nursing ii skills lab syllabus nur 1214l · course syllabus – skills lab course nur 1214l-nursing...

NUR 1214L-Nursing II Skills Revised December, 2012

NURSING II

SKILLS LAB SYLLABUS

NUR 1214L

Course Syllabus – Skills Lab Course

NUR 1214L-Nursing II Skills Revised December, 2012

TABLE OF CONTENTS

GENERAL CLASS AND COURSE INFORMATION ............................................. 1

PROFESSORS CONTACT INFORMATION ....................................................... 3

CLASS REQUIREMENTS ................................................................................ 3

CLASS POLICIES & METHODOLOGY ............................................................. 5

COLLEGE POLICIES AND WEB INFORMATION .............................................. 8

DEPARTMENT CONTACT INFORMATION: ...................................................... 9

GETTING STARTED .................................................................................... 10

FORMS: SIGNATURE PAGE ......................................................................... 11

COURSE OBJECTIVES BY CONCEPT ............................................................ 13

SKILLS PERFORMANCE RECORD ................................................................ 27


NUR 1214L-Nursing II Skills 1 Revised December, 2012

GENERAL CLASS AND COURSE INFORMATION Course Number: NUR 1214L Class Reference Number: Multiple Term: 2012-1 Course Title: Nursing II Skills Lab Credit/Contact Hours: 1 credit/3 lab hours Course Description: Students will achieve complex client care skills that are utilized by the nurse to implement the nursing process. Students gain competency by practicing skills in a supportive and supervised environment in the college campus lab. This includes a “Wellness” portion for the development of self awareness of health practices. Special fee required. Course Learning Outcomes: As a result of taking this course, the student will be able to:

1 Demonstrate skills performance in a professional manner, utilizing awareness of legal/ethical and cultural considerations of client across the lifespan.

2 Exemplify the role of the professional nurse in patient care, education, prevention and maintenance of all aspects of patient care for optimum outcomes and quality of life.

3 Demonstrate all necessary skills and dexterity while performing a comprehensive physical assessment also called a full or head-to-toe assessment.

4 Demonstrate ability and dexterity while setting up and administering intravenous therapy, and demonstrate proper techniques of insertion, maintenance and discontinuing of peripheral intravenous sites.

5 Demonstrate aseptic technique while priming and maintaining primary and secondary intravenous tubing and therapies.

6 Demonstrate the ability to assess, maintain and administer medication via the intravenous route.

7 Demonstrate skills and dexterity while maintain aseptic technique during airway clearance and/or suctioning of any airway and tracheostomy management.

8 Demonstrate skill in the care and management of the client with chest tubes.

9 Demonstrate all steps and skills necessary to maintain aseptic technique and perform foley insertion, open bladder irrigation and manage the client with a continuous bladder irrigation.

10 Demonstrate accuracy while caring for clients with urinary and colon diversions or stoma management. This includes manual dexterity and accuracy applying theory learned while measuring and applying ostomy appliances.

11 Demonstrate proper nursing care of the client post joint replacement and status post bone fractures. This includes the care of external fixation devices, casts, traction and CPM.

12 Demonstrate ability to perform client education through short wellness activity or presentation assigned weekly.

13 Demonstrate all steps and skills necessary to maintain aseptic technique and perform nasogastric tube insertion and manage the client with nasogastric tubes.

14 Demonstrate all steps and skills necessary to maintain aseptic technique and perform wound care irrigations, packing wounds, wet to moist dressings and management of the client.

Course Outline for NUR1214L - NURSNG 2 SKILLS LAB

http://www.palmbeachstate.edu/asp/IE_ShowOutline.asp?show=Y&CourseID=NUR1214L



Class Schedules: See Class Calendar as schedule is dependent upon section to which student is assigned. A calendar of skills and due dates will be posted and communicated for all skill class groups. All attempts will be made to maintain the schedule. Textbooks Information: Textbooks are listed as Required and Recommended in the NUR 1213 course syllabus. Required: You may purchase your textbook(s) at any one of Palm Beach State College’s campus bookstores or online. Skills Lab Kits: Supplemental kits for semester 2 will be provided during the first 2 weeks of the semester. Students must bring kits to skills lab for each class and each check-off appointment. Access to MyNursingLab: is a textbook specific online learning program that gives students access to videos of assigned clinical skills and opportunities to test themselves on key concepts. Each student must have access to the program. The access code is bundled with the Fundamentals textbook package. The code allows for 4 semesters of access to the program. A demonstration of this resource will be provided during online orientation.

The Electronic Essential Nursing Resources Video list is recommended & available in MTIS (Media Technology and Instructional Services) located on the first floor of the LLRC. Some of the required videos are streamlined and can be accessed using this link and your Panther Web access (username and

password). The list of recommended videos can be found on Blackboard.

Although Nursing is a limited access program and as such maintains policies and procedures specific to Nursing Department needs, all nursing students will adhere to Palm Beach State College’s polices as stated in the Palm Beach State College student handbook. All students enrolled in a Nursing course are required to obtain and read the current Nursing Student Handbook and the Palm Beach State College Student Handbook. All Nursing students are responsible for the information contained in these publications. Both of these publications are published on the Palm Beach State College web site. All Nursing students must maintain compliance with the policies and procedures published in the Nursing Student Handbook in addition to those established for the general college population by Palm Beach State College. Please refer to the following documents:

Palm Beach State College Student Handbook:

Palm Beach State College Nursing Student Handbook:

PantherWeb Student Information: Web Content Information: This course does not have a web component.

http://www.efollett.com/

http://www.palmbeachstate.libguides.com/content.php?pid=28521

http://www.palmbeachstate.edu/mtis/ShowSeries.asp?cid=1&View=11

http://www.palmbeachstate.edu/Documents/Nursing/Nursing%20Student%20Handbook.pdf


http://www.palmbeachstate.edu/Documents/Marketing/studenthandbook.pdf



https://www.palmbeachstate.edu/x5687.xml



PROFESSORS CONTACT INFORMATION

Carol Alexander, MSN, RN Professor I

BA 121, (561) 868-3425 Lake Worth campus

Email

Deborah Copeland, MSN, RN Department Chair, Professor II

AH 207, (561) 868-3431 Lake Worth campus

Email

Buddy Herrington, MSN, RN Department Chair, Professor


Email

Margaret Holmes-DeGraw, MSN, ARNP, CNM Professor I


Email

Leslie Kent, MSN, RN Professor II

AH 201/ (561) 868-3436 Lake Worth

email

Winsome Vassell, MSN, ARNP, RN Professor 1

AH 213, (561) 868-3576 Email

Office Hours are Posted on the Faculty Web Pages and Outside Office

CLASS REQUIREMENTS Assignments: Each student is required to read, print, and sign the Signature page of the Ethical Agreement (students taking NUR 1213 along with this course do not have to resubmit this form). If a student is only taking NUR 1214L it is the students responsibility to submit this form to the team leader by the first class. The student should place a second copy in their student portfolio. Students are responsible for their Skills Performance Competency as follows: A. The student must successfully perform each skill safely and accurately by the deadline outlined

in the course calendar. B. If unsuccessful further practice and re-evaluation with successful completion of the skill is

mandatory. C. Students must make an appointment in Open-Lab for skills check offs. D. Objectives or skills will be evaluated through return demonstration. E. Skills demonstration will be in sequential order. E. Students must have the following required materials for skills return demonstration:

1. Nursing Skills Equipment Kit(s)

http://www.palmbeachstate.edu/x461.xml?id=Alexandc

mailto:[email protected]

http://www.palmbeachstate.edu/x461.xml?id=copeland

http://www.palmbeachstate.edu/x461.xml?id=copeland


http://www.palmbeachstate.edu/x461.xml?id=Herrinbd


http://www.palmbeachstate.edu/x461.xml?id=holmesm

http://www.palmbeachstate.edu/x461.xml?id=holmesm


https://www.palmbeachstate.edu/faculty/index.asp?id=kentln


http://www.palmbeachstate.edu/x461.xml?id=vassellw




2. Skills Performance Record 3. Skill Checklist, from the Clinical Skills CD-ROM or Blackboard. This is the student’s ticket to

enter check-off. The student must have this record.

Equipment necessary for the skill (watch, stethoscope, etc.)

4. Student Panther Card and name tag

G. Students that do not adhere to the competency demonstration deadlines in the syllabus

and class calendar will not pass the course.

H. It is the student’s responsibility to ensure the accurate documentation of the completed skills. I. NOTE: It is the student’s responsibility to print procedure checklists from the CD-ROM or

Syllabus posted online at: Nursing home page and bring to skills lab for skills lab class, practice and skills check off.

Open Lab:

A. Students sign up for ONE open Lab appointment time PER WEEK online for skills check-off using the Palm Beach State College Nursing home page at the Lake Worth and Belle Glade campuses. Belle Glade students may practice skills and be checked off at the Lake Worth skills lab. If the student is unsuccessful in getting checked off on the skill, another appointment (not on the same day) is to be arranged. The skill that is practiced with an instructor may not be checked off on the same day.

B. Open Lab hours will be posted online and on the Skills Lab bulletin boards., and appointments are not required to practice in the Lab. Appointments are to be made for check-offs and/or practice with an instructor as necessary. If appointments are available on the day of your appointment or practice you may sign up in the Lab for additional practice time with an instructor.

C. Successful check-off of skills must be done in the order in which the skills are scheduled. (Ex: A week 7 skill must be successfully completed before the week 8 skill is checked-off.) Additionally, all skills are to be completed within 6 days of the class. (Ex: Tuesday Lab class skills need to be successfully completed by close of business the following Monday night. Also note that Monday classes will have a Saturday deadline.)

D. Entrance will be through the double doors at the West end of the corridor on the Lake Worth

campus and through the entrance to CRB 218 Skills Lab in Belle Glade. E. Students must wear their name tag and have their student ID (Panther card) to gain entrance. F. Faculty must be notified of cancellations.

1. If off campus, leave a message on the lab office phone voice mail: Lake Worth – 561-868-3411

Belle Glade – 561-993-1453 2. In case of an emergency only, please notify the nursing office. Lake Worth – 5461-868-3412 Belle Glade – 561-993-1145

G. Without proper notification of an absence or cancellation of an appointment, unpreparedness, or unprofessional behavior, a Performance Improvement Plan (PIP) on Professionalism will be administered. The PIP on Professionalism will require a 3 page paper in APA format, with 3 professional (nursing) references to be submitted before any more skills may be checked off.

H. If students are unsuccessful during their first or second attempt, the Faculty will give feedback regarding skills attempts and additional practice/review is needed.

I. Students will validate the master skills register in the Skills Lab at the time a skill is successfully

http://www.palmbeachstate.edu/nursing.xml

http://www.palmbeachstate.edu/nursing.xml



checked off.

Late Assignment Policy: All required assignments must be completed by assigned deadline

dates. Incomplete work or tardiness may result in course failure by not meeting learning

outcomes. Incomplete work will result in failure. Class tardiness will result in inability to attend

the class, initiation of a PIP for non professional behavior, and required completion of those class

objectives before the next class. Grading Scale & Policy: All students must receive a passing grade in each of the Semester 2 Nursing Courses in order to proceed to the third semester. The following courses are considered Semester 2 courses:

NUR 1213 or NUR1213DL or NUR1213HY

NUR1213L

NUR1214L Nursing Department Grading Scale and Policy: Skills are signed off by the evaluating instructor on the Skills Performance Record that is posted at the end of this syllabus. Students are graded as follows:

Grades are recorded as satisfactory or unsatisfactory (S/U) scale.

Upon successful performance of the semester’s required skills; the Wellness Integrated Activity; and the Final Integrated Skills Demonstration Exam, the student will receive a satisfactory grade for the course.

Any student who does not receive a satisfactory in the course will not advance to the next semester in the nursing program.

Make-up Exam Policy: Should classes or content be missed, the student is responsible to make up the content within one week. A skills lab referral and performance improvement plan (PIP) will be generated to assist the student in completing this objective successfully by the due date. There is no Make-up Exam Policy for Skills.

CLASS POLICIES & METHODOLOGY Attendance: Professors are required to take attendance. Attendance in skills lab class is mandatory.

1. Students are required be on time and to sign in to each Skills Lab class on the attendance

sheet. When the student does not sign the attendance sheet they are considered absent for

that class.

2. Class tardiness will result in inability to attend the class, initiation of a PIP for non

professional behavior, and the completion of those class objectives before the next class.

3. In the event of an absence the student must notify the skills lab instructor as soon as possible.

Missed classes must be made up through practice in the Skills Lab and successful completion

of the PIP.

4. Students may make an appointment in the Skills Lab to review any specific practice

questions with an instructor

5. Students are required to successfully complete the missed skills before the next class.

All students are expected to attend all classes and clinicals/labs. In the event of an absence the student is expected to notify the appropriate faculty member as soon as the absence is expected.



Electronic Device Use: Laptops and Hand-held devices are allowed in class for note-taking purposes, only. The use of Hand-held devices that are iPod capable are encouraged to facilitate downloadable information as learning strategies and study tools. Cell phones must be turned off in class. Visual recording of instructors is not authorized. Visual recording of students may be used as a part of the evaluation or practice of a skill.

Email Policy: All email correspondence must be conducted using the college email system, all students have access to a college email account. It is the responsibility of the student to activate this account in order to be kept current with college, program and course information. College email must be checked, daily. Email communication between faculty and students will only be made using the college email system or Blackboard, so be certain to check these email accounts daily for any updates or changes to coursework and scheduling.

Equipment & Supplies: Required text books; access to a computer with active Internet service; knowledge of password and student ID for program and testing access, word processing and printing capabilities are essential to be successful in this class. Students must bring kit to Skills Lab class; check-off appointments; and all practice sessions. All manikins and Palm Beach State College supplies should be replaced after use and treated with respect. Professor’s Expectations and Student Role and Responsibility: Students will:

1. Arrive to class on time and prepared to practice planned skills. 2. Attend at all classes

A. Preparation: The student will be prepared for skills lab class by utilizing: 1. A-V materials 2. Required skills text readings 3. Skills lab practice time

B. Materials: 1. Each student must bring the following to lab class:

a. Skills Lab Equipment Kits I and II (Do not discard reusable items) b. Required texts/resources c. Stethoscope d. Pen light e. Watch with second hand f. Skills performance record. g. Skills competency check list from the Clinical Skills CD-ROM or Blackboard h. Student identification and name tag

C. Dress Code: 1. Students must wear their Panther Card with photo ID to gain entrance into the lab.

2. See Nursing Student Handbook for dress code D. Station Maintenance:

It is the responsibility of ALL students to clean and straighten the practice stations after each and every practice or use.

E. Clinical Competency Responsibility: The student will be responsible for keeping their skills checklist current and available to their skills lab and clinical instructor at all times by bringing the skills performance record to each clinical day.

Reminder:

With any skill (i.e. catheterization) requiring lubricant, do not use water-soluble lubricant on the mannequins. This will harden when dried and obstruct the orifices. Use only diluted liquid soap to “lubricate” the tubing.

http://www.palmbeachstate.edu/x15002.xml




Methods of Instruction: Include the following: 1 Demonstrations and Return Demonstrations 2 Simulations 3 Hands-on Skills Practice and Performance 4 Computer Assisted Instruction 5 Critical Thinking Exercises 6 Multimedia activities 7 Interactive educational activities 8 Audio visuals Evaluation Methods: Include the following:

1. Objective skills performance or observations 2. Attendance and participation as previously written. 3. Wellness Activity Completion 4. Satisfactory performance of Integrated Skills Final.

Unique Requirements of the Class: During the review of the Nursing Student Handbook, students should pay particular attention to the following Policies and Procedures:

1. Student Preparedness 2. Attendance 3. Medication Administration Calculation Test 4. Medical/CPR Requirements 5. Computer Competency Component 6. Written Assignments 7. Palm Beach State College’s Nursing Curriculum Organization

Integrated Skills - Student Exam: interpretation and Directions: The Integrated Skills Student Exam will begin during finals week. Students will sign up on separate appointment sheets in the Skills Lab. Students may sign up for one appointment at a time only. Students will receive a short case study that combines several learned skills in an integrated manner enhancing critical thinking and planning of client care. Students will have a total of 50 minutes for their integrated skills demonstration.

1. Check in at the desk in AH 102 2. Arrive 15 minutes prior to your appointment. 3. Bring all supplies as needed for skills lab class and clinical performance:

a) The students’ completed Semester 2 Skills checklist is their ticket for entrance. b) Students will not be able to complete their Final Integrated Skills Exam without the

completed checklist. c) Skills lab kit (s) with all equipment from semesters 1 & 2. d) Stethoscope; Penlight; Pen/pencil; Medication Book resource. e) Please dress appropriately for this experience, either uniform scrubs or casual business

(comfortable for psychomotor skills) attire. f) No cell phones or PDAs will be permitted. Use of cell phones or PDAs will result in failure

for the Final Integrated Skills Exam. g) Wear your PALM BEACH STATE COLLEGE name badge!

4. In the event of unsuccessful integrated skills return demonstration: a) A lab referral form and Performance Improvement Plan (PIP) will be generated by the

skills lab Instructor explaining the necessary practice for the student to be successful after additional practice.



b) The student must make another appointment online to satisfy the referral. c) The student must also make another appointment for a second attempt at an

Integrated Skills scenario. d) The skills identified on the lab referral form (and PIP) must be practiced before the

student’s second attempt at Integrated skills testing. e) If the student is unsuccessful on their second attempt, this will result in an

unsatisfactory grade for NUR 1214L.

COLLEGE POLICIES AND WEB INFORMATION

Academic Dishonesty

Academic dishonesty includes the following actions, as well as other similar conduct aimed at making false representation with respect to the student's academic performance:

(1) Cheating on an exam, (2) Collaborating with others on work to be presented, if contrary to the stated rules of the course, (3) Submitting, if contrary to the rules of the course, work previously submitted in another course, (4) Knowingly and intentionally assisting another student in any of the above actions, including assistance in an arrangement whereby work, classroom performance, examination, or other activity is submitted or performed by a person other that the student under whose name the work is submitted or performed, (5) Plagiarism.

Please refer to the Palm Beach State College Student Handbook for further information.

Classroom Etiquette and Student Behavior Guidelines

Students will demonstrate respect for professors and fellow students. Behavior that is disruptive to a positive learning environment reported by the professor will result in a warning on the first instance; the second instance might result in expulsion from the course or campus.

Computer Competency Component

Each student will, to the satisfaction of the instructor, demonstrate a fundamental understanding of basic computer operations through various instructor-determined exercises and/or assignments. These exercises/assignments are included in this syllabus.

Disability Support Services

Students with disabilities are advised, in compliance with federal and state laws, that accommodations and services are available through the office of Disability Support Services (DSS). It is the student's responsibility to contact Disabled Student Services Advisorsand to submit appropriate documentation prior to receiving services.

Eating, Drinking and Smoking

Eating and drinking are NOT ALLOWED IN THE SKILLS LAB, and are confined to areas designated on the campus. Smoking is not permitted in any College building and only in areas designated at each campus.

Student Responsibility Policy

When students attend the College, they become subject to its jurisdiction. Students are expected to conduct themselves in a responsible manner, in all areas of campus life. By enrolling, they pledge to obey the rules and regulations of the College and are responsible for observing all College policies and procedures as published in the student handbook, the College catalog and other College publications. The students are responsible for preparing for class, participating in class, and completing assignments on time.


http://www.palmbeachstate.edu/disabilities.xml




College Websites of Interest

Withdrawal Policy for Individual Courses: The last day to withdraw from a College course with a "W" grade in this course is posted on the college academic calendar. It is the responsibility of the student to use the PantherWeb system or visit a campus Registrar’s office to withdraw. Without a formal withdrawal from the course, lack of attendance will result in failure. An official withdrawal entitles the student to a grade of "W" in the class. Withdrawal or lack of participation in even one nursing course (NUR 1213, NUR 1213L, NUR 1214L,) will result in being removed from all the nursing courses as all nursing course are to be taken concurrently.

DEPARTMENT CONTACT INFORMATION: Kellie Bassell, MSN, EdS, RN Nursing Program Director AH 110 (561) 868-3412 Fax (561) 868-3452 E-mail





GETTING STARTED

1. Make sure you have all the computer system requirements as listed in the Computer Requirements section of this syllabus.

2. Update your profile in Panthernet. The professor will communicate with you through your college email account.

3. Obtain course materials. The textbook(s) can be purchased at the Palm Beach State College campus bookstore or online.

4. There is no Blackboard component for this course. Be certain to print the syllabus, including the course calendar, and assignment sheet so that you know what is expected of you during the semester.

5. Print the Skills Performance Record and obtain copies of the Skills Checklist from your instructor or from the CD ROM that accompanies the textbook required for Skills Lab classes.

6. Begin completing your assignments as listed on the course calendar and/or class schedule.

Have fun!

Disclaimer Changes may be made to the syllabus at any time during the term by announcement of the

professor. It is the responsibility of the student to make any adjustments as announced.

http://www.efollett.com/

SKILLS PERFORMANCE RECORD SEMESTER TWO

NUR 1214L Nursing II Skills Lab Revised December, 2012

11

FORMS: SIGNATURE PAGE



12

COURSE SYLLABUS REVIEW “SIGNATURE PAGE”

I, _________________________________________________ have read, understand and Print Name Agree with the course Procedures, Guidelines and Policies for NUR 1214L as stated in the course syllabus. Signature: ____________________________________________________ Date: _______________ Witness: _____________________________________________________ Date: ___________________



13

COURSE OBJECTIVES BY CONCEPT



14

CONCEPT I: OXYGENATION – PHYSICAL ASSESSMENT

OBJECTIVES CONTENT RELATED LEARNING ACTIVITIES

The student will be able to:

1. Perform a Cardiopulmonary focused head-to-toe physical Assessment

2. Demonstrate dexterity and skill at a cardiopulmonary focused assessment by performance.

3. Use of all equipment as necessary to complete a full head to toe physical assessment.

A. Cardiopulmonary physical Assessment 1. A & P Thorax and Lungs overview 2. Assessment and recognition of

adventitious breath sounds. 3. Cardiovascular System overview and

assessment including but not limited to: Bradycardia, tachycardia, irregularity.

B. Perform a head-to-toe acute care client

assessment as will be performed in the clinical facility. 1. Demonstrate all previously successful skills

from semester I such as parenteral medication administration, NG tube insertion and maintenance, indwelling catheter insertion and management.

Required: Kozier skills and textbook as related to the

subjects to be covered. Required Reading/Viewing:

Kozier and Erb’s (2008)”Techniques in Clinical Nursing”.

Physical Assessment pp 44-138, to include

oxygenation/perfusion Use entire skills book resources including CD-Rom Use Essential Nursing Resources Page: for video

and other computer assisted learning tools. Read current nursing periodicals on skills and other

concepts of concern.

http://www.palmbeachstate.libguides.com/content.php?pid=28521



15

CONCEPT I: OXYGENATION – CHEST TUBE MANAGEMENT



1. Assist with Chest Tube Insertion

2. Maintain the Chest Tube site and Drainage/suction system

3. Assist with Chest Tube Removal and assessments.

A. Chest Tubes and suction or drainage systems: 1. Assessment of chest tube site and

respiratory status 2. Assess patency and maintain chest drainage

system 3. Perform aseptic chest tube site care 4. Measurement of output and documentation 5. Assisting with insertion and removal of

chest tubes.

Required Reading and/or Viewing: Kozier: Chest Tubes pp 469-478 PTLC videos: CCTV-1-12891 “Closed Chest” (22min). Necessary Equipment:

Manikin Thoracentesis tray for viewing only Torso model for Anatomy review Wall suction Sterile Vaseline and 4X4 gauze silk tape 50ml syringe 100mL bottle sterile water 2 Rubber tipped clamps (6-8 in) Disposable drainage system Bottle drainage system-if available Suction / Pleurevac management



16

CONCEPT I: OXYGENATION – TRACHEOSTOMY CARE

OBJECTIVES

CONTENT

RELATED LEARNING ACTIVITIES


1. Demonstrate skill and understanding of proper technique during tracheostomy care.

2. Identify the multiple parts of a tracheostomy tube, tracheostomy kits and suction equipment.

3. Demonstrate removal, cleaning and replacement of the inner cannula

4. Demonstrate ability to change tracheostomy dressings whether velcro or tie type dressing change.

5. Demonstrate safety measures and maintenance of asepsis during tracheostomy care.

6. Demonstrates ability and understanding of how to safely inflating and deflate a tracheostomy cuff. The RN student also demonstrates knowledge of when to consult a Respiratory Therapist or the HCP when managing tracheostomy patients.

7. Demonstrates skill

8. Demonstrate documentation of tracheal suctioning and tracheostomy care.

A. Tracheostomy Care 1. Parts of tracheostomies, types, special

manifestations. 2. Care and management of client with a

tracheostomy and the oxygen system used for assistance/ administration.

B. Oxygen Therapy and Safety

1. Trach collars 2. Tracheostomy Tube and Oxygen delivery 3. Oral care and management of the client

with a tracheostomy

Required Reading and/or Viewing: Kozier. pp. 459-467 Video: 1-20296 Tracheostomy Basic and Advanced Care – 24" Necessary Equipment:

Manikin Thoracentesis tray (optional) Wall suction set-up Oxygen set-up Tracheostomy set and dressing on manikins Disposable inner cannula (others if

available: discussed, show if available). Show or discuss

1. fenestrated and nonfenestrated cannula

2. Speaking Valve – placement, management.

Review oxygenation and equipment used in a variety of airways Tracheostomy care practice to include Velcro tie and other ties. include documentation of care or interventions and how the client tolerated the procedure.



17

CONCEPT I: OXYGENATION – RESPIRATORY SUCTIONING



1. Perform Respiratory Suctioning safely and effectively.

2. Define assessment findings indicating the need for tracheal suctioning.

3. Using a suction catheter and a closed (in line) system, perform tracheal suctioning on a manikin.

4. Demonstrates suctioning of the respiratory system and appropriate documentation

5. Demonstrate oropharyngeal and nasopharyngeal suctioning.

6. Demonstrate documentation of airway clearance method

A. Types, Equipment, and theories of safety behind Respiratory Suctioning: 1. Nasopharyngeal 2. Oropharyngeal 3. Endotracheal:

a. Open system b. Closed system

4. Tracheal suctioning as with tracheostomy care.

5. Suctioning & Assessment methods a. Open catheter method b. Closed (in line) system

Required Reading and/or Viewing: Kozier and Erb’s (2008) Techniques in Clinical Nursing: Ch.22 Suctioning pg.445-457 video: 1-20296 Tracheostomy Basic and

Advanced Care – 24" Necessary Equipment

Pulse oximeter (if available) Oxygen Flow meter& different administration sets for review:

a. Nasal cannula b. face mask c. venti-mask

Stethoscope Suction set-up a. canister & regulator

b. yankauer (oral) c. student’s suction catheter kit d. Ballard (In- line closed suctioning) e. sterile saline f. lubricant for nasal suctioning.

Trach care tray Ambu bags & Ventilator (if avail. for show) Personal Protective Equipment

ProCalc : problem will be practiced weekly!



18

CONCEPT II: CELLULAR INTEGRITY – PERIPHERAL INTRAVENOUS THERAPY



1. Prime both primary and Secondary IV tubing.

2. Verbalize assessment and manifestations of complications of intravenous therapy.

3. State client teaching considerations of intravenous therapy.

5. Demonstrate aseptic and correct techniques when administering intravenous site care.

6. Demonstrate skill at administration of intravenous solutions using primary, secondary tubing sets via both peripheral and central lines.

7. Demonstrate changing of intravenous tubing and/or solutions.

8. Demonstrate skill and maintenance of asepsis when adding medications to intravenous solution bag.

9. Demonstrate knowledge of administration of all types of solutions using different intermittent or specialized infusion sets.

10. Demonstrate understanding of complications of IV therapy by listing at least five reasons for discontinuing an intravenous site.

11. Demonstrate removal of a peripheral IV site.

12. Demonstrates understanding of pertinent information for documentation of IV Therapy.

A. Peripheral Intravenous Therapy: insertion & Equipment 1. Insertion sites; Insertion procedures; site

assessment and care; 2. Discontinuing IV catheters; and discussion

of documentation. 3. IV therapy management 4. Change and prime different types of tubing 5. Demonstration and return demonstration

of regulation of flow rate 6. Adding medications to solutions and

administering IVPBs 7. Listing and discussion of all potential

Complications of IV therapies B. Exposure to specialized solutions with same IV

administration principles plus special discussed aspects to: blood transfusion set-ups, PCA set-ups, and TPN/PPN with or without Lipids set-ups.

Required Reading and/or Viewing: Kozier and Erb’s (200 8) Techniques in Clinical Nursing: Intravenous Medications pp 560-578 Intravenous Therapy pp 578-617

Skills 2: Intravenous Administration http://media1.palmbeachstate.edu/wmroot/1-13005.asx Skills2: Venipuncture, Starting an Intravenous Infusion; http://media1.palmbeachstate.edu/wmroot/1-13006.asx Skills2: Venipuncture,Maintaining & Discontinuing an Intravenous Infusion; http://media1.palmbeachstate.edu/wmroot/1-13007.asx Enrichment AV Material:

1-13005 IV Medication Administration – 22" 1-13006 Venipuncture – 17" 1-13007 Maintaining IV Therapy – 14"

http://media1.pbcc.edu/wmroot/1-13005.asx








19

CONCEPT II: CELLULAR INTEGRITY – CENTRAL INTRAVENOUS THERAPY



1. Demonstrate understanding of assisting with insertion of temporary Central (CVCs) & Peripherally Inserted Central Catheters (PICC) Lines by listing or gathering necessary supplies.

2. Demonstrate skill and proper technique of assessment of clients with different types of temporary and permanently inserted central venous catheters and dressings.

3. Demonstrate ability to teach clients necessary information and considerations with central venous access or sites.

4. Demonstrate aseptic and proper technique while performing central line dressing and cap changes.

5. Demonstrates ability to flush central lines or ports of central venous catheters following catheter preferences, aseptic technique, with discussion about facility specific concerns.

6. Demonstrates ability to administer medications continuously or intermittently via central venous accesses or catheters.

A. Care and Management of Clients Receiving Intravenous Therapy via a Central Line 1. Demonstration of equipment necessary for

insertion of temporary central venous catheter.

2. Demonstration and return demonstration of dressing and cap changes for central venous catheters both temporary and permanent (tunneled) central venous catheters.

3. Demonstrate assessment and understanding of clinical manifestations of complications of IV therapy.

4. Demonstrates proper aseptic technique during all central line care.

5. Demonstrates proper assessment and management of the client with a central venous access device.

6. Demonstration and return demonstration of administration of intermittent medications or solutions and flushing of ports or lines using central venous access devices.

7. Demonstration and return demonstration of blood drawing from a central venous access device.

Required Reading and Viewing;

Kozier and Erb’s (2008)

Techniques in Clinical Nursing;

Central Lines pp 607-614; Parenteral Nutrition pp 614-617

Necessary Equipment:

Torso manikin with assorted central lines Central Line Dressing kit(s) (students should

have own). Central Line insertion tray (for show –

assistance with supplies only) Kozier and Erbs CD-ROM for animation

Note: contents of central line dressing kit are re-usable and others are not. Additional sterile gloves if needed.



20

CONCEPT II: CELLULAR INTEGRITY – ASESPSIS AND WOUND CARE


The student will: A. Asepsis

1. Identify the purpose of sterile/aseptic technique.

2. Explain the differences between sterile and clean technique.

3. Demonstrate opening a sterile field and donning sterile gloves.

B. Wound Care 1. State the principles of wound healing. 2. Explain the purpose of wet to damp

dressings. 4. List the equipment needed for dressing

changes. 5. Demonstrate the procedure for packing a

wound. 6. Demonstrate a sterile dressing change,

using a mannequin. 7. Demonstrate the procedure for irrigating a

wound, using a mannequin.

A. Asepsis 1. Principles of Sterile Technique a. Sterile field b. Gloving B. Wound Care 1. Principles 2. Equipment 3. Dressings a. Wet to Damp b. Packing 4. irrigation C. Sterile Specimen Collection 1. Purpose 2. Types a. Culture and sensitivity

Complex Required Reading:

Skills in Clinical Nursing

Infection Control, pp. 297-312

Wound Care, pp. 619-643

Available AV Material:

1-12708 Hand washing – 27"

1-12693 Breaking the Chain of Infection – 25"

1-12460 Basic Principles – 22"

1-12695 Basic Sterile Techniques – 22"

1-12454 The Immune System – 24"

1-13001 Wound Care – 25"

Activity:

View AV 1-12695 Basic Sterile Techniques

Perform sterile gloving

Perform wound care, culture, irrigation and dressing change

ACTIVITY:

Obtain cultures using proper technique

Use personal protective equipment when indicated



21

CONCEPT II: CELLULAR INTEGRITY – ASESPSIS AND URINARY CATHETERIZATION


Urinary Catheterization

The student will: 1. Describe the rationale for the insertion of a urinary

catheter. 2. Describe the differences between the types of

urinary catheters. 3. Demonstrate the insertion and removal of an

indwelling urinary catheter, using a male and female mannequin or simulator.

4. Explain the differences between male, female, geriatric, and pediatric catheterization.

5. Describe care of an indwelling catheter. 6. Explain the teaching considerations which relate to

urinary catheterization. 7. Demonstrate the application of an external catheter,

using a mannequin.

A. Urinary Catheterization

1. Principles

2. Equipment

3. Types

a. Straight

b. Indwelling

4. Insertion & Removal

a. Straight

b. Indwelling

5. Male Vs Female

6. Pediatric Considerations

7. Geriatric Considerations

8. Catheter Care

9. Specimen Collection

10. External Catheter

Required Reading:


Urinary Catheterization, pp. 394-408

Print skills check list for urinary elimination from Kozier CD-ROM.

Access mynursinglab.com

View videos related to urinary elimination

Available AV Material:

1-12999 Catheterization

Activity:

Discuss types of catheters and sizes.

Perform catheterization on mannequin (45 minute practice).

Practice opening a sterile field

a. Practice donning sterile gloves

b. Practice sterile dressing application

c. Practice catheterization on manikin

1. female

2. male



22

CONCEPT II: CELLULAR INTEGRITY – NASOGASTRIC TUBE INSERTION


The student will: 1. Identify rationale for insertion of nasogastric tube. 2. Demonstrate NG tube insertion using a mannequin. 3. Demonstrate management of nasogastric tube

.

1. Nasogastric Tube Insertion

2. Management of nasogastric tube

Required Reading:


Invasive Procedures: pp. 10-12

Necessary Equipment:

Nasogastric tube

Cup with straw and water

Towel

Water soluble lubricant

Stethoscope

Tape

Suction equipment if required

Non-sterile gloves

Manikin



23

CONCEPT III: REGULATION – OSTOMY CARE



1. Care for a client with an urostomy, ileostomy and a colostomy appliance.

2. List/state five findings of an assessment of a stoma.

3. Demonstrate teaching a client care of the peristomal skin appliance application, and independent stomal maintenance.

4. Demonstrate application of at least two types of ostomy appliances.

5. Verbalize pertinent information to be documented in regard to stoma care.

A. Ostomy Care 1. Ileostomy/Colostomy/Urostomy a. Assessment b. Client education c. Stomal and Peristomal Skin Care d. Appliances: assorted.

Required Reading/Viewing: Kozier and Erb’s (2008) Techniques in Clinical Nursing Assisting with Invasive Procedures pp 2-13 Ostomy Care pp 376-387, 403-408 Kosier and Erb CD ROM-checklist procedure 46-2 Changing Bowel Diversion Ostomy Appliance Necessary Equipment:

Gloves Ostomy demonstration board Ostomy care supplies: measuring, cutting,

skin barriers and I & O worksheet Manikins with stomas (assorted)



24

CONCEPT III: REGULATION – BLADDER IRRIGATION



1. State the goals of treatment for the clients with intermittent and/or continuous bladder irrigation.

2. State the purpose of bladder irrigation and assessment techniques used to evaluate effectiveness of treatment.

3. Demonstrate dexterity of skill and maintenance of sterility / aseptic technique during closed and open bladder irrigation.

4. Demonstrate skill at maintaining fluid administration during a continuous bladder irrigation and ability to calculate true urine output.

5. Maintain asepsis while accurately demonstrating open intermittent bladder irrigation.

6. Demonstrate understanding of pertinent data to be assessed and documented during the care and management of clients receiving bladder irrigation of any type.

A. Bladder Irrigation 1. Continuous (CBIs) (NS solution, tubing) 2. Intermittent a. Rare Closed irrigation-maintains the

closed system by injecting the solution through an aspiration port* or through a three way irrigation system-

b. *Open irrigation- using an indwelling catheter and irrigation tray, syringe, and sterile normal saline solution.

3. Demonstration and return demonstration of pertinent information to be assessed, documented and reported.

Required Reading and/or viewing: Kozier and Erb’s (2008) Techniques: Bladder Irrigation pp 403-405 (Nutrition & Elimination part 2, including Catheterization: MTIS (irrigation is @ 13 minutes into video) Necessary Equipment:

Manikin with 3-way foley set-up Continuous bladder irrigation set-up I & O worksheet Irrigation tray Manikin for Foley catheter insertion kit Foley catheter insertion kit Self protective equipment

http://www.palmbeachstate.edu/mtis/ShowSeries.asp?cid=1&View=11



25

CONCEPT V: MOBILITY and SENSORY/PERCEPTION/COGNITION – MUSCULOSKELETAL & NEUROVASCULAR

OBJECTIVE CONTENT RELATED LEARNING ACTIVITIES


1. Perform an assessment of the musculo-skeletal and neurovascular systems

2. Identify needs in the care of the orthopedic patient.

3. Perform nursing interventions to the orthopedic patient.

4. Observe and discuss principles of appliance/equipment use.

5. Apply an abduction device.

6. Explain the principles and nursing responsibilities of continuous passive motion equipment.

7. Discuss principals of maintaining traction

A. Demonstration of Assessing: 1. gait 2. posture 3. balance 4. symmetry 5. muscle strength B. Review and Demonstrate proper body

alignment: 1. standing 2. sitting 3. lying C. Review and demonstrate ROM exercises in

logical sequence: i.e. Flexion, Extension, Eversion, Inversion

1. hip 2. leg 3. knee 4. ankle 5. foot D. Review and demonstration ROM exercises in

logical sequence: 1. shoulder 2. arm 3. elbow 4. wrist 5. hand

Required Reading/viewing: Kozier and Erb’s (2008) Techniques in Clinical Nursing pp 236-248, 251-256, 645-652 Enrichment AV Materials:

1-11188 Hip Fracture – 21" 1-11189 Hip Replacement – 25" 1-11190 Knee Replacement – 25" 1-12524 Broken Bones – 26" 1-20145 Bones and Joints – 20" 1-20146 Muscles – 20"

Necessary Equipment

CPM machine SCD’s machine Bucks Traction/weights Mannequin with cast TV with VCR CD- Rom for animation – Fracture/ROM

review CD- Rom Checklist – student

should download for Sequential compression Devices



26

CONCEPT V: MOBILITY and SENSORY/PERCEPTION/COGNITION – MUSCULOSKELETAL

OBJECTIVE CONTENT RELATED LEARNING ACTIVITIES

Student will:

1. Manage care of client with External Fixation Devices

2. Perform a physical inspection of external devices, including assessment of the 6 P’s.

3. Apply the principles of asepsis in the care and maintenance of external orthopedic devices.

4. Develop an educational nursing plan of care for the long-term orthopedic patient.

A. Demonstrate maintenance of: 1. buck’s traction 2. cervical traction 3. pelvic traction 4. splints and slings 5. cervical collar B. Complete a neurovascular check: (6 P’s) 1. pain 2. pallor 3. pulse 4. parasthesia 5. paralysis 6. pyrexia/poikilothermia C. Demonstrate External fixation device pin care D. Demonstrate: 1. Continuous Passive Motion Equipment 2. Application of abduction Pillow E. Care of the total joint replacement client(s).

Assignment: In-class presentation Each student has 1 orthopedic equipment topic area of pertinent nursing consideration to review with class in 2-3 minutes 1. CPM machine, 2. Traction with pin care, and 3. Other equipment as listed. Rotate in order every 40 minutes Necessary Equipment for pin care:

Sterile gloves 250cc Normal Saline sterile cotton swabs sterile 4x4 gauze



27

SKILLS PERFORMANCE RECORD


NURSING II

Student Name ____________________________________Clinical Instructor ____________________________Skills Lab Class Instructor____________________ Directions: Students will be evaluated and “signed off” on the following skills during Skills Lab, Open Lab and Clinical experiences. It is the responsibility of each student to bring this record to all lab and clinical experiences (NUR 1213L). Instructors will initial skills completed in the appropriate box/column. Legend - S: Satisfactory

Performs safely and accurately during the performance. Demonstrates coordination and dexterity. Generally appears relaxed and confident most of time with occasional display of anxiety. Completes the skill within a reasonable time frame. Focuses on the client initially, but as the skill progresses, focuses on the task. Applies knowledge of the principles of the skill accurately.

U: Unsatisfactory

Requires direction or cues from the instructor. Demonstrates partial lack of dexterity; is awkward. Takes a longer time to complete the skill. Wastes energy due to poor planning/anxiety. Focuses primarily on the task, not on the client. Needs direction in application of the principles of the task. Unable to complete the skill within allotted time.

NOTE: In order to progress, students MUST complete additional practice and meet the criteria for Satisfactory performance of the skill.

Instructor Initials and Signature:


Name LAB COMPETENCY DEMONSTRATED CLINICAL COMPETENCY

DEMONSTRATED

SKILL DEADLINE

DATE

DATE

INITIALS

1ST

ATTEMPT COMMENTS

DATE

INITIALS

2ND

ATTEMPT COMMENTS

DATE

INITIALS COMMENTS

1. PHYSICAL ASSESSMENT

A. Perform a comprehensive health assessment, “head to toe” physical assessment

U S U S U S

2. INTRAVENOUS THERAPY & VASCULAR ACCESS…………………………………………………………..CELLULAR INTEGRITY

A. Perform venipuncture U S U S U S

B. Start an intravenous (IV) infusion; utilize an infusion pump or manually adjust rate

U S U S U S

C. Add medications to IV fluid containers

U S U S U S

D. Administer intermittent intravenous (IV) medications using a Secondary Set

U S U S U S

E. Change IV dressing and assess the venipuncture site

U S U S U S

F. Discontinue Infusion devices

U S U S U S

G. Administer blood transfusions using a y- set; initiate, maintain and terminate a blood transfusion

U S U S U S



DEMONSTRATED

SKILL DEADLINE

DATE

DATE

INITIALS

1ST

ATTEMPT COMMENTS

DATE

INITIALS

2ND

ATTEMPT COMMENTS

DATE

INITIALS COMMENTS

H. Manage Pain- PCA Pump U S U S U S

3. CENTRAL VENOUS CATHETERS

A. Manage central lines U S U S U S

B. Perform central line / PICC line dressing changes

U S U S U S

4. ORTHOPEDICS: MUSCULOSKELETAL & NEUROVASCULAR………………………………………. MOBILITY AND SENSORY/PERCEPTION/COGNITION

A. Integrate care of patient with hip fracture/ hip replacement

U S U S U S

B. Demonstrate care of clients in skeletal traction

U S U S U S

C. Monitor and provide care of the client with skin traction

U S U S U S

D. Provide initial cast care

U S U S U S

E. Provide ongoing cast care

U S U S U S

5. Equipment

A. Demonstrate use of continuous passive motion devise (CPM)

U S U S U S

B. Apply sequential compression devices (SCD’s)

U S U S U S



DEMONSTRATED

SKILL DEADLINE

DATE

DATE

INITIALS

1ST

ATTEMPT COMMENTS

DATE

INITIALS

2ND

ATTEMPT COMMENTS

DATE

INITIALS COMMENTS

6. RESPIRATORY CARE……………………………………………………………………………………………………OXYGENATION / VENTILATION

A. Perform oropharyngial, nasopharyngeal & nasotracheal suctioning

U S U S U S

B. Suction a client with tracheostomy or endotracheal tube

U S U S U S

C. Provide tracheostomy care

U S U S U S

7. CHEST TUBES

A. Assist with chest tube insertion

U S U S U S

B. Maintain chest tube drainage

U S U S U S

C. Assist with chest tube removal

U S U S U S

D. Assist with and care for the patient undergoing thoracentesis

U S U S U S

8. OSTOMY CARE……………………………………………………………………………………………………………REGULATION/ELIMINATION

A. Perform urinary ostomy care

U S U S U S

B Change a bowel diversion ostomy appliance

U S U S U S



DEMONSTRATED

SKILL DEADLINE

DATE

DATE

INITIALS

1ST

ATTEMPT COMMENTS

DATE

INITIALS

2ND

ATTEMPT COMMENTS

DATE

INITIALS COMMENTS

9. BLADDER

A. Performing urethral urinary catheterization

U S U S U S

B. Performing bladder irrigation

U S U S U S

10. WOUND CARE…………………………………………………………………………………………………………..CELLULAR INTEGRITY

A. Perform a damp-to- damp dressing change

U S U S U S

B. Obtain a wound drainage specimen

U S U S U S

C. Demonstrate wound irrigation

11. NASOGASTRIC TUBE

Insert a nasogastric tube U S U S U S