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NATIONAL AMERICAN UNIVERSITY BLOOMINGTON CAMPUS BSN PROGRAM Nursing 3361: Holistic Nursing Care in Acute Illness I - Clinical

Spring 2010 Learning Plan 3 Clinical Day #3 -Safety Objective of the Course/Competency: 1. Examine the use of therapeutic communication skills in the development of therapeutic relationships with clients and families.
Knowledge and skills leading to mastery of this competency

a. Incorporate caring and healing techniques that promote a therapeutic nurse client relationship. b. Communicate effectively with the client and the clients support network. c. Maintain self-awareness and a reflective nursing practice. d. Complete a health history. e. Demonstrate the ability to report orally the information necessary to facilitate the continued nursing care of a client. 2. Demonstrate professional behavior by maintaining appropriate dress and demeanor, maintaining client confidentiality, and assuming accountability for own actions.
Knowledge and skills leading to mastery of this competency

a. b. c.

Demonstrate accountability for personal and professional behaviors. Incorporate the professional standards of moral, ethical, and legal conduct. Demonstrate professionalism, including attention to appearance, demeanor, respect for self and others, and attention to professional boundaries with clients and families as well as among caregivers d. Protect client privacy and confidentiality of client records and other privileged communications. e. Ensure that ethical standards related to data security, regulatory requirements, confidentiality, and clients right to privacy. 3. Incorporate the art and science of nursing when performing psychomotor skills, managing common symptoms and clients responses to interventions.
Knowledge and skills leading to mastery of this competency

a. b.

Examine the Patterns of Knowing. Provide compassionate, client-centered, evidence-based care that respects client and family preferences. c. Demonstrate the application of psychomotor skills for the efficient, safe, and compassionate delivery of client care. d. Implement evidence-based nursing interventions as appropriate for managing the acute care of clients across the lifespan. e. Implement holistic, client-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across the lifespan 1

. 4. Interpret health data from a culturally and age appropriate health assessment and focus on physiologic, developmental and behavioral patterns of client response to acute conditions and processes.
Knowledge and skills leading to mastery of this competency

a.

Complete a comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessment of health and illness parameters of acute care clients, using developmentally and culturally appropriate approaches. b. Assess health/illness beliefs, values, attitudes, and practices of individuals and their families. c. Discuss the critical thinking process of the professional nurse in health assessment. d. Identify a variety of measurements of growth and development across the age span. 5. Develop plans of care that are client and family centered using evidence to inform nursing actions.
Knowledge and skills leading to mastery of this competency

a. b.

Use behavioral change techniques to promote health and manage illness. Provide nursing care based on evidence that contributes to safe and high quality client outcomes. c. Facilitate client-centered transitions of care, including discharge planning and ensuring the caregivers knowledge of care requirements to promote safe care. d. Demonstrate the effective use the nursing process. e. Create an individualized, holistic and culturally appropriate nursing care plan and/or concept map. f. Practice client and family level nursing actions. 6. Communicate effectively the clients status and outcomes to others on the health care team.
Knowledge and skills leading to mastery of this competency

a. Use information and communication technologies to share client information. b. Communicate effectively with all members of the healthcare team. c. Use inter- and intraprofessional communication and collaborative skills to deliver evidence-based, client-centered care. d. Contribute the unique nursing perspective to interprofessional teams to optimize client outcomes. e. Report orally the information necessary to facilitate the continued nursing care of a client by any others involved. f. Record information necessary to maintain a record of nursing actions, client reactions to the care, and resulting client outcomes. 7. Apply ANA code of ethics to the care of clients with acute conditions/processes.
Knowledge and skills leading to mastery of this competency

a. Use an ethical framework to evaluate the impact of social policies on health care. b. Act to prevent unsafe, illegal, or unethical care practices. c. Analyze an ethical dilemma, citing ethical principles and a systematic approach or resolving the ethical dilemma. Overview: This clinical experience will build on the foundational concepts to provide holistic and culturally congruent nursing care for adult clients in a sub-acute and long-term care setting. This clinical 2

will place emphasis on learning the nursing actions necessary to manage clients who present with acute signs and symptoms. Students practice will be guided by clinical practice guidelines and standard policy and procedures, while learning to provide direct nursing care such as performing delegated medical treatments (medication administration, IV therapy, wound care, oxygen therapy, sterile technique, and surgical care). Students will be required to collect and interpret a variety of data to provide client and family centered care. Learning Activities: o Client Safety Environmental safety Physical hazards Transmission of pathogens o Nursing diagnosis Risk for falls Risk for injury Clinical Assessment Tool Attachment 1

Review: Perry and Potter (2009) Chapter 38 Review: http://www.jointcommission.org/NR/rdonlyres/B4558410-BD95-4B88-8BA232BBAE02A7F5/0/LTC_2010_NPSG.pdf Come to class prepared to discuss: Safety issues in the clinical site Environmental and physical hazards Prevention Post-class: Clinical paperwork Learning Objectives 1. Discuss the purpose of the National Patient Safety Goals 2. Describe how unmet basic physiological needs of oxygen, nutrition, temperature, and humidity threaten clients safety 3. Identify assessment activities designed to identify clients physical, psychosocial, and cognitive status as it pertains to their safety status 4. Identify nursing diagnoses associated with risks to safety

Clinical Assessment Tool Attachment 1 Patient


________Patient name outside of room ________Wrist band: Name verified with patient and DOB __ Picture of patient in MAR

Tubes and Lines

follow each line from patient to device, look at connections, amount of room to move, secured in place, and labels Oxygen _______Nares any skin breakdown _______Source flow rate______, ordered flow rate________ Feeding tubes (DH) _______Nares any skin breakdown _______Source label on bag________, dated_______ _______Irrigation set-up clean/dated________ Abdominal tubes _______Type: G-tube (input) Biliary tube (output) _______Site described in pathway_______, labeled________, bag attached_________ Tracheostomy _______Description of trach and size written on pathway _______Suction catheters available in room _______Extra trach tube available in room _______Obturator in sight _______Sterile water at bedside for trach care? Dated if opened__________ Foley _______Date of original insertion noted on pathway _______Tubing dependent and without loops _______Drainage bag below level of bladder IVs _______Site inspect for redness, swelling, warmth, tenderness, drainage _______Follow tubing to solution check connections________, label________ _______Solution Correct drug______, time_______, dose_______, route_______ Compare all of above to MAR/admin RX _______Pump: Green light_______ Plugged in to wall socket________

Environment
4

_______Side rails necessary? _______Bed in low position _______Call light working and within reach _______No obstacles/clutter at bedside or in route to bathroom _______No obstacles in route to sink _______No obstacles at bedside _______Patient assistive devices within reach i.e. glasses, hearing aids _______Correct date/nurse name on white board in patient room _______Water pitcher or glass available and clean _______Urinal at bedside _______Bathroom or Bedside commode emptied _______Trash receptacle available and within easy reach Questions for patient (5 minute sit-down) What would you like to see happen today? How would you describe your hospitalization Is there anything that could be done to make it better? What should nursing students know about what its like being a patient in the hospital?

Assessment Tool completed by_____________________________________________ Reviewed by (Reported to) ___________________________________________RN

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