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LOSANGELESHARBORCOLLEGEASSOCIATEDEGREENURSINGPROGRAM

NURSING339NURSINGPROCESSANDPRACTICEINTHECAREOF

THEGERONTOLOGICPATIENT2017-2018

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LOSANGELESHARBORCOLLEGEAssociateDegreeNursingProgram

COURSEOUTLINE

N339NursingProcessandPracticeinTheCareOfTheGerontologicPatient(2units)

FacultyContactInformation:EdieMoore,RN,MSNOffice#124(officehourspostedoutsideofdoorandbyappointment)Officephone#:(310)233-4377Cellphone#:(310)408-3431(textingwelcome)mooreev@lahc.eduCourseDescription:ThiscoursefocusesontheGeriatricpatientandissuesrelevanttotheircareandintegratescontentoftheRoyAdaptationModelandtheNursingProcess.Thiscourseexpandsconcepts,principles,knowledge,andskillslearnedinpreviousnursingcourses.Itemphasizespsychosocial,physiological,environmentalandethicalconceptsandissuesthatimpactnursingcareservicesforolderadultsinvariouscaresettings,e.g.longtermcarefacilities(LTC)andHomeHealthAgencies.Amoreadvancedroleofthenurseisemphasized.Thecourseconsistsofsixunits:Unit1:IntroductiontoHomeHealth/Hospice(SelfTeachingUnit)andCommunityCare.Unit2:IntravenousInstructionalUnit.Intravenoustherapy(I.V.)isintroduced,e.g.intravenousinsertionandinfusionconsiderationofthegerontologicpatient.Unit3:IntroductiontotheGerontologicNursingandInfluencesonHealth&Illness.Unit4:WellnessIssues,CommonPsychophysiologicStressors,andDiagnosticStudies&

PharmacologicManagement.Unit5:NursingCareofPhysiologicandPsychologicalDisorders.Unit6:LongTermCare/CommunityBasedGerontologicCare.Clinicalexperienceswillbe

comprisedoftraditionalinstructorsupervisedlearninginlongtermcarefacilitiesandservicelearningassignmentsinavarietyofcommunityagenciesfortheelderly.

Credit/ContactHours:Lecture/discussionwillaverage4.5hoursperweekandclinicaltotals54hours(locationhoursandassignmentTBA)for4.5weeks(includingfinalexamination).Transferability:Conditional Prerequisites:AdmissiontotheNursingProgram,successfulcompletionoffirstandsecondsemesters,N333,andN335withagradeof“C”orhigher.Allrequiredsciencecoursesmustbecompleted.Thestudentisresponsibleforallpreviouslylearnedmaterialsinthephysiologicalandpsychosocialmodes,anddemonstratedsatisfactoryclinicalperformanceforclinicalcompetenciesthatwereevaluatedforallpreviousnursingcourses.“LVN-30unit”option:Admissiontonursingprogramandmeetallrequirements.“LVNAdvancedPlacement”:Asaboveandcompletionofrequired2ndand/or3rdsemester–N333andN335nursingprogramcoursesandcognates,andSociology1orAnthropology102withgradesof“C”orbetter.

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StudentLearningOutcomes:Atthislevel,whichcomprisescoursesinthethirdandfourthsemesterofthenursingprogram,studentsareexpectedtocontinuetoapplyandadaptmedicalsurgicalnursingconceptstopatientsacrossthelifespaninavarietyofcommunitybasedhealthcaresettings,modifyplanofcareandmakedecisionsforpatientsatavarietyofdevelopmentalstagesonthebasisofgeneralguidelinesorprinciplesderivedfrompreviousexperiences,organizeandprioritizenursinginterventionswithsupervision,anduseappropriateresourcestoassistinsolvingpatientproblems.Thestudentcanadapttodifferentagegroupsbasicskillsanddevelopsnewskillsapplyingguidelinesthatarebasedoncuesfromexperts.Theyattempttocorrelateandbuildonmedicalsurgicaltheoryandpractice.ProgramLearningOutcomesforlevelthreeare:

1. ApplythenursingprocessusingtheRoyAdaptationModelincaringforindividualsandgroupsacrossthelifespananddevelopmentalstages.

2. Practiceprofessionalbehaviorstandardsofnursingpractice.3. Demonstrateclinicaldecisionmakingthatisaccurateandsafe.4. Providesafe,patient-centeredcare.5. Functioneffectivelywithinnursingandinterprofessionalteamsutilizingeffective

communicationstrategies.6. Incorporateevidence-basedpractices,whichsupportclinicalreasoning.7. Identifyareasforimprovementinqualityandsafetyofhealthcaresystems.8. Utilizetechnologytoresearchpatientinformation,communicatewith

interprofessionalteams,manageknowledge,mitigateerror,andsupportdecision-making.

CourseOutcomes:Uponcompletionofthiscourse,withappropriatestudyandpracticeintheclassroom,campuslearninglab,andcommunitysettings,thethirdsemesterstudentnursewillutilizetheNursingProcessandRoy’sAdaptationModeltoassess,plan,implement,andevaluatenursingcarefordependentandindependentolderpatients.TheobjectivesrelatetotheStudentLearningOutcomesLevelIII[1-8].Thethirdsemester,nursingstudentwillbeableto:

1. Comparebiological,sociologic,andpsychologicaltheoriesofaging.[3,4,6]2. Evaluateatheorybaseforunderstandingandimplementingnursingcareinvarious

settingsforphysiologicalandpsychosocialchangesassociatedwithnormalaging.[1,3,4,5]

3. Compareandcontrastnormalagingchangesfrompathologicalbehaviors.[1,3,4,6]4. ApplytheGerontologicStandardsofPractice,OBRAregulations,ethicalstandardsof

practice,includingthePatientSelf-DeterminationAct,andtheJointCommissionsafetyguidelines.[3,4,5,6,7]

5. Developstrategies,techniques,andmodificationsnecessaryforconductingacomprehensivegerontologicassessmentforthephysiologic,rolefunction,self-concept,andinterdependencemodes.[1,4]

6. Appraiseenvironmental,physiological,cultural,sexual,andpsychosocialfactorsthatputgerontologicpatientsatphysical/andoremotionalrisk.[1,3,4,6,7]

7. Analyzehowphysical,mental,andsocialhealth;safety;culturalvariances;humansexuality;andactivitycontributetohealthyaging.[1,3,4,5]

7. Evaluatecommondilemmasrelatedtoend-of-lifedecisionmakingthatimpactolderpeopleandtheirfamilies.[1,2,4,5,6,7]

8. AdherestoNationalPatientSafetyGoalsandotherguidelines.[2,3,4,6,7]9. Performsnursingskillssafely.[2,3,4,6,7]10. Implementpainmanagementinterventionsforgerontologicpatients.[4,5]11. Appraisetypesofservicesavailableinthecommunityfortheagingpopulation.[4,5]12. Recognizeandreporteldermistreatmentandabuse.[1,2,3,4]

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13. Assessanddevelopstrategiestomeettheeducationalneedsofthepatientandfamily.[3,4,5,6]

14. Internalizeculturallysensitive,individualizednursingcareforgerontologicpatientsresidingincommunitybasedandlong-termcaresettings.[2,4]

15. Integratestepsofthenursingprocesstoassess,plan,initiate,monitor,andevaluateolderadultpatient’sresponsetointravenoustherapy.[1,3,4]

16. Organizenursingcareforolderadultsapplyingthenursingprocess,rolesofpractice,andRoyAdaptationModeltocoordinatepatientcareforpatientswithphysiologicalandpsychosocialneeds.[1,3,4,6]

17. Practiceprofessionalroleperformancebehaviorsbyadheringtoethicalprinciples,andlegalboundariesoftheprofession,clinicalagency,andcollege.[2,4]

18. CoordinatenursingcarebasedontheANAStandardsofGerontologicalNursingPractice,prioritizedpatientneeds,andappropriate,efficientuseofavailableresources.[1,2,3,4,6]

19. Displayeffectivecommunicationandcollaborationwithpatientandinterdisciplinaryteamtoachievepatientoutcomeswhileprovidingcareforolderadultpatientsinavarietyofcommunity-basedshortandlong-termsettings.[1,2,4,5,6,7,8]

20. Implementevidence-basedpracticethroughresearchonbestpracticesinthedeliveryofcareforthegerontologicpatient.[1,3,4,5,6]

21. Advocateforpatientsandfamilies.[3,4,5]22. Demonstratescomputerliteracyinaccessinginformationfromtheinternetrelated

tocoursecontent,clinicalpreparation,clinicaldocumentation,andpatientmanagement.[8]

23. InternalizedomainsoflearningwhenimplementingN339outcomes/competenciesthatincludeutilizingcriticalthinkingabilities,communicationskills,andtherapeuticnursinginterventionsto:a) Developandmaintaintherapeuticpatient/family/nurserelationshipsas

evidencedincommunication,careplan,instructionalconferencesandinterdisciplinaryteammeetings.

b) AdministerMentalStatusExaminations.[1]c) Conductfunctional(instrumentalandADL)assessments.[1,4,6]d) Conductahome,community,andcarefacilityassessmentforcontributing

factorsthatmayjeopardizethesafetyofolderadults.[1,4,7]e) Conductalifestory/reviewwitholderadult.[4]f) Activelyparticipateinservicelearningactivitiesinassignedagencies.[2,4,5]g) Developandpresentsensorystimulationprojectatseniorcitizencenter.[2,5]h) Performvenipuncturebyinsertinganintravenousneedlewithcannula.[4]

RequiredTextbooksandSupplies:Tablowski,PatriciaA.(2014).Gerontologicalnursing(3rded.),NewJersey:

Pearson/PrenticeHall.Scantronanswersheetsforexaminations(RedScantron–OneF-1712[8.5x11”]plusfiveF-289-PAR_LorX-101864-PAR-L[4.25x11”])SupplementaryTexts:Seo-Cho,J.M.(1999).Nursingprocessmanual:AssessmenttoolfortheRoyadaptationmodel.

Glendale,CA:PolarisPublishingCompany.

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CoursePolicies:SeeCollegeCatalog,NursingStudentHandbook,andCourseSyllabus.ClinicalEligibility:Tobeeligibleforclinicalattendanceallstudentsarerequiredtohavethefollowing:AmericanHeartAssociationProfessionalCPR,whichincludestrainingwithAED;BasicFirstAidCertificationorequivalent(e.g.EMTcertification);backgroundcheckclearance;currentTBtestorchestx-ray;positiverubella,varicella,rubeola,andhepatitisBtiters(orsignatureonappropriatedeclinationforms);currentinfluenzavaccine(unlessunavailable);physicalexaminationwithinthepasttwoyears;OSHAcertification;Fittesting;andcurrentpersonalliabilityinsurancefortheperiodoftimethatthestudentwillbeparticipatinginthiscourse.Printedcopiesofallmustbeprovidedinthehealthpacketaswellasactualresultsofalllaboratory,x-ray,andTBskinteststothestudent’sclinicalinstructorpriortothestudent’sattendanceatHomeHealth,adultdaycare,orassistedlivingplacementorthefirstdayofclinicalatthelongtermcarefacilityrotation.Inadditionallagencyrequiredtests,mustbecompletedandsubmittedtoyourclinicalinstructor.ForcompleteClinicalRequirements,seetheStudentHandbookonlineatwww.lahc.edu.Anybehaviorbyastudentthatputsthepatientinjeopardyorislifethreateningwillbeterminatedfromthecoursewithafailinggrade.AcademicDishonesty:TheDistrictAcademicDishonestyPolicy9803.28describesacademicdishonestyviolationsasfollows:“ViolationsofAcademicIntegrityinclude,butarenotlimitedto,thefollowingactions:cheatingonanexam,plagiarism,workingtogetheronanassignment,paperorprojectwhentheinstructorhasspecificallystatedstudentsshouldnotdoso,submittingthesametermpapertomorethanoneinstructor,orallowinganotherindividualtoassumeonesidentityforthepurposeofenhancingonesgrade.”AcademicdishonestywillnotbetoleratedintheNursingDivision.Forfurtherclarification,thenursingfacultyhasaddresseddefinitionsforthefourmajorformsofacademicdishonesty.

• Plagiarism-presentingtheworkofanotherasifitwerestudent’sownwork.Eachtimeasourceisutilized,acitationforthesourcemustbeincludedinthetextofthepaper.

• Cheating-engaginginanactofdeceptionwheneverbymisrepresentingmasteryofinformationonanacademicexercisethathasnotbeenmastered.

• Fabrication-falsifyingresearchorinventsinformationwiththeintenttodeceive.• Academicmisconduct-violationofcollegepolicies,tamperingwithgrades.

AttendancePolicy:Hoursforthisshort-termcoursearenotpro-ratedfromsemesterhours.Anabsenceofoneclinicdayoronelectureis“excessive”.Thecollegecatalogdefines“excessiveabsences”asabsencesinexcessofthehourstheclassmeetsinoneweek.Therearenounexcusedabsences.Reasonsforanexcusedabsencearelimitedtopersonalillness,deathofanimmediatefamilymemberorpersonalemergency.Astudentwhohas“excessiveabsences”mustmeetwiththeinstructortoassessthestudents’abilitytomastercontentandmeetthecourseobjectives.Astudentmayremaininthecourse,askedtowithdraworbefailed,asdecidedbythethirdsemesterfacultyteam.StudentsareNOTtobeabsent,andareremindedthatthestudentisresponsibleforallinformation,announcements,andlearningmaterialsgivenduringclassandclinicaltime.Studentsareexpectedtoarriveanddepartfromclassontime.Two(2)tardiesintheclassroomequaloneabsence.Absencesthatexceedspecifiedmaximummayresultinexclusionfromthecourseorreceivingan“F”grade.

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MathTestPolicy:Nonerequired.KaplanPolicy:NoKaplanrequiredatendofcourse.RemediationReadmissionPolicy:Ifastudentfailstocompletethiscoursewithapassinggrade,includingexitingthecoursebeforecompletionbyexclusionorawithdrawal,thestudentisrequiredtocompleteanExitInterviewwiththeclinicalinstructororleadinstructorandthenursingremediationcounselor.Tobereadmittedtotheprogram,thestudentmustcompleteaRRT&Crequestformandsubmittheform,totheDepartment’sAdministrativeSecretary.ThestudentrequestwillbeconsideredbytheRRT&CCommitteeandreadmissionwillbedeterminedbyeligibilityofcurrentadmissionpolicies,numberofpreviousexits,completionofanyrequiredremediation,andavailablespace.Readmissiontotheprogramisnotautomatic;studentsmustcompletetheprograminatimelymanner.Studentsoutoftheprogramfortwoormoresemestersmaybeaskedtodoremediationworkand/orrepeatpriorcoursescompleted.PleaserefertotheStudentHandbookfortheRRT&CPolicyandProcedureforthiscourse.CourseCreditChallengingPolicy:ThestudentwhosatisfiestheLosAngelesHarborCollegeandNursingDivisionrequirementsforreceivingCreditbyExaminationiseligibletochallengetheNursingN339theoryportionofthecourse,butnottheclinicalportion.ThestudentmustfulfilltheclinicalrotationforN339andchallengethetheoryportionwiththefollowingrequirements:Achievingaminimalscoreof75%foreachofthecourseunitsandfinalexaminationforN339(onthefirstattempt).*AlltestingmustbecompletedontheLosAngelesHarborCollegecampus,inatest-securedroomwithinthenursingbuilding,.Nomorethan1.5minutesareallottedforthecompletionofeachexamquestion.ThestudentisexpectedtohavecompletedtheCourseSyllabusmaterialsaspreparationforthechallengeexam,includingassignedreadingsdesignatedinthecourseunits.CollegeandDepartmentPolicies:SeeCollegeCatalog,andNursingStudentHandbook.BoardPolicies/Accommodations:1.NursingstudentsrequiringSPECIALACCOMODATIONSinacoursemustpresentofficialdocumentationofthetypeofaccommodationsrequiredtothenursingfaculty.2.BoardRule9803.12.Dishonesty,suchascheating,orknowinglyfurnishingfalseinformationtothecollege.Examplesofacademicdishonesty:Astudentcopiesfromanotherstudent,tohelpanacademicallyweakerstudentbyprovidinganswerstoatestorusing"crib"notes.3.BoardRule9803.14.Obstructionordisruptionofclasses,administration,disciplinaryprocedures,orauthorizedCollegeactivities.4.BoardRule9803.19.AlcoholandDrugs.AnypossessionofcontrolledsubstanceswhichwouldconstituteaviolationofHealthandSafetyCodesection11350orBusinessandProfessionalCodesection4230,anyuseofcontrolledsubstancethepossessionofwhichareprohibitedbythesame,oranypossessionoruseofalcoholicbeverages.

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5.TitleIX(ofthe1972EducationAmendments)protectsstudentsandstaffalikefromdiscriminationbasedonsex,includingSexualHarassmentandSexualAssault,whichareformsofSexualMisconduct.UnderTitleIX,allpeopleintheeducationalenvironmentmustbetreatedequitably,regardlessofsex,sexualorientationorexpression,and/ortransgenderidentity.IfyouhaveexperiencedorlearnedofapossibleviolationofTitleIXand/orwouldliketoknowaboutoptions,resources(includingconfidentialservices),thelaw,orDistrictpolicy,pleasedonothesitatetocontactaTitleIXCoordinator.

LAHCCampusTitleIXCoordinators:PeggyLoewyWellisch(310)233-4321loewywp@lahc.edu&DawnReid(310)233-4237reidd@lahc.eduDistrictTitleIXOffice:OfficeforDiversity,Equity,andInclusion(213)891-2315TitleIX@email.laccd.edu

PleaseseeLAHCCollegeCatalog(https://www.lahc.edu/classes/schedules.html) foralistingofallDistrictBoardRules.Also,refertotheStudentDisciplineProcedurefordueprocessfordisciplinaryissues,grievancesandthestudentappealprocess.AllstudentsarerequiredtoreadtheStudentNurseHandbook.TheStudentNurseHandbookcanbefoundonlineundertheLAHC–NursingProgramwebsite.CourseGrading:Thiscoursehas250points.Testsarebasedonunitlearningobjectives.Bothclinicallaboratory(field&IVcompetencytesting)andtheorymustbepassedtosatisfactorilycompletethiscourse.ü UnitI-HomeHealthExamination=20pts.ü ExamsforUnitIII(50pts.),IV(50pts.),andV(50pts.)ü FinalExamination=50pts.ü UnitII-IntravenousTherapyExamination=20pts.ü Selfevaluationpaperutilizingcriticalthinkingandthenursingprocess=10ptsGradeofA (100to90%) 250-225pointsGradeofB (89to81%) 224-202pointsGradeofC (80to75%) 201-187pointsGradeofD (74to60%) 186-150pointsGradeofF (59%andbelow) 149-0pointsTherearenoscheduledmake-upexams.StudentsareurgedtocontacttheInstructorpriortotheexam,ifmajorillnessrequiresmissinganexam.Thehighestgradeobtainableforanexamtakenafterthescheduledtestingdateis75%.Make-upexamsmaybemultiplechoice,fill-in,essay,orassessment/andorNursingCarePlansoracombinationofalltheabove.

HomeCareExamination:StudentsmustsuccessfullycompletetheHomeHealthExaminationwithavalueof20pointswith75%accuracypriortocommunity-basedrotations.Thescorefromthefirstexamwillbeaddedforthecoursegrade.Ifthestudentdoesnotpassthefirstattempt,theymustretaketheexamuntiltheypasswitha75%.ClinicalLabs:StudentsarerequiredtobeSATISFACTORYintheirclinicalworkregardlessoftheorygradetosuccessfullycompletethiscourse.CriticalOutcomes:Astudentmustreceivearatingof“satisfactory”inclinicinordertoPasstheclinicalcomponentbytheendofthecourse.RefertoHomeHealth–CommunityClinicalGuideandLongTermCare–ClinicalGuideforgradingcriteriaandevaluationtool(s)toidentifythatwhichearnsthestudenteithera“satisfactory”,“needsimprovement”or“unsatisfactory”inclinic.Studentsareresponsibleforallprocedureslearnedandpracticedinallpreviousnursingcoursesatasatisfactorylevel.Clinicalperformancewillhaveafinalgradeof“Satisfactory”or“Unsatisfactory”.Examscoresandclassroomperformancewilldeterminethefinalcoursegrade,iftheclinicalgradeis“Satisfactory”.

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Iftheclinicalgradeis“Unsatisfactory”,thehighestcoursegradethatcanbeearnedisaD.Note:A“D”isNOTaPassinggradeintheNursingProgram.LearningResources:

♦ CollegeorHospitalLibrary♦ ComputerLab♦ NursingLearningLab♦ LearningResourceCenterinMainLibrary♦ Internet♦ SimulationLab

HealthDatabasesforNursingStudents,www.medscape.com,www.guideline.govandwww.GeroNurseOnline.org.MethodsofInstruction:

♦ Selected/relatedreadings♦ Lectures♦ Discussion♦ Demonstrations♦ Videotapes,DVD’s,CD’s,films,etc.♦ Computer-AssistedInstruction♦ JournalArticles♦ Casestudies♦ Clinicalexperiences♦ CriticalThinkingandProblemSolvingExercises♦ Simulations,e.g.useofthe“experienceagingsuit”

StudyTime:TheCollegeexpectsaminimumofthreeormorehoursofstudyandpreparationbythestudentforeachhouroflectureandoneormorehoursofpreparationforeachhourofclinicallaboratory.Thismeansaminimumof13.5hours/weekofstudyforlectureandanaverageof13.5hours/weekofstudy/preparationforclinic.EvaluationMethod:NCLEXblueprintedexamsdesignedtomeasureknowledge,application,nursingjudgment,andcriticalthinking.Overallscoreof75%mustbeachievedWrittenassignments-requiredclinicalpapersassignedmustmeetspecifiedcriteria-seeclinicalgradingcriteria.ClinicalPerformance-seeevaluationofclinicalperformancepagefoundunder“clinicalmaterials”.CompliancewithCollege,NursingProgram,CoursePolicies,andapplicableFacilitypoliciestowhichthestudentisassigned.CourseEvaluation:TheN339courseevaluationwillbedoneonline.Thisevaluationmustbefilledoutduringthelastweekofthiscourse.Yourfeedbackisessentialifanyopportunityforpositivechangeistooccur.

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ClassEtiquetteAstudentenrollinginthenursingprogrammayrightfullyexpectthatthefacultyandadministratorswillmaintainanenvironmentinwhichthereisfreedomtolearn.Thisrequiresthattherebeappropriateconditionsandopportunitiesintheclassroom.

1. Notextingandcellphoneuseduringclasstime

2. Noelectronicdeviceswithtonesthatmaycauseclassdisruption

3. Nochildren,friends,orguestintheclassroom,stimulationlab,andclinicalsettings

4. Nofood/drinksintheclassroomatanytime(waterisokay)

5. Anyexcessivetalkingwillresultindismalofthestudentfromtheclass

6. Seatsmaybeassignedatthediscretionoftheinstructor

7. Notaping,recording,photographyorcomputerrecordingoftheclasswithoutpermission.

8. Pleasebringyourtextbooktoclass(forclassroomuse)asitwillbereferredtooften

9. Demonstrateprofessionalbehaviorsinclass,includingbutnotlimitedto:promptand

timelyarrivaltoclass,usingrespectfultone,language,attitude,Nofallingasleepinclass

10. Academicintegrityisexpectedbythecollegeandtheprofessorwillupholdthese

expectations.Anyviolationwillresultinzeropointsfortheexam/assignmentinquestion

andapossible1-2dayssuspensionfromtheclass.Beawarethatthismayresultinfailureof

thecourse

11. Theprofessormaydismissstudent(s)fromtheclassiftheyarebeingdisruptiveinanyway

12. DONOTseekinformationaboutthiscoursefrominappropriatesources.Ifyouhavea

questionabouttheclass,asktheprofessororclinicalinstructorsofrecord

13. Duringtesting,nocaps,hats,orlargesweatshirtsaretobeworn.Nobeveragecontainerson

thedesks.Allbelongingsmustbeplacedinadesignedareaoftheclassroom

14. Thetestingpolicyisincludedinthesyllabusandwillbefollowedwithoutexception

15. Anytalkingaftertheinstructorhasannouncedthatthetesthasofficiallybegun,willresult

in“zero”pointsforthetest.

AdoptedbyDr.FrancesEason,EdD,MSN,CNE,ANEFEastCarolinaUniversitySchoolofNursingRefertoLAHCStudentHandbookasneeded