/discussion Access www.ahrq.gov to find a clinical practice guideline

pertinent to you area of practice, and provide an overview of the recommended guideline. Be prepared to lead a 10-minute class discussion related to your topic. BE SURE TO INCLUDE THE PHARMACOLOGIC INTERVENTIONS.

Bring examples of new pharmacologic treatment protocols from your current areas of nursing practice.

Assignment due week 7: Start of group education project presentations

Session VITuesday June 19, 2007: Chris Mitchell

Content:Teaching groups or populations about pharmacologic issues common to that group or population

Drug classes: Antihypertensive agents

Chapter 24Bronchodilators & other respiratory agents

Chapter 36

Learning activity: Present to the class the design of the teaching project

you have chosen.


http://www.ahrq.gov/

Session VIIILearning activities

Cumulative medication final examination (2 hours) Course evaluations Continuation of group presentations (if needed) What’s new on the horizon?

Please note: All written assignments MUST be typed and all references must be in APA format.


NUR 546 Summer I, 2007

Activity Checklist

Graded Activities

Activity Due Date Grade

Class participation (5%) Weekly

Entrance Paper/ Needs

Assessment (5%)

5/8 –Session 1

Drug Test Development

(15%)

5/15-Session 2

Med Error Case

Study/Root cause

analysis (5%)

5/22-Session 3

Midterm (15%) 5/29-Session 4

Internet Project (10%) 6/5-Session 5

Group Education

Project (15%)

6/19 & 6/26-Sessions 7

& 8

Individual Education

Project (15%)

As assigned

Starting 5/15-Sessions

2-7

Final Exam (15%) 5/26-Session 8

Learning Activities (please refer to syllabus for details)

Activity Date

Be prepared to discuss: How

institutions are addressing the

JCAHO safety goals

5/15-Session 2

Explore drug references: Bring to

class a copy of the drug reference

used at your workplace

5/22-Session 3

Bring advertisement from consumer

magazine and journal

6/5-Session 5

Access www.ahrq.gov 6/12-session 6

What new medications/guidelines

are being utilized in your workplace

6/26-Session 8


http://www.ahrq.gov/

N546, Summer I, 2007Detailed descriptions of graded assignments with grading

rubrics

Please hand in the grading rubric sheet with each assignment. ALL assignments are expected to be typed and done using APA

format, unless otherwise noted.

Entrance Paper/Needs Assessment: Due 5/8/07Entrance paper (your needs assessment) is due at the first class meeting, answering the following questions:

What is your nursing background? Describe your previous education and professional nursing experience.

What are your pharmacological strengths? (What drugs or class(es) of drugs are you most familiar/comfortable with?)

What are your pharmacological weaknesses? (What drugs or age groups do you feel that you don’t know enough about?)

What new medications do you currently use in your clinical practice area?

Have you participated in or observed any clinical trials? If yes, describe your experience.

What are your learning goals? What do you expect to get out of this course?

Where do you currently obtain medication information and updates?

What is the most commonly utilized drug reference in your current practice? What do you like/dislike about it?

This assignment does NOT need to be in APA format.


Drug Calculation Test development: Due 5/15/07

Target audience: Junior nursing students who are entering a

medical-surgical unit that receives pediatric overflow

patients. Assume that the students have already completed

a pharmacology course.

You are to develop a drug calculation test that is designed to

identify students with a weakness in drug calculations prior

to entering the clinical unit. The test should be based on 100

points/percentage. Number of questions is dependent on

difficulty level, however you should have AT LEAST 25.

Provide answer key with the rationale for each question.

Please bring “clean” copy (test without answers) to distribute

in class.

Grading Rubric

Drug Calculation Test Development

Test questions appropriate for target audience

15 points _______

Well-constructed questions

40 points ________

Answer key correct and includes thorough rationale/explanation of

answer (ie “work-out” the problem)

40 points ________

Copies available for students


5 points _______

Total _____

Medication Error/Root Cause analysis Case Study: Due 5/22

You will be given a case study dealing with medication errors.

You will write a short 2-3 page paper analyzing the case study using root cause analysis.

Grading Rubric

Medication Error Case Study

Well-developed analysis

85 points ______

Paper well written: correct grammar and good sentence structure

10 points ______

APA format followed

5 points _______

Total _______


Internet Project Due: 6/5 You are to log onto the internet and find three (3)

web sites that have drug information. (For example: Search the internet to find information of Singulair)

At least one site needs to be consumer oriented

At least one site needs to be health care provider focused (ie: NIH, CDC, AMA, etc.)

You need to include the complete web site address using APA format.

You are to then write a 4-6 page paper addressing the following:

Discuss the differences among the various sites and give your analysis of the amount & accuracy of information and the facts/concepts that your patients are learning. What differences, if any are noted between the sites? Is there a discrepancy of information? Is the information presented differently? (give examples) How accurate are the sites?

You will need to include the following information about the web sites you’ve chosen:

o Who is managing the site?o What are their credentials?o Do you feel that the information you’ve

obtained from each site is reliable?o Please provide rationale.

Is the world wide web the best place for your patients, students, or staff nurses to get information? Why or why not?

Discuss techniques that would be useful in teaching consumers, students, and nurses in finding accurate information on the internet.


Grading Rubric

Internet Project

Three websites perused. References in APA format

10 points ______

Discussion of site differences

20 points _______

Analysis of accuracy of information

20 points _______

Inclusion of site information: Who is managing the site? What are their

credentials? Do you feel that the information you’ve obtained from

each site is reliable? Rationale

20 points _______

Discussion of how patients, students, and nurses should utilize the

World Wide Web. Include teaching tips.

20 points _______

Paper well written: correct grammar and good sentence structure

10 points _______


Total: _______

Group Education Project: Due 6/19 & 6/26

You and a partner will pick a particular group/population and discuss the important issues or concepts related to medications that nurses need to address with that particular group.

Come up with a creative way to accomplish this, whether it’s in the home setting, outpatient setting, hospital, or the classroom.

Create an outline for the class and then you and your partner will conduct a 20-30 minute presentation for the class discussing your teaching plan and how you would address the issues in that particular population.

Please bring copies of any handouts you would use in teaching the group or population you have chosen

Make sure you allow time for class discussion of the topic.

Some possible examples that you MIGHT want to consider:

o Children Parent teaching, correct dosages, etc.

o Elderly Polypharmacy, remembering when to

take medications.o People with chronic illnesses

How to keep patients compliant with treatment regimens and how to deal with acute illness in the face of a chronic illness.

o New parents Correct dosages of drugs & what

drugs are considered safe.o Middle-aged adults

Dealing with the start of medical problems: HTN, high cholesterol and starting to take medications.

o Nursing students Safe administration of drugs

o People with disabilities


How would you teach a person who is illiterate, hearing impaired, visually impaired, mobility impaired, etc.

Grading Rubric for Group Education Project

Names: ____________________________________________

Topic: _____________________________________________

o Issues 20 points ______

o Plan 20 points______ Learning objectives are well defined & appropriate for particular group chosen.

o Outline 20 points ______ Concise & helpful

o Handouts 10 points ______ Appropriate developmental level, reading level, and easy to understand.

o Creativity 10 points ______

o Presentation 10 points ______

Professional, interesting, limited use of notes

o Use of time 10 points ______

Total Points: _________


Comments:

Individual lecture on selected pharmacology

concept/drug classification(s): 5/15-6/19

You will each be assigned a drug, class of drugs or pharmacology concept and will prepare a 15 – 20 minute lecture for the class on that particular drug/class/concept. You will decide whether the presentation is designed for undergraduate nursing students (please specify what level) or staff development (please specify what unit, years experience of nurses)

You are also asked to prepare five test questions that pertain to the material you are presenting along with the answers to the questions. You need to provide the rationale and rate the difficulty of each of the questions. They can be multiple choice, matching, or completion.

o At least 3 of the 5 need to be multiple choice, and one needs to be some sort of calculation problem relating to a drug in the class you have presented.

o These will be handed in along with an outline for your lecture.

You will be graded on your creativity, use of time allotted, accuracy of information and your ability to communicate the information to the group.

A portion of your grade will also be determined by your fellow students:o They will be asked to anonymously evaluate your

presentation and provide feedback. All feedback will be compiled and handed back to you.


o They will be using the same grading rubric as the facilitator. The points will be totaled and averaged to give you the student feedback portion of your grade.

Grading Rubric

Individual lecture on selected pharmacology concept

and drug classification(s)

Presentation: includes objectives, description of pharmacology

concept/ drug classification, appropriate pathophysiology, inclusion of

disease(s)/disorder(s) treated, side effects, drug-drug interactions,

contraindications, patient teaching, nursing considerations.

Content is well researched using resources other than textbook

required for class.

Please submit references to facilitator.

50 points: _______

Comments:____________________________________________________________

________________________________________________________________________

________________________________________________________________________

_______________________________________________

Professional presentation: creative, positive, interactive, uses allotted

time

10 points: ________

Comments:____________________________________________________________

________________________________________________________________________


________________________________________________________________________

_______________________________________________

Outline: Concise, helpful

15 points:_______

Comments:____________________________________________________________

________________________________________________________________________

________________________________________________________________________

_______________________________________________

Test questions: Well written question, well written answers (if

appropriate), referenced rationale

20 points: _______

Comments:____________________________________________________________

________________________________________________________________________

________________________________________________________________________

_______________________________________________

Student feedback

5 points:__________

Student comments:

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________


____________________________________________________________

____________

Total points: _______


Health & Medicine

WAYNESBURG COLLEGE.doc