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REGION A NURSING CONSORTIUMHaywood Community CollegeTri-County Community College

COURSE OUTLINE/OBJECTIVESNUR 111 Introduction to Health Concepts

COURSE DESCRIPTION

This course introduces the concepts within the three domains of the individual, healthcare, and nursing. Emphasis is placed on the concepts within each domain including medication administration, assessment, nutrition, ethics, interdisciplinary teams, informatics, evidence-based practice, individual-centered care, and quality improvement. Upon completion, students should be able to provide safe nursing care incorporating the concepts identified in this course.

PREREQUISITES: Admission to the Nursing Program

CO-REQUISITES:None

CONTACT HOURS: CLASS 4 LAB 6 CLINICAL 6___

CREDIT HOURS: 8___

REQUIRED TEXTBOOKS

Region A Nursing Consortium’s Lippincott Williams & Wilkins Textbook Bundle and Digital Resource Package. ISBN: 9781469845012

NOTE: Following admission to the nursing program, evaluation of health and overall behavior of the student continues throughout the program. Dismissal from the program will result if a student (1) presents problems in physical or emotional health which do not respond to appropriate treatment and/or counseling within a reasonable period of time, or (2) demonstrates behavior which conflicts with safety essential to nursing practice.

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Domain of the Individual

Objective I: Upon completion of the course, the learner will be able to relate to the individual as a holistic, complex, multidimensional, unique, and significant being.

Learning Outcomes:1. Articulate all concepts within the domain of the healthy individual.2. Distinguish between the healthy individual within a changing internal and external environment and individuals with simple alterations in health.

Please note that concepts related to the individual are in bold.

(9 hours) Fluid and ElectrolytesOutcomes:

1. Describe the location and functions of body fluids, including the factors that affect variations in fluid compartments.

2. Describe the functions, regulation, sources, and losses of the main electrolytes of the body.3. Explain the principles of osmosis, diffusion, active transport, and filtration.4. Describe how thirst and the organs of homeostasis (kidneys, heart and blood vessels, lungs,

adrenal glands, pituitary gland, parathyroid glands) function to maintain fluid homeostasis. 5. Discuss various types of intravenous solution types.6. Demonstrate skills in initiating and maintaining intravenous infusion devices.

(21 hours) EliminationOutcomes:

1. Describe factors affecting elimination.2. Relate the physiological processes involved with normal elimination.3. Describe the basic diagnostic and laboratory tests utilized to determine the patient’s

elimination status.4. Discuss the causes of abnormal elimination including: urinary retention, urinary

incontinence, bowel incontinence, constipation, and impaction.5. Assess the patient’s elimination status through the health history and physical exam of the

urinary and gastrointestinal systems.6. Identify nursing interventions including rationale that promote elimination.7. Identify nursing interventions to help the patient cope with elimination problems.8. Discuss the implication of age (elderly and pediatric) on urinary and bowel disorders.9. Perform catheterizations utilizing proper aseptic technique.10. Identify appropriate nursing interventions when administering enemas, rectal suppositories,

and performing digital removal of stool.11. Plan nursing care for a patient with an ostomy.12. Demonstrate proper care of an ostomy.

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(2 hour) ThermoregulationOutcomes:

1. Explain the principles and mechanisms of thermoregulation.2. Describe nursing measures that promote heat loss and heat conservation.3. List signs and symptoms of hypothermia.4. List signs and symptoms of hyperthermia.5. Identify nursing interventions appropriate for patients experiencing hypothermia.6. Identify nursing interventions appropriate for patients experiencing hyperthermia.

(2 hours) InflammationOutcomes:

1. Discuss the events in the body’s inflammatory response.2. List factors affecting inflammation.3. Explain physical assessment techniques used to assess for inflammation.4. List common laboratory tests to determine and individual’s inflammatory response.

(4 hours) Tissue Integrity-Wound HealingOutcomes:

1. Discuss the normal process of wound healing.2. Describe the differences of wounds healing by primary and secondary intention.3. Describe complications that can occur during wound healing.4. Explain the factors that impede or promote wound healing.5. Describe the differences between nursing care of acute and chronic wounds.6. Complete an assessment for a patient with impaired skin integrity.7. Develop a nursing care plan for a patient with impaired skin integrity.8. Perform and document a wound assessment.9. Implement appropriate dressing changes for different kinds of wounds.

(2 hours) Tissue Integrity-Pressure UlcersOutcomes:

1. Discuss the risk factors that contribute to pressure ulcer formation.2. Identify patients at risk for pressure ulcer development.3. Describe the pressure ulcer staging system.4. Provide nursing interventions to prevent pressure ulcers.

(1 hours) Tissue Integrity-Contact DermatitisOutcomes:

1. Understand the pathophysiology that occurs with contact dermatitis.2. Describe medical management and related nursing care of a patient with contact dermatitis.3. Utilize the nursing process in caring for a patient with contact dermatitis.

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(2 hours) InfectionOutcomes:

1. Explain the infection cycle.2. Describe nursing interventions used to break the chain of infection.3. Define hospital acquired (nosocomial) infections.4. Describe factors that increase the risk of the patient for developing an infection.5. Identify the signs and symptoms of infection.6. Discuss developmental considerations that may increase risks for developing an infection.7. Identify laboratory data that may indicate an infection.8. Discuss nursing interventions and rationales for a patient with an infection.9. Identify the medical practices that contribute to development of resistant strains of

pathogens and its prevalence in current medical practice.10. Differentiate between pathogens that are susceptible to drug intervention and resistant

pathogens that cause infection.

(2 hours) Infection-Urinary Tract Infection (UTI) Outcomes:

1. Identify the medical practices that contribute to development of UTI and its prevalence in current medical practice.

2. Identify risk factors for acquiring an UTI infection.3. Identify the signs and symptoms of UTI infections.4. Discuss treatment and nursing interventions for the patient with UTI.5. Identify key teaching points for patients, family members, medical workers, and the

community related to UTI infections.

(2 hours) Infection-Methicillin Resistant Staph Aureus (MRSA)Outcomes:

1. Identify risk factors for acquiring a MRSA infection.2. Understand the modes of transmission for MRSA.3. Identify the signs and symptoms of MRSA infections.4. Identify the specific Standard and Transmission based precautions and infection control

measures required for patients identified with MRSA.5. Describe the key preventative strategies for MRSA transmission to other patients.6. Discuss treatment and nursing interventions for the patient with MRSA.7. Identify key teaching points for patients, family members, medical workers, and the

community related to MRSA infections.

(1 hour) Infection-CellulitisOutcomes:

1. Differentiate between the types of cellulitis.2. Understand the pathophysiology that occurs with cellulitis.3. Describe medical management and related nursing care of a patient with cellulitis.4. Utilize the nursing process in caring for a patient with cellulitis.

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(1 hour) Infection-Vancomycin-resistant Enterococcus (VRE)Outcomes:

1. Identify risk factors for acquiring a VRE infection.2. Understand the modes of transmission for VRE3. Identify the signs and symptoms of VRE infections.4. Identify the specific Standard and Transmission based precautions and infection control

measures required for patients identified with VRE.5. Describe the key preventative strategies for VRE transmission to other patients.6. Discuss treatment and nursing interventions for the patient with VRE.7. Identify key teaching points for patients, family members, medical workers, and the

community related to VRE infections.

(1 hour) Infection-ShinglesOutcomes:

1. Understand the pathophysiology that occurs with shingles.2. Describe medical management and related nursing care of a patient with shingles.3. Utilize the nursing process in caring for a patient with shingles.4. Describe the role of immunization in preventing shingles.

(1 hour) Infection-C-DifficuleOutcomes:

1. Identify risk factors for acquiring a C-Difficule infection.2. Understand the modes of transmission for C-Difficule.3. Identify the signs and symptoms of C-Difficule infections.4. Identify the specific Standard and Transmission based precautions and infection control

measures required for patients identified with C-Difficule.5. Describe the key preventative strategies for C-Difficule transmission to other patients.6. Discuss treatment and nursing interventions for the patient with C-Difficule.7. Identify key teaching points for patients, family members, medical workers, and the

community related to C-Difficule infections.

(2 hours) Sensory/PerceptionOutcomes:

1. Explain the effects of aging on the auditory system.2. Demonstrate specific diagnostic tests to be performed on patients with common hearing

disorders.3. Identify common treatments for hearing impaired patients.4. Identify nursing interventions including rationales for specific hearing disturbances.5. Indentify methods of communication to assist patients with hearing impairment.

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(8 hours) MobilityOutcomes:

1. Describe the functions of the musculoskeletal and nervous systems in the regulation of movement.

2. Discuss physiological and pathological influences on body alignment and joint mobility.3. Assess for correct and impaired body alignment and mobility.4. Discuss the importance of no-lift policies for the patient and health care provider.5. Describe equipment needed for safe patient handling and movement.6. Compare and contrast active and passive range-of-motion exercises.7. Discuss and utilize principles of proper body mechanics.8. Describe the effects of exercise and immobility on major body systems.9. Demonstrate proper application techniques of devices used to reduce the risk of

complications associated with immobility.

(4 hours) Comfort-PainOutcomes:

1. Define the concept of pain.2. Compare and contrast the characteristics of acute and chronic pain.3. Discuss the physiology of acute and chronic pain.4. Discuss factors that may affect an individual’s pain experience.5. Discuss multicultural and developmental attitudes and beliefs to expression of pain.6. Obtain a complete pain assessment using appropriate interviewing and physical assessment

skills.7. Describe the nurse’s role in collaborative strategies for pain management:

a. Pharmacologicalb. Non –pharmacologicalc. Alternative therapies

8. Individualize a pain treatment plan in collaboration with other members of the health care team.

9. Evaluate patient response to pain interventions.

(3 hours) Comfort-Fatigue and Sleep Rest DisordersOutcomes:

1. Describe the functions and physiology of sleep.2. Identify variables that influence rest and sleep.3. Describe nursing implications that address age-related differences in the sleep cycle.4. Perform a sleep assessment using interview questions and physical assessment skills.5. Describe common sleep disorders, noting key assessment criteria.6. Develop a nursing plan of care for patients experiencing sleep disorders.7. Define chronic fatigue syndrome.8. Develop a nursing plan of care for patients experiencing sleep disorders.

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(2 hour) Stress & CopingOutcomes:

1. Explain the interdependent nature of stressors, stress, and adaptation. 2. Discuss the physical and emotional responses to stress.3. Discuss the effects of short-term and long-term stress on basic human needs, health and

illness, and the family structure.4. Describe the components of an anxiety assessment.5. Integrate knowledge of healthy lifestyle, support systems, stress management techniques,

and crisis intervention into hospital-based and community-based care.6. Develop a nursing plan of care for patients experiencing short-term and long-term stress.

(2 hours) Grief and Loss Outcomes:

1. Explain the concepts of loss and grieving, including types of loss and grief reactions.2. Describe the signs of impending death.3. Compare and contrast the five emotional stage of dying defined by Kubler-Ross.4. Explain the six factors that affect loss, grief, and dying.5. Using the nursing process to plan and implement care for dying patient and family.6. Describe symptoms of grief and signs of grieving.7. Discuss factors that facilitate or impede healthy grieving.8. Discuss the nurse’s role in caring for the dying patient and their families.9. Identify own perceptions and reactions to death and dying.

(2 hours) CognitionOutcomes:

1. Discuss the concept of cognition relative to the patient throughout the lifespan.2. Identify those patients who are at risk for developing confusion.3. Identify clinical features or behaviors associated with the confused patient.4. Identify pathological processes responsible for confusion and/or conditions that may

contribute to the development of confusion.5. Explore nursing interventions used in the care of the confused patient.

(2 hours) SelfOutcomes:

1. Explain the relationship of psychosocial factors to overall health and self-development.2. Identify factors that influence the development and stability of self-concept.3. Perform a patient self-concept assessment using the exemplars of self-concept, self-esteem,

self-identity, and body image.4. Develop nursing diagnoses that identify patient disturbances in self-concept.5. Discuss nursing strategies that are effective in resolving role performance conflicts and self-

concept problems for children, adults, and older adults.

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(2 hours) FamilyOutcomes:

1. Define family dynamics.2. Assess family structure and roles through review of health history.3. Demonstrate health promotion education activities with a focus on the family, through a

concept map, care plan and teaching plan.4. List factors affecting family response to health alterations and disparities.5. Identify therapeutic nursing interventions to assist families during response to a health

alteration.6. Evaluate the families’ response to the total treatment plan following an alteration in health.

(2 hours) Diversity-Outcomes:

1. Identify vulnerable populations.2. Recognize differences among identified populations.3. Contrast individual innate and acquired characteristics based on

a. Ageb. Genderc. Raced. Abilitiese. Individual life experiencesf. Sexual orientation

(2 hours) CultureOutcomes:

1. Explain concepts of cultural diversity2. Describe influences that affect culturally competent healthcare.3. Discuss examples of diversity in health and illness care, including culturally based traditional

care.4. Practice cultural competence when assessing and providing nursing care for patients from

diverse cultural groups.5. Discuss factors in the healthcare system and in nursing that facilitate or impede culturally

competent nursing care.

(2 hours) SpiritualityOutcomes:

1. Explore personal beliefs related to spirituality and nursing.2. Identify spiritual needs in self and others.3. Identify major religious faiths and their traditions that relate to healthcare.4. Incorporate age appropriate spiritual assessment questions into the nursing assessment of

spiritually.5. Utilize the nursing process in planning care for patients experiencing spiritual distress.

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(2 hours) Health, Wellness, and IllnessOutcomes:

1. Describe concepts and models of health, wellness, and illness.2. Compare and contrast acute illness and chronic illness.3. Describe the nurse’s role in assisting patients to adjust to illness or other health conditions.4. Explain the levels of preventive care.5. Discuss the following as they impact a person’s ability to achieve, maintain and manage

their health and wellness:a. Physical fitness/exerciseb. Oral healthc. Nutritiond. Life style choicese. Health beliefsf. Self-managementg. Sleep and rest pattern

6. Identify screening procedures used for early diagnosis of illness or other health conditions.7. Identify goals and focus areas for Healthy People 2020.8. Demonstrate the ability to guide patients in the appropriate use of commonly used

alternative therapies

(6 hours) Oxygenation Outcomes:

1. Describe factors affecting respiration.2. Relate the physiological processes involved in ventilation and perfusion.3. Assess the client’s oxygenation status through the health history and physical exam of the

respiratory system.4. Describe the basic diagnostic and laboratory tests utilized to determine the client’s

oxygenation status.5. List the various oxygen delivery systems.6. Apply the nursing process in providing culturally competent caring interventions across the

lifespan for clients with common oxygenation/ventilation disorders.7. Explain the utilization of interdisciplinary teams in care of the patient with impaired

oxygenation.8. List health promotion measures for prevention and management of respiratory health.1. Identify nursing interventions that promote oxygenation for individuals across the lifespan.2. List health promotion measures for prevention and management of respiratory health.

(4 hours) Perfusion Outcomes:

1. Describe factors affecting perfusion.2. Relate the physiological process involved in circulation and perfusion.3. Explain assessment techniques used to determine perfusion status.4. Describe the basic diagnostic and laboratory test utilized to determine the client’s perfusion

status.

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Domain of Nursing

Objective II: Upon completion of the course, the learner will be able to internalize foundational principles of professional nursing practice to provide safe, culturally competent, therapeutic care for individuals.

Learning Outcomes:1. Receives an awareness of the values, attitudes, behaviors, and beliefs important to professional nursing.2. Incorporate all concepts within the domain of nursing to safely provide therapeutic care to individuals.3. Competently perform holistic assessments, caring nursing interventions, and clinical decision-making.4. Communicate professionally and effectively while providing care to individuals.5. Effectively collaborate with the individual/individuals and members of the interdisciplinary healthcare team to safely provide therapeutic care.6. Facilitate the acquisition of knowledge and learning to enhance self-care for each individual.7. Collaboratively manage care of the individuals.

Please note that concepts related to nursing are in bold.

(4 hours)CommunicationOutcomes:

1. Describe the various communication modalities.2. Describe communication as a two-way process and an active process.3. Identify blocks to effective communication4. Utilize skills for effective communication.5. Describe multidisciplinary communication within the health care team.6. Utilize the principles and techniques of basic communication to interact with patients and

other interdisciplinary team members.

(4 hours)Communication-DocumentationOutcomes:

1.Identify purposes of a health record.2.Discuss legal guidelines for documentation.3.Identify ways to maintain confidentiality of records and reports.4.List guidelines for effective documentation and reporting, avoiding legal problems.5.Identify abbreviation and symbols commonly used for charting.6.Describe the different methods used in documentation and record keeping.7.Describe the purpose and content of a change-of-shift report.8.Explain how to verify telephone orders.9.Describe how SBAR can increase quality of care.

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10. Actively documents and reports patient care to nursing and interdisciplinary team members.

(4 hours) Assessment-Techniques and equipmentOutcomes:

1. Identify the four techniques used in physical assessment.2. Use correct techniques for safety and infection control.3. Accurately inspect the patient and document findings using correct medical terminology.4. Compare light versus deep palpation.5. Demonstrate the correct technique for percussion.6. Demonstrate the correct technique for auscultation.7. Compare the purpose of the four techniques of physical assessment.

(28 hours) Assessment-System AssessmentsOutcomes:

1. Assigned body systems: Skin, Hair, and Nails; Head and Neck; Eyes; Ears; Thorax and Lungs; Heart and Neck Vessels; Abdominal; Musculoskeletal, Neurological

2. For each assigned body system, identify:a. Structures and functions of systemb. Subjective and objective data to collect from patientc. Differentiate normal and abnormal data associated with body systemd. Document assessment findings for body system using appropriate medical terminology.e. Identify teaching opportunities for the body system.

3. Perform holistic physical assessment including vital signs.

(1 hour) Clinical Decision Making- Nursing ProcessOutcomes:

1. Describe the nursing process and each of its five steps.2. List five characteristics of the nursing process.3. Describe the steps in creating concept maps.

(1 hour) Clinical Decision Making- Nursing Process-AssessmentOutcomes:

1. Define and describe the purpose of four types of nursing assessments.2. Differentiate objective and subjective data.3. Identify sources of patient data useful to the nurse.4. Describe the purpose of nursing observation, interview, and physical assessment.5. Obtain and document purposeful, complete, accurate, factual, and relevant patient data.

(1 hour) Clinical Decision Making- Nursing Process-Diagnosing

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Outcomes:1. Describe the term nursing diagnosis, distinguishing it from a collaborative problem and a

medical diagnosis.2. Use the guidelines for writing nursing diagnoses when developing diagnostic statements.3. Identify five types of nursing diagnoses.4. Describe means to validate nursing diagnoses.5. Describe the benefits and limitations of nursing diagnoses.

(1 hour) Clinical Decision Making- Nursing Process-Outcome Identification and PlanningOutcomes:

1. Describe the purpose and benefits of outcome identification and planning.2. Prioritize patient health problems and nursing 3. Describe how patient goals/expected outcomes and nursing orders are derived from nursing

diagnoses.4. Develop a plan of nursing care with properly constructed outcomes and related nursing

interventions.5. Differentiate nurse-initiated interventions, physician-initiated interventions, and collaborative

interventions.6. Describe the rationale for standardized outcomes and interventions for nursing.

(1 hour) Clinical Decision Making- Nursing Process-ImplementingOutcomes:

1. Differentiate nurse-initiated interventions, physician-initiated interventions, and collaborative interventions.

2. Implement a plan of nursing care.3. Discuss guidelines for implementing care.4. Describe variables that influence the way a plan of care is implemented.5. Discuss how ongoing data collection is used to determine how to safely and effectively

implement a plan of care.6. Explain why reassessment after nursing intervention is important.

(1 hour) Clinical Decision Making- Nursing Process-EvaluatingOutcomes:

1. Describe evaluation, its purpose, and its relation to the other steps in the nursing process.2. Evaluate the patient’s achievement of four types of outcomes specified in the plan of care.3. Use the patient’s response and progress to modify the plan of care as needed.

(2 hours) Caring InterventionOutcomes:

1. Discuss the meaning of caring.2. Discuss the role that caring plays in building a nurse-patient relationship.3. Describe how nurses demonstrate caring in practice.

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4. Explore the value of caring in today’s technologically advanced health care system.5. Evaluate the importance of self-care for the professional nurse.6. Demonstrate competence in the caring interventions listed on the lab skill sheet.

(3 hours) Teaching-LearningOutcomes:

1. Describe the teaching-learning process, including domains, developmental concerns, and specific principles.

2. Describe the factors that should be assessed in the learning process.3. Describe potential barriers to the learning process.4. Compare and contrast barriers and facilitators of the teaching-learning process.5. List strategies to motivate learners.6. Describe methods to evaluate learning.

(1 hours) CollaborationOutcomes:

1. Define collaboration.2. Describe collaboration as it relates to the nursing team.3. Define collaborative care in the modern healthcare environment.

(1 hour) Managing CareOutcomes:

1. Differentiate among the types of nursing care delivery models.2. Discuss strategies used by nursing to reduce health care costs.

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Domain of Healthcare

Objective III: Upon completion of the course, the learner will be able to transfer knowledge of the concepts within the domain of the healthcare system to safely and ethically administer care to the individual.

Learning Outcomes:1. Practice safely and ethically within the healthcare system according to the nursing practice act, healthcare policy, and National Patient Safety Goals.2. Employ information technology to support clinical decision making.3. Utilize principles of evidence-based practice while safely providing therapeuticnursing care to individuals in the healthcare system.

Please note that concepts related to healthcare are in bold.

(3 hours) SafetyOutcomes:

1. Define and incorporate JCAHO’s National Patient Safety Goals for the current year into the patient’s plan of care.

2. Implement basic safety principles into the provision of patient care.3. Define Hand-off communication.4. Discuss how Hand-off communication can be utilized to increase quality of patient care.5. Identify factors that affect safety in an individual’s environment.6. Identify patients at risk for injury.7. Describe specific safety risk factors for each developmental stage.8. Describe health-teaching interventions to promote safety for each developmental stage.9. Describe nursing interventions to prevent injury to patients in healthcare settings.10. Describe the components of and utilize the CDC guidelines for standard and transmission-

based precautions.11. Demonstrate techniques for medical asepsis and sterile technique.

(1 hour) AdvocacyOutcomes:

1. Define and discuss principles of patient advocacy.2. Define and discuss vulnerable populations.3. Recognize the need for nursing intervention for vulnerable populations.

(2 hours) Legal IssuesOutcomes:

1. Discuss the components of the North Carolina Nursing Practice Act.2. Verbalize the legal responsibilities of nursing students and registered nurses.3. Identify the four specific areas of The Health Insurance Portability and Accountability Act of

1996 (HIPAA) and their impact on nursing practice.

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4. Identify the requirements of the Patient Self-Determination Act of 1991 and nursing responsibilities.

5. Identify when the nurse has an obligation to report practices that endanger the health and safety of patients.

(1 hour) Health PolicyOutcomes:

1. Discuss the roles of selected regulatory agencies as they relate to healthcare systems:a. OSHAb. DHHSc. DHSRd. CMSe. Accrediting Bodies-Joint Commission

(1 hour) Health Care Systems Outcomes:

1. Discuss the changes regulation and competition has had on modern day healthcare and nursing care.

2. Discusses how Diagnostic Related Grouping (DRG) affects access to healthcare.3. Discuss primary, secondary and tertiary care.4. Discuss nursing care delivery systems noting advantages and disadvantages of each.

(2 hours) EthicsOutcomes:

1. Define ANA Code of Ethics.2. Define Patient Rights.3. Explain the relationship between values and ethics in professional practice.4. Identify ethical principles.

(1 hour) AccountabilityOutcomes:

1. Define professional competence.2. Locate and verbalize understanding of the North Carolina Board of Nursing competency

standards for licensed nurses.3. Describe how to demonstrate professional behavior in the clinical setting.

(4 hours) Evidence Based PracticeOutcomes:

1. Define evidence based practice.2. Describe evidence based practice in nursing, including the rationale for its use.3. Discuss the evolution of nursing research.4. Compare and contrast quantitative and qualitative research methods.5. Outline the steps in implementing evidence-based practice.6. Read and understand, on a beginning level, a published nursing research article.

(1 hour) Quality Improvement

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Outcomes:1. Describe the process of a nursing report.2. Discuss how nursing reports are associated with quality improvement.3. List five examples of sentinel events and discuss how sentinel events are associated with

quality improvement.

(2 hours) InformaticsOutcomes:

1. Discuss the relationship between informatics and quality health care.2. Identify ways to reduce data entry errors.3. Discuss how computers are utilized in healthcare organizations.4. Utilize informatics to record, document, and evaluate nursing care.

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