Merced College Registered Nursing Medical/Surgical Nursing ... · Merced College Registered Nursing...

Adapted from ©2012, Linda Caputi, Inc. T:\RN‐LVN‐Nursing\MyFiles\Nursing\RN\Forms\Clinical Eval\REGN 34_Clinical_Portfolio.doc

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Merced College

Registered Nursing 34:

Advanced Medical/Surgical Nursing and

Pediatric Nursing

Course Description, Student Learning

Outcomes and Competencies, Clinical

Evaluation Tool, and Clinical Activities

Portfolio

Prepared by

Linda Caputi, MSN, EdD, RN, ANEF, CNE

June, 2012


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Course Student Learning Outcomes and Competencies

The following course student learning outcomes and competencies represent

the overall behaviors the student is to accomplish by the end of the course. They will

build throughout the program to culminate in the program student learning outcomes

and competencies. The individual weeky units taught in the classroom specify the

specific content to be taught. As that content is taught it should be connected to the

course student learning outcomes and competencies; this puts the weekly “lesson”

content into the bigger perspective of your curriculum strucuture. The same is true for

the clinical experience. Therefore, the clinical evaluation tool (CET) is developed based

on these course student learning outcomes and competencies. Included with the CET

are clinical activities for each competency that provide students an opportunity to

demonstrate their ability to achieve that particular competency. This provides validity to

the CET. Grading rubrics are used for each activity so all faculty are grading students

using the same criteria and all students are aware of the criteria used to grade them.

This provides reliability to the CET. Grading rubrics are included, but faculty should

review these and revise if they believe the expected level of behaviors should be higher

or lower than indicated.

Students keep all the activities for the course in a 3‐ring binder known as a

clinical activity portfolio. Each of the 6 course outcomes can be divided into sections

with a page divider then all the activities for the competencies for each of the outcomes

are contained in the section for each that outcome. Some of the activities may be

completed as students provide traditional patient care. However, some of them may be

carried out as the only assignment for the day. Often two students work together on an

activity then discuss their findings in postconference.

It is most helpful to complete these clinical activities during clinical time with

feedback from the faculty during clinical time. This promotes active learning in the

context of the environment and the patient. Students can be asked to correct any errors


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while still in the environment where the information resides and with the faculty

available for feedback and discussion.

Please feel free to add, delete, or revise any of the clinical portfolio activities.

Nursing 34: Advanced Medical/Surgical Nursing and Pediatric Nursing

Registered Nursing 34 builds on REGN‐24, focusing on complex medical/surgical conditions of the adult patient and common pediatric conditions. Builds on nursing theory, communication, collaboration, and critical thinking skills necessary for safe, patient‐centered nursing care to developmentally and culturally diverse adult and pediatric patient populations. Incorporates best practices, professional standards, and legal and ethical responsibilities of the professional nurse as applied in the acute care and pediatric settings. Includes acquisition of nursing skills required in the acute care and pediatric settings. Application of knowledge and skills occurs in the nursing skills laboratory and clinical settings. Registered Nursing 34 Course Outcomes 1. Apply medical/surgical nursing concepts to plan patient‐centered, evidence‐based

care to pediatric patients and patients with complex medical/surgical conditions taking into consideration individual differences, developmental level, and culture.

2. Engage in collaboration with members of the interdisciplinary team when caring for pediatric patients and patients with complex medical/surgical conditions.

3. Demonstrate critical thinking and clinical reasoning when addressing patient care issues for pediatric patients and patients with complex medical/surgical conditions.

4. Differentiate various roles of leadership and how they impact patient care and quality improvement for pediatric patients and patients with complex medical/surgical conditions.

5. Demonstrate ways information technology can be used to increase safety and quality when caring for pediatric patients and patients with complex medical/surgical conditions.

6. Interpret ways in which professional standards of legal and ethical conduct are required for safe, quality care of pediatric patients and patients with complex medical/surgical conditions.

Course Outcomes and Competencies 1. Apply medical/surgical and pediatric nursing concepts to plan patient‐centered,

evidence‐based care to pediatric patients and patients with complex medical/surgical conditions taking into consideration individual differences, developmental level, and culture.

Relate physiological processes that require medical/surgical interventions to nursing care for adult and pediatric patients.


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Apply medical/surgical nursing concepts to plan compassionate, patient‐centered, evidence‐based care taking individual differences including growth and developmental stages into consideration.

Conduct a comprehensive and focused physical, behavioral, psychological, spiritual assessment of pediatric patients and patients with complex medical/surgical conditions, eliciting patient values, experiences, and expressed needs.

Plan holistic, patient‐centered care that reflects psychosocial integrity, physiological integrity, and health promotion and maintenance for pediatric patients and patients with complex medical/surgical conditions within a variety of healthcare systems.

Perform psychomotor skills for the efficient, safe, and compassionate delivery of nursing care to pediatric patients and patients with complex medical/surgical conditions.

Deliver care within expected timeframe. Monitor patient outcomes, including interpretation of assessment data and

appropriate follow‐up, to evaluate the effectiveness of nursing interventions for pediatric patients and patients with complex medical/surgical conditions.

Analyze the clinical microsystem of the medical‐surgical and pediatric units. Apply quality measures when evaluating effects of medical‐surgical and pediatric

nursing interventions appropriate to the care environment. Create a culture of caring for the patient and the patient’s support network. Communicate effectively with the patient and the patient’s support network. Communicate effectively when reporting care provided and evaluation data including

appropriate handoff reports. Evaluate own level of communication skills in encounters with patients, families,

children, and other healthcare providers. Employ patient teaching that reflects developmental stage, age, culture, spirituality,

patient preferences, and level of health literacy for pediatric patients and patients with complex medical/surgical conditions.

Evaluate effectiveness of patient teaching to pediatric and adult patients and families experiencing high‐acuity medical/surgical interventions.

Plan, implement, and evaluate evidence‐based care based on the components of research evidence, clinical expertise, and patient/family values.

2. Engage in collaboration with members of the interdisciplinary team when caring for

pediatric patients and patients with complex medical/surgical conditions. Use effective communication techniques that produce positive professional working

relations in the medical‐surgical and pediatric environments when caring for pediatric patients and patients with complex medical/surgical conditions.

Interact with members of the healthcare team to plan patient care based on patient values, preferences, and expressed needs for pediatric patients and patients with complex medical/surgical conditions.

Collaborate with the patient, the patient’s support network, and other members of the healthcare team to evaluate progress toward achievement of outcomes.


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Analyze the nurse’s role in decision making related to pediatric patients and patients with complex medical/surgical conditions.

Examine examples of conflict on the medical/surgical and pediatric units and describe possible resolutions.

Incorporate own role as a member of the interdisciplinary healthcare team when working with pediatric patients and patients with complex medical/surgical conditions.

Relate ways the interdisciplinary team functioning impacts safety and quality improvement for pediatric patients and patients with complex medical/surgical conditions.

3. Demonstrate critical thinking and clinical reasoning when addressing patient care

issues for pediatric patients and patients with complex medical/surgical conditions. Apply critical thinking/clinical reasoning skills when planning patient care and

working with pediatric patients and patients with complex medical/surgical conditions.

Demonstrate ambiguity and unpredictability when caring for pediatric patients and patients with complex medical/surgical conditions.

Interpret and correctly implement physician and inter‐professional orders for pediatric patients and patients with complex medical/surgical conditions.

Anticipate risks and predict and manage potential complications that may occur when caring for pediatric patients and patients with complex medical/surgical conditions.

Prioritize patient care activities. Identify gaps between local and best practice. Identify errors and ways to improve the healthcare system. 4. Differentiate various roles of leadership and how they impact patient care and

quality improvement for pediatric patients and patients with complex medical/surgical conditions.

Apply the delegation process in the care of pediatric patients and patients with complex medical/surgical conditions.

Compare and contrast the differences in the provision of patient care among various pediatric patients and patients with complex medical/surgical conditions.

Compare and contrast the nursing leadership and its effect on a medical‐surgical and pediatric unit.

Adapt the provision of patient care to changing healthcare setting and management system required for the safe care of pediatric patients and patients with complex medical/surgical conditions.

Describe the quality improvement processes on a pediatric and medical‐surgical unit used to effectively implement patient safety initiatives and monitor performance measures.

Apply the National Patient Safety Goals to patients on a pediatric and medical‐surgical unit and identify any areas in need of improvement.


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5. Demonstrate ways information technology can be used to increase safety and

quality when caring for pediatric patients and patients with complex medical/surgical conditions.

Maintain organizational and patient confidentiality. Use the clinical information system on the pediatric and medical‐surgical unit for safe

nursing practice. Analyze the role of information technology in improving patient care outcomes and

creating a safe care environment on the pediatric medical‐surgical unit. Use high quality electronic sources of healthcare information.

6. Interpret ways in which professional standards of legal and ethical conduct are

required for safe, quality care of pediatric patients and patients with complex medical/surgical conditions.

Apply rules and regulations that authorize and define professional nursing practice related to the care of pediatric patients and patients with complex medical/surgical conditions and their families.

Demonstrate professional standards of moral, ethical, and legal conduct when providing care for pediatric patients and patients with complex medical/surgical conditions and their families.

Assume accountability for own behaviors, including a recognition for when to ask for assistance.

Practice within the parameters of individual knowledge and experience.

Adapted from ©2012, Linda Caputi, Inc. T:\RN‐LVN‐Nursing\MyFiles\Nursing\RN\Forms\Clinical Eval\REGN 34_Clinical_Portfolio.doc 12/16/2016

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Registered Nursing 34: Advanced Medical/Surgical Nursing and Pediatric Nursing: Mid‐term and Final Clinical Evaluation Tool –

Scoring Sheet

Student: ____________________________________________Clinical Faculty: ___________________________________ S = Satisfactory NI = Needs Improvement U = Unsatisfactory (Must be Satisfactory by final evaluation)

Course Outcome Midterm Grade Final Grade

Evaluation Tool S NI U S U

1. Apply medical/surgical and pediatric nursing concepts to plan patient‐centered, evidence‐based care to pediatric patients and patients with complex medical/surgical conditions taking into consideration individual differences, developmental level, and culture. a. Relate physiological processes that require medical/surgical interventions to

nursing care for adult and pediatric patients. b. Apply medical/surgical nursing concepts to plan compassionate, patient‐

centered, evidence‐based care taking individual differences including growth and developmental stages into consideration.

c. Conduct a comprehensive and focused physical, behavioral, psychological, spiritual assessment of pediatric patients and patients with complex medical/surgical conditions, eliciting patient values, experiences, and expressed needs.

d. Plan holistic, patient‐centered care that reflects psychosocial integrity, physiological integrity, and health promotion and maintenance for pediatric patients and patients with complex medical/surgical conditions within a variety of healthcare systems.

e. Perform psychomotor skills for the efficient, safe, and compassionate delivery of nursing care to pediatric patients and patients with complex medical/surgical conditions.

f. Deliver care within expected timeframe. g. Apply quality measures when evaluating effects of medical‐surgical and

pediatric nursing interventions appropriate to the care environment. h. Create a culture of caring for the patient and the patient’s support network.

a. Pathophysiology of a Disease Process and Planning Table b, c. Collecting data for Patient Centered Care d. No tool for this competency; completed with 1a e. Psychomotor Skills Reflection Sheet f. No tool for this competency; faculty observation. g. Evidence‐based Care with the RN h. Create a Caring Outcome Grid

Course Outcome Midterm Grade Final Grade Evaluation Tool


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S NI U S U

i. Communicate effectively when reporting care provided and evaluation data

including appropriate handoff reports.

j. Evaluate own level of communication skills in encounters with patients,

families, children, and other healthcare providers.

Employ patient teaching that reflects developmental stage, age, culture,

spirituality, patient preferences, and level of health literacy for pediatric

patients and patients with complex medical/surgical conditions.

k. Communicate effectively with the patient and the patient’s support network.

Evaluate effectiveness of patient teaching to pediatric and adult patients and

families experiencing high‐acuity medical/surgical interventions.

l. Plan, implement, and evaluate evidence‐based care based on the

components of research evidence, clinical expertise, and patient/family

values.

i. SBAR Patient Report j, k. Patient Teaching Tool l. Using Evidence‐Based Guidelines Evaluation of Skills Performance Tool

2. Engage in collaboration with members of the interdisciplinary team when

caring for pediatric patients and patients with complex medical/surgical

conditions.

a. Use effective communication techniques that produce positive professional

working relations in the medical‐surgical and pediatric environments when

caring for pediatric patients and patients with complex medical/surgical

conditions.

b. Interact with members of the healthcare team to plan patient care based on

patient values, preferences, and expressed needs for pediatric patients and

patients with complex medical/surgical conditions.

c. Examine examples of conflict on the medical/surgical and pediatric units and

describe possible resolutions.

d. Relate ways the interdisciplinary team functioning impacts safety and quality

improvement for pediatric patients and patients with complex

medical/surgical conditions.

a. Communication as Perceived by the Patient b. Teamwork for Planning Care c. Conflict Resolution d. Informed Consent


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Course Outcome

Midterm Grade Final Grade


3. Demonstrate critical thinking and clinical reasoning when addressing patient care issues for pediatric patients and patients with complex medical/surgical conditions. a. Apply critical thinking/clinical reasoning skills when planning patient care and

working with pediatric patients and patients with complex medical/surgical conditions.

b. Demonstrate ambiguity and unpredictability when caring for pediatric patients and patients with complex medical/surgical conditions.

c. Interpret and correctly implement physician and inter‐professional orders for pediatric patients and patients with complex medical/surgical conditions.

d. Anticipate risks and predict and manage potential complications that may occur when caring for pediatric patients and patients with complex medical/surgical conditions.

e. Prioritize patient care activities. f. Identify gaps between local and best practice. g. Identify errors and ways to improve the healthcare system.

a, b, c. Applying Critical Thinking d, e. Predict and Manage Potential Complications f, g. The Joint Commission's Roadmap for Hospitals

4. Differentiate various roles of leadership and how they impact patient care and quality improvement for pediatric patients and patients with complex medical/surgical conditions. a. Apply the delegation process in the care of pediatric patients and patients

with complex medical/surgical conditions. b. Compare and contrast the nursing leadership and its effect on a medical‐

surgical and pediatric unit. c. Adapt the provision of patient care to changing healthcare setting and

management system required for the safe care of pediatric patients and patients with complex medical/surgical conditions.

d. Describe the quality improvement processes on a pediatric and medical‐surgical unit used to effectively implement patient safety initiatives and monitor performance measures.

e. Apply the National Patient Safety Goals to patients on a pediatric and medical‐surgical unit and identify any areas in need of improvement.

a. Delegation Tool b. Nursing Leadership and Safe, Quality Patient Care c. Adapting Care d. Nursing‐Sensitive Quality Indicators e. National Patient Safety Goal Activity

Course Outcome

Midterm Grade Final Grade



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5. Demonstrate ways information technology can be used to increase safety and quality when caring for pediatric patients and patients with complex medical/surgical conditions. a. Use the clinical information system on the pediatric and medical‐surgical unit

for safe nursing practice. b. Analyze the role of information technology in improving patient care

outcomes and creating a safe care environment on the pediatric medical‐surgical unit.

c. Use high quality electronic sources of healthcare information.

a, b. Using the Clinical Information System c. Electronic Sources of Healthcare Information

6. Interpret ways in which professional standards of legal and ethical conduct are required for safe, quality care of pediatric patients and patients with complex medical/surgical conditions. a. Apply rules and regulations that authorize and define professional nursing

practice related to the care of pediatric patients and patients with complex medical/surgical conditions and their families.

b. Demonstrate professional standards of moral, ethical, and legal conduct when providing care for pediatric patients and patients with complex medical/surgical conditions and their families.

c. Assume accountability for own behaviors, including a recognition for when to ask for assistance.

d. Practice within the parameters of individual knowledge and experience.

a, b. Moral, Ethical, Legal, and Professional Standards Observation Rubric c, d. Accountability Observation Rubric

Additional Comments:


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REGN 34 Grade _____________________

C.T. Tool Completion _________________

Expired Immunization ________________

Skills Check Off _____________________

Clinical Performance:

Signatures: Midterm Evaluation Date: ______________________

Student____________________________________________

Faculty ____________________________________________

REGN 34 Grade _____________________

C.T. Tool Completion _________________

Expired Immunization ________________

Skills Check Off _____________________

Clinical Performance:

Signatures:

Final Evaluation Date: _______________________

Student______________________________________________

Faculty ______________________________________________


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The following pages contain the Clinical Activity Portfolio Tools for Advanced Medical/Surgical Nursing and Pediatric Nursing Course Student Learning Outcome #1. Course Student Learning Outcome #1: Apply medical/surgical and pediatric nursing concepts to plan patient‐centered, evidence‐based care to pediatric patients and patients with complex medical/surgical conditions taking into consideration individual differences, developmental level, and culture.


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Course Student Learning Outcome #1, Competency: a. Relate physiological processes that require medical/surgical interventions to nursing care for adult and pediatric patients. Tools: Pathophysiology of a Disease Process and Planning Table


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Medical Surgical Patient Pathophysiology of a Disease Process and Planning Table

Medications & Treatments Disease

Pathophysiology

*** START HERE ***

Risk Factors

Nursing Diagnoses Diagnostic Tests

Signs & Symptoms/ Risk Factors


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Using the information in the previous tools, answer the following questions: What care will you plan related to the patient’s level of growth and development? What care will you provide related to the pathophysiology? What care will you provide related to pharmacology? What care will you provide related to the medical management of this patient? What evidence‐based nursing interventions will you plan into the patient's care? Then, complete this Planning Table:

Nursing interventions Related to the above Questions Expected outcomes from the nursing interventions for THIS patient


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Grading Rubric for Planning Table

Performance Level

S

NI

U

Plans nursing interventions based on completed tools.

Identifies > 5 nursing interventions based on completed tools.

Identifies 3‐4 nursing interventions based on completed tools.

Identify less than 2 nursing interventions based on completed tools.

Analyzes data and derives expected outcomes based on individual patient data.

Develops > 3 expected outcomes based on individual patient data.

Develops 1 or 2 expected outcomes based on individual patient data.

Unable to develop expected outcomes based on individual patient data.


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Course Student Learning Outcome #1, Competencies: b. Apply medical/surgical nursing concepts to plan compassionate, patient‐centered, evidence‐based care taking individual differences including growth and developmental stages into consideration. c. Monitor patient outcomes, including interpretation of assessment data and appropriate follow‐up, to evaluate the effectiveness of nursing interventions for pediatric patients and patients with complex medical/surgical conditions.

Tool: Collecting data for patient centered care

Assignment: Students in all areas of care should review the patient’s chart. Review the patient’s history and related conditions.

Address the following with patient data: Medical/Surgical Pediatrics

Age of the patient

Cultural background, beliefs, Socioeconomic status

Approach to nursing care based on: Behaviors that are age and developmental level appropriate, those that are not

Acute & Chronic conditions

Extent of family involvement: who is present? How much involvement does that person have with the patient? Is that person close, distant, wanting to learn?


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Approach to teaching based on patient/family characteristics

How will you individualize the care for your patient based on this data?

Compare and contrast the care of similar cases. What was done the same? What was done differently and why?

Type of medical insurance, any limitations related to medical insurance


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Rubric for Collecting Data for Patient‐Centered Care

Performance Level

S

NI

U

Compare and contrast care of similar cases

Able to compare and contrast care of similar cases

Able to correctly compare and contrast care of similar cases with some of the information, but not all information.

Unable to compare and contrast care of similar cases


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Course Student Learning Outcome #1, Competency: e. Perform psychomotor skills for the efficient, safe, and compassionate delivery of nursing care to pediatric patients and patients with complex medical/surgical conditions.

Tool: Psychomotor Skills Reflection Sheet

Date

Skill

How the performance of this skill varied from the textbook explanation and why

the adaptation was needed.

How performance of this skill varied for the

pediatric patient. How I believe I performed.

Ways I can improve.

Oral Medications

LPAT

I.V. Medications


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Rubric for the Psychomotor Skills Reflection Sheet

Performance Criteria

S

NI

U

Demonstrates competent and safe nursing care.

Clearly describes how the psychomotor skill was performed, evaluates self performance, and offers 2 ways for improvement.

Able to describe how the psychomotor skills was performed but with limited insight to problems on self performance. Offers one way to improve performance.

Descriptions of performance of psychomotor skills are scant and unorganized. Does not offer ways to improve future performance.


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Course Student Learning Outcome #1 Competency: g. Apply quality measures when evaluating effects of medical‐surgical and pediatric nursing interventions appropriate to the care environment. Tool: Evidence‐based care with the RN Activity: 1. Work with your staff RN leader. 2. The student will observe the RN performing one nursing intervention (e.g. changing a dressing, educating a patient on a specific

topic, assessing one or more vital signs). Students are encouraged to NOT make medication administration a focus of this activity. 3. As soon as possible after the observation, ask the RN the questions listed in the box below. Be sure to be non‐judgmental and

thank the RN for assisting you with this activity. You might also offer to share the conclusions from the class discussion on this topic after it occurs.

4. Locate and review the policies, procedures or standards available in that clinical setting related to the intervention you observed and answer the second set of questions listed below.

Are there policies/protocols/procedures that define practice standards for this intervention?

Are there references to research or evidence used to determine the standards?

Did the RN you observed perform the intervention according to those standards?

5. Using the information search strategies you have learned previously, locate the best published evidence regarding

recommendations related to the intervention you observed and complete the third set of questions below.

How difficult was it for you to locate quality, relevant, timely evidence?

How do the policies/protocols/procedures compare with the best evidence you located?

How does the observed RN’s performance compare with the best evidence you located?

6. Reflect on your activity by answering:

What did you learn?

How will you use the lessons learned?

What more do you need to learn about evidence‐based nursing practice?

How does this evidence‐based practice experience relate to quality improvement?

What quality improvement processes are used on the pediatric unit? How do they relate to patient safety?


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Rubric for Evidence‐based care with the RN in Pediatric Rotation

Performance Level

S

NI

U

Tool completion. All areas of the tool are completed.

Able to, but not all, areas of the tool are completed.

Unable to complete the tool.

Relates the evidence‐based practice interventions to quality improvement.

Able to relates the evidence‐based practice interventions to quality improvement.

Makes some relationship but not complete.

Unable to relates the evidence‐based practice interventions to quality improvement.

Rubric for Evidence‐based care with the RN in Medical/Surgical Rotation

Performance Level

S

NI

U

Tool completion. All areas of the tool are completed.

Able to, but not all, areas of the tool are completed.

Unable to complete the tool.

Relates the evidence‐based practice interventions to quality improvement.

Able to relates the evidence‐based practice interventions to quality improvement.

Makes some relationship but not complete.

Unable to relates the evidence‐based practice interventions to quality improvement.


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Course Student Learning Outcome #1 Competency: h. Create a culture of caring for the patient and the patient’s support network. Tool: Create a Caring Outcome Grid Observe the workings of the unit and the interactions of the RN and staff with the patient and the patient’s response.

Indicator of Caring Behaviors

Example of the caring behavior by the nurse/staff

Examples of violations of the caring behavior by the

nurse/staff

Compare and contrast the caring environment of the

Medical/Surgical unit with the Pediatric unit

Med/Surg.

Pediatrics


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Rubric for Create a Caring Outcome Grid ‐ Pediatrics

Performance Level

S

NI

U

Answers all questions on the tool.

Accurately answers all questions on the tool.

Able to answer some, but not all, of the questions on the tool.

Unable to accurately answers all questions on the tool.

Compares the medical/surgical unit with the pediatric unit.

Completely and accurately compares the medical/surgical unit with the pediatric unit.

Makes some comparisons but misses some important aspects.

Unable to compare the medical/surgical unit with the pediatric unit.

Rubric for Create a Caring Outcome Grid – Medical/Surgical

Performance Level

S

NI

U




Unable to accurately answers all questions on the tool.






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Course Student Learning Outcome #1 Competency: i. Communicate effectively when reporting care provided and evaluation data including appropriate handoff reports. Tool: SBAR Patient Report Situation Include basic demographics about your patient; name, ethnicity. age, gender, and pertinent information about the patient’s condition/situation. Include patient preferences.

Patient Name: Code Status: VS: Outputs: IVs/fluids: Abnormal/concerns:

Background patient’s admitting diagnosis, hospital day, medical history that might complicate her current admission, any data about what has led up to any problems the patient is currently experiencing.

Pertinent background information affecting the patient’s current condition. Other history that is also present and may or may not affect current condition but needs to be considered.

Assessment Signs and symptoms that are related to patient’s diagnosis, including vital signs, O2 Sats, and any other pertinent assessment data.

Mental Status: Alert and oriented Confused Cooperative or non‐cooperative Agitated or combative Lethargic but conversant and able to swallow Stuporous and not talking clearly and possibly not able to swallow Comatose. Eyes closed. Not responding to stimuli Skin:


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Should correlate with the information on the signs and symptoms tools.

Warm and dry Pale Mottled Diaphoretic Extremities are cold Extremities are warm Patient is or is not on oxygen: L/min or oxygen for min(hrs) Pulse ox reading What you think the problem is: The pt is Stable, unstable, getting worse

Recommendations Include what you have done and the patient’s response.

I suggest that you: Any diagnostic labs/test needed/pending: Need to notify the physician or primary healthcare provider:


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Grading Rubric for the SBAR Patient Report

Performance Criteria S NI U

Informs responsible staff member of patient status.

Clearly completes the SBAR report for a patient. All criteria are documented on and are easy to understand and follow.

Clearly completes portions of the SBAR report for a patient. Some criteria do not have documentation and/or and are not easy to read.

The SBAR report is scant and/or unorganized. It is difficult to understand.


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Course Student Learning Outcome #1 Competencies: j. Employ patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and level of health literacy for pediatric patients and patients with complex medical/surgical conditions. k. Evaluate effectiveness of patient teaching to pediatric and adult patients and families experiencing high‐acuity medical/surgical interventions. Tool: Patient Teaching Tool Refer to your pathophysiology tool. Plan teaching related to the needs identified on your concept map?. _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ What modifications will you need to make related to your teaching methods based on the patient’s developmental stage, age, culture, preferences, and level of health literacy? _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ Teach your patient. Was your teaching effective? If so, how do you know? If no, how do you know and what will you do? _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________ _____________________________________________________________________________________________________


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Grading Rubric for the Patient Teaching Tool

Performance Level

S

NI

U

Identifies teaching needs.

In depth explanation of patient's learning needs.

Explanation includes some but not all of patient's learning needs.

Brief explanation of patient's learning needs.

Explains modifications to teaching based on patient's developmental stage, age, culture, spirituality, patient preferences, and level of health literacy.

In depth explanation of necessary modifications to teaching based on patient's developmental stage, age, culture, spirituality, patient preferences, and level of health literacy.

Explanation includes some but not all necessary modifications to teaching based on patient's developmental stage, age, culture, spirituality, patient preferences, and level of health literacy.

Brief explanation of necessary modifications to teaching based on patient's developmental stage, age, culture, spirituality, patient preferences, and level of health literacy.

Evaluates effectiveness of teaching.

In depth explanation of effectiveness of teaching.

Explanation includes some but not all issues related to the effectiveness of teaching.

Brief explanation of the issues related to the effectiveness of teaching.


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Course Student Learning Outcome #1 Competency: l. Plan, implement, and evaluate evidence‐based care based on the components of research evidence, clinical expertise, and patient/family values. Tools: Using Evidence‐Based Guidelines: Core Measure Sets The Joint Commission: i.e., VTE, PNE, HF, MI… Individualize care based on best current evidence in practice and patients’/families’ preferences and values. Describe reliable sources for locating evidence reports and clinical practice guidelines. Activity:

Access an Internet source used by the agency to locate a national agency with guidelines related to your patient (ie, American Heart Association Guidelines, American Diabetes Association, etc.)

Access the agency’s Intranet source they have for clinical guidelines. Select the pertinent guidelines.

Review your textbook related to care for this patient

Review the appropriate guidelines with the patient’s chart to see how closely the guidelines are followed.

Note if there are variances and find our why there are variances.

Key recommendations of guidelines

Adherence to guidelines or variation

Reasons for variance (Pt preference, physical or other conditions)

RN responsibility to patient and his or her prescribed plan of care


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Grading Rubric for Using Evidence‐Based Guidelines


Completed table with information from evidence‐based guidelines

Completed all aspects of table noting evidence‐based guidelines.

Completed some, but not all, aspects of table. Able to note evidence‐based guidelines.

Unable to complete the table and unable to located evidence‐based guidelines.


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The following pages contain the Clinical Activity Portfolio Tools for Advanced Medical/Surgical Nursing and Pediatric Nursing Course Student Learning Outcome #2. Course Student Learning Outcome #2: Engage in collaboration with members of the interdisciplinary team when caring for pediatric patients and patients with complex medical/surgical conditions.


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Course Outcome #2 Competency: a. Use effective communication techniques that produce positive professional working relations in the medical‐surgical and pediatric environments when caring for pediatric patients and patients with complex medical/surgical conditions. Tool: Communication as Perceived by the Patient This tool reflects information from HCAHPS, which stands for Hospital Consumer Assessment of Health Providers and Systems which is a government survey for measuring patient satisfaction at hospitals across the country. The HCAHPS survey provides information from the patient’s perspective regarding hospital care, including communication among the healthcare team. This tool builds on the work of HCAHPS and focuses on communication:

Interview direct‐care RN or Unit Manager regarding continuous efforts to improve patient satisfaction. o How can nurses improve communication with the patient and with other healthcare providers.

o What are the barriers to communication and how can they be managed?

o How can patients be reassured of staff responsiveness?

o How can student nurses assist with patient satisfaction related to communication?

o What role does the "Patient Board" play in clear communication that results in positive professional working relations?

o What lessons can you derive from the above answers that you can use to improve your practice as a nurse?


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Grading Rubric for the Communication as Perceived by the Patient


Questions answered Answered all questions clearly and completed.

Answered most questions clearly and completed.

Unable to answer all questions.

Lessons learned Lessons learned are clear, practical, and easy to implement.

Lessons learned are superficial and/or not necessarily helpful.

Unable to draw conclusions related to lessons learned.


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Course Outcome #2 Competency: b. Interact with members of the healthcare team to plan patient care based on patient values, preferences, and expressed needs for pediatric patients and patients with complex medical/surgical conditions.

Tool: Teamwork Collaboration for Planning Interdisciplinary Care Answer the following questions considering how they relate to the healthcare team working to plan patient care based on the individual patient.

1. Who are the members in the interdisciplinary care team?

2. How can the team improve the patient’s hospital stay (i.e., safety, quality, satisfaction) based on information gathered in number one?

3. What safety considerations come to mind given this patient’s age, developmental level, current diagnosis, medical history, and problems?

4. How can other members of the healthcare team contribute toward enhancing the patient’s hospital experience?

5. What lessons can be derived from the above relating to planning care that focuses on the individual patient's needs?


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Grading Rubric for the Teamwork for Planning Care


Questions answered Answered all questions clearly and completed.

Answered most questions clearly and completed.

Unable to answer all questions.

Lessons learned Lessons learned are clear, practical, and easy to implement.

Lessons learned are superficial and not necessarily helpful.

Unable to draw conclusions related to lessons learned.


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Course Outcome #2 Competencies: c. Examine examples of conflict on the medical/surgical and pediatric units and describe possible resolutions. Tool: Conflict Resolution

Interview a Nurse and One Other Healthcare Provider to Identify An Area of Conflict on the

Unit

Ask the Nurse and Healthcare Professional How the Conflict was

Resolved

Observe the Interactions of the

Healthcare Professionals on the

Unit

What Conflicts did you Observe and How were they Handled or Not

Handled

Compare and Contrast Your Findings on the Two Units:

Pediatric and Medical/Surgical Units

Med/Surg.

Pediatrics


39

Grading Rubric for the Conflict Resolution – Medical Surgical

Grading Rubric for the Conflict Resolution – Pediatric


S

NI

U

Conflict identified on the unit.

Clearly describes a conflict on the unit.

Description of a conflict on the unit are is vague and unclear.

Unable to describe any conflicts on the unit.

Suggestions for how to resolve the conflict.

Clearly and accurately describes solutions for resolving the identified conflict.

Identifies some but not all possible solutions for resolving the identified conflict.

Unable to describe solutions for resolving the identified conflict.






S

NI

U

Conflict identified on the unit.

Clearly describes a conflict on the unit.

Description of a conflict on the unit are is vague and unclear.

Unable to describe any conflicts on the unit.

Suggestions for how to resolve the conflict.

Clearly and accurately describes solutions for resolving the identified conflict.

Identifies some but not all possible solutions for resolving the identified conflict.

Unable to describe solutions for resolving the identified conflict.






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Course Outcome #2 Competency: d. Relate ways the interdisciplinary team functioning impacts safety and quality improvement for pediatric patients and patients with complex medical/surgical conditions. Tool: Informed Consent Assure the patient has given informed consent for treatment. (Informed consent requires team of the nurse and other professionals working together to ensure safe performance of a procedure that requires consent from the patient or the patient’s guardian.) Answer the following Questions:

1. Who is legally responsible to educate and discuss the risks and benefits to the patient?

2. Who is legally eligible to sign consent?

3. What considerations come into play for a minor, under age 18, signing consent?

4. When a patient is admitted to a hospital what consent forms are obtained?

5. When a nurse “witnesses” consent what does it indicate?


41

Grading Rubric for Informed Consent


S

NI

U

Identifies the nurse's role on the interdisciplinary team related to informed consent.

Clearly and accurately describes the nurse's role on the interdisciplinary team related to informed consent.

Identifies some but not all roles of the nurse on the interdisciplinary team related to informed consent.

Unable to describe the nurse's role on the interdisciplinary team related to informed consent.

Describes how team functioning impacts patient outcomes related to safety and quality improvement measures.

Clearly and accurately describes how team functioning impacts patient outcomes related to safety and quality improvement measures.

Identifies some but not all ways team functioning impacts patient outcomes related to safety and quality improvement measures.

Unable to describe how team functioning impacts patient outcomes related to safety and quality improvement measures.


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The following pages contain the Clinical Activity Portfolio Tools for Advanced Medical/Surgical Nursing and Pediatric Nursing Course Student Learning Outcome #3. Course Student Learning Outcome #3: Demonstrate critical thinking and clinical reasoning when addressing patient care issues for pediatric patients and patients with complex medical/surgical conditions.


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Course Outcome #3 Competencies: a. Apply critical thinking/clinical reasoning skills when planning patient care and working with pediatric patients and patients with complex medical/surgical conditions. b. Demonstrate ability to deal with ambiguity and unpredictability when caring for pediatric patients and patients with complex medical/surgical conditions. c. Interpret and correctly implement physician and inter‐professional orders for pediatric patients and patients with complex medical/surgical conditions. Tool: Applying Critical Thinking On another sheet of paper address the following:

Introduction:

Describe a nursing situation you encountered this week.

Background:

Describe your relationship to the patient at the time you noticed the situation (e.g., previous contact with patient and /or family, the quality of your relationship).

Consider experiences you have had that helped you provide nursing care in this situation. Describe your formal knowledge (e.g., physiology, psychology, communication skills), previous nursing experience with a similar problem, and/or personal experiences that helped guide you as you worked with the patient.

Describe your role as the nurse working in this situation.

Describe any emotions you had about the situation.

What physician/inter‐professional orders were written focused on this condition and how will you implement nursing actions related to these order?


44

Noticing:

What did you notice about the situation initially?

Describe what you noticed as you spent more time with the patient and /or family.

Interpreting:

Describe what you thought about the situation (e.g., its cause, potential resolutions, patterns you noticed).

Describe any similar situations you have encountered in practice before. Describe any similarities and differences you observed when compared with the current situation.

What other information (e.g., assessment data, evidence) did you decide you needed as you considered the situation? How did you obtain this information? What help with problem solving did you get from your professional partner?

Your conclusion: What did your observations and data interpretation lead you to believe? How did they support your response to the situation? Include pertinent pathophysiology and/or psychopathology.

Responding:

After considering the situation, what was your goal for the patient, family, and /or staff? What was your nursing response, or what interventions did you do? List all actions that you took.

Describe stresses you experienced as you responded to the patient or others involved in the situation.

Reflection‐in‐Action

What happened? How did the patient, family and/or staff respond? What did you do next?

Reflection‐on‐Action and Clinical Learning

Describe three ways your nursing care skills expanded during this experience.

Name three things you might do differently if you encountered this kind of situation again.

What additional knowledge, information and skills do you need when encountering this kind of situation or a similar situation in the future?

Describe any changes in your values or feelings as a result of this experience.

This reflection tool is adapted from Tanner’s Clinical Judgment Model: Tanner, C.A. (2006) Thinking Like a Nurse: A research‐based model of clinical judgment in nursing. Journal of Nursing Education, 45, 204‐211.


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Rubric for Applying Critical Thinking ‐ Pediatrics

Rubric for Applying Critical Thinking – Medical/Surgical


S

NI

U

Clear and accurate answers to all questions on tool.

Clearly and accurately answers all questions on tool.

Clearly and accurately answers some but not all questions on tool.

Unable to clearly and accurately answers all questions on tool.


S

NI

U

Clear and accurate answers to all questions on tool.

Clearly and accurately answers all questions on tool.

Clearly and accurately answers some but not all questions on tool.

Unable to clearly and accurately answers all questions on tool.


46

Course Outcome #3 Competencies: d. Anticipate risks and predict and manage potential complications that may occur when caring for pediatric patients and patients with complex medical/surgical conditions. e. Prioritize patient care activities. Tool: Predict and Manage Potential Complications

For each patient answer these questions:

1. What are you on alert for today with this patient? 2. What are the important assessments to make? 3. What complications may occur? What could go wrong? 4. What interventions will prevent complications? 5. How will you prioritize implementation of nursing interventions? Explain.


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Rubric for Predict and Manage Potential Complications Pediatrics

Rubric for Predict and Manage Potential Complications Medical/Surgical


Able to identify the potential complications.

Clearly identifies potential complications.

Description of potential complications for this patient is scant.

Unable to identify potential complications.

Able to identify the important assessment data to monitor for this patient.

Clearly identifies the important assessment data to monitor for this patient.

Description of the important assessment data to monitor for this patient is scant.

Unable to identify the important assessment data to monitor for this patient.

Able to identify all factors influencing the most important data to monitor.

Clearly identifies all factors influencing the most important data to monitor.

Description of all factors influencing the most important data to monitor is scant.

Unable to identify the most important data to monitor.

Able to prioritize planned interventions.

Clearly identifies ways to prioritize planned interventions.

Superficially discusses ways to prioritize planned interventions.

Unable to prioritize planned interventions


Able to identify the potential complications.

Clearly identifies potential complications.

Description of potential complications for this patient is scant.

Unable to identify potential complications.

Able to identify the important assessment data to monitor for this patient.

Clearly identifies the important assessment data to monitor for this patient.

Description of the important assessment data to monitor for this patient is scant.

Unable to identify the important assessment data to monitor for this patient.

Able to identify all factors influencing the most important data to monitor.

Clearly identifies all factors influencing the most important data to monitor.

Description of all factors influencing the most important data to monitor is scant.

Unable to identify the most important data to monitor.

Able to prioritize planned interventions.

Clearly identifies ways to prioritize planned interventions.

Superficially discusses ways to prioritize planned interventions.

Unable to prioritize planned interventions


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Course Outcome #3 Competencies: f. Identify gaps between local and best practice. g. Identify errors and ways to improve the healthcare system. Tool: The Joint Commission’s Roadmap for Hospitals This assignment can be completed by 10 students working in groups of 2 for a day on the unit. There will be no traditional patient care assignment on that day. Divide Chapter 6 in the Roadmap (obtained from the Joint Commission's website) with one group looking at: 1. Leadership 2. Data Collection and Use 3. Workforce 4. Provision of Care, Treatment, and Services 5. Patient, Family, and Community Engagement The groups will analyze the unit and compare how it is run to the recommendations in the Roadmap. Use the information in Chapter 6 as a guide for making your assessment. Compare and contrast the recommendations to the unit’s activities. Provide own recommendations on how to correct deficiencies. Report in post‐conference.


49

Rubric for The Joint Commission’s Roadmap for Hospitals

.


S

NI

U

Analysis of unit compared to recommendations in the Roadmap.

Clearly and accurately compares the working of the unit with that in the Roadmap.

Analysis of the working of the unit with that in the Roadmap is scant.

Unable to analyze the working of the unit with that in the Roadmap.

Identifying gaps and identifying ways to improve the healthcare system.

Clearly and accurately identifies gaps and ways to improve the healthcare system.

Explanation of gaps and ways to improve the healthcare system is scant.

Unable to identify gaps and ways to improve the healthcare system.


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The following pages contain the Clinical Activity Portfolio Tools for Advanced Medical/Surgical Nursing and Pediatric Nursing Course Student Learning Outcome #4. Course Student Learning Outcome #4: Differentiate various roles of leadership and how they impact patient care and quality improvement for pediatric patients and patients with complex medical/surgical conditions.


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Course Outcome #4 Competency: a. Apply the delegation process in the care of pediatric patients and patients with complex medical/surgical conditions. Tool: Delegation Tool Today you are the RN and you have an LVN and a CNA working with you. Obtain the following information on three patients (obtain from report, medication record, care plan, chart, etc): 1. Visit each patient and perform a quick (2‐minute) assessment of the patient and the patient’s environment. 2. Identify and prioritize the health care needs for each patient and give rational:

Use the ABCD prioritization model: A (absolutely now), B (better get to in the first hour) C (can wait for a few hours) D (can delegate) prioritization method.

Patient Diagnosis Patient Data

Primary 2 min assessment

Nursing Interventions Prioritized

To whom will you delegate these interventions and why

What info will you provide to ensure interventions are carried out safely

What info do you expect back from them

1

2

3


52

Rubric for the Delegation Tool Medical/Surgical


S

NI

U

Data collection

Data collection for all important information is complete and accurate.

Data collection for all important information is somewhat complete and almost all are accurate.

Data collection for all important information is incomplete and/or inaccurate.

Questions related to delegation All delegation questions are clearly and completely answered.

Superficially answers all delegation questions.

Unable to answer clearly and completely all delegation questions.


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Course Outcome #4 Competency: b. Compare and contrast the nursing leadership and its effect on a medical‐surgical and pediatric unit. Tool: Nursing Leadership and Safe, Quality Patient Care Participate in change of shift Charge Nurse Report meet at 0630 to assigned floor Activity: Identify the nursing leadership positions in the institution. Locate the job descriptions for those positions. Observe the interactions of the nurse leaders on the unit then complete the table. This table can be completed over the course of a few weeks. Complete the following:

Job Title

Major Responsibilities

Observed Interactions with Others: (list, ie, RN, CNA,

etc.)

Your Perception of the interactions of the nurse leaders with the staff. Effective? Ineffective?

Compare the leadership on this unit with that on other

units assigned in this course.

Hospital Supervisor

Department Manager

Charge Nurse

Staff Nurse


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Rubric for Nursing Leadership and Safe, Quality Patient Care


S

NI

U

Provides accurate observations about the interaction of the nursing staff.

Clearly provides accurate observations about the interactions of the nursing staff.

Explanation of observations about the interactions of the nursing staff is scant.

Unable to explain interactions of the nursing staff.

Explain the effect of nursing leadership on improved patient safety and quality care.

Able to explain the effect of nursing leadership on improved patient safety and quality care.

Superficially discusses the effect of nursing leadership on improved patient safety and quality care.

Unable to discuss the effect of nursing leadership on improved patient safety and quality care.


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Course Outcome #4 Competency: c. Adapt the provision of patient care to changing healthcare setting and management system required for the safe care of pediatric patients and patients with complex medical/surgical conditions. Tool: Adapting Care Under each column discuss what is typical for that aspect of the clinical microsystem for the medical/surgical unit and for the pediatric unit. Then discuss how differences influence the nurse’s care on the pediatric unit.

Adult medical/surgical unit Pediatric unit Modifications to nursing care based on the regulations governing the pediatric unit

Access to the unit

Who is allowed to visit

Visiting hours

Restrictions on what can be brought onto the unit

Nurse to patient ratio

Etc, etc,


56

Rubric for Adapting Care


S

NI

U

Clear and accurate responses to all items on tool.

Clearly and accurately addresses all items on tool.

Clearly and accurately answers some but not all items on tool.

Unable to clearly and accurately addresses all items on tool.


57

Course Outcome #4 Competency: d. Describe the quality improvement processes on a pediatric and medical‐surgical unit used to effectively implement patient safety initiatives and monitor performance measures. Medical/Surgical John Hopkins Fall Assessment and Braden Skin Assessment performed every clinical day. Tool: Nursing‐Sensitive Quality Indicators

What are nursing sensitive quality indicators on the pediatric and

medical/surgical units?

What nursing

sensitive quality measures apply to your patient?

How are the nursing sensitive quality

indicators measured?

What screening tools are used?

What prevention measures and precautions are implemented for your patient?

Pediatrics

PEWS Assessment

Pediatrics

Skin Assessment


58

Rubric for Nursing‐Sensitive Quality Indicators

Performance Level

S

NI

U




Unable to accurately answer all questions on the tool.


59

Course Outcome #4 Competency: e. Apply the National Patient Safety Goals to patients on a pediatric and medical‐surgical unit and identify any areas in need of improvement. Tool: National Patient Safety Goal Activity 1. Research the Joint Commission’s safety initiatives for the hospital and any other environment you will be experiencing in clinical. 2. Identify ways the healthcare agency addresses these safety goals. 3. Identify ways the agency may improve upon application of each safety goal.

Safety goal:

How agency addresses this

goal:

An improvement may be:

Medical/Surgical

Medical/Surgical

Pediatrics

Pediatrics


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Rubric for National Patient Safety Goal Activity


S

NI

U

Identifies the NPSG most applicable to this patient.

Clearly identifies the NPSG most applicable to this patient.

Scantly identifies the NPSG most applicable to this patient.

Unable to identify the NPSG most applicable to this patient.

Explains if the safety goals are being met, and if not, explains what to do to correct the situation.

Able to explain if the safety goals are being met, and if not, explains what to do to correct the situation.

Superficially explains if the safety goals are being met, and if not, superficially explains what to do to correct the situation.

Unable to explain if the safety goals are being met, and if not, explains what to do to correct the situation.






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The following pages contain the Clinical Activity Portfolio Tools for Advanced Medical/Surgical Nursing and Pediatric Nursing Course Student Learning Outcome #5. Course Student Learning Outcome #5: Demonstrate ways information technology can be used to increase safety and quality when caring for pediatric patients and patients with complex medical/surgical conditions.


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Course Outcome #5 Competencies: a. Use the clinical information system on the pediatric and medical‐surgical unit for safe nursing practice. b. Analyze the role of information technology in improving patient care outcomes and creating a safe care environment on the pediatric medical‐surgical unit. Tool: Using the Clinical Information System

Review the EMR Activity

Note any areas of difficulty in obtaining patient history, data or pertinent information from medical record. Also note what was easy to navigate.

Gather information about your patient. Where needed include trends in results and most current, pertinent information in order to develop a plan of care.

Answer these questions: 1. Describe the computer information system on the unit. How does its use contribute to safe nursing care? 2. Discuss how missing data on admission and inconsistencies in documentation affect the accuracy of the information being used to make

clinical decisions in the healthcare setting. What information was missing for your patient and how did that affect safe nursing practice? 3. Discuss the benefits of having access to advanced technology in the healthcare setting, such as Electronic Medical Records and

Computerized Order Entry. 4. What is the nurses’ obligation and accountability to ensuring proper documentation of clinical data to support coordination of care.

Reflections: 1. Summarize your impression of the importance of technology in patient care. 2. How will you use technology to provide safe patient care?


63

Grading Rubric for Using the Clinical Information System


S

NI

U

Summarize your impression of the importance of technology in patient care.

Summary reflects information gathered on the tool.

Scantly summarizes information gathered on the tool.

Unable to summarize information gathered on the tool.

Discuss how will you use technology to provide safe patient care.

Able to discuss how technology is used to provide safe patient care.

Superficially discusses how technology is used to provide safe patient care.

Unable to discuss how technology is used to provide safe patient care.


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Course Outcome #5 Competency: c. Use high quality electronic sources of healthcare information. Tool: Electronic Sources of Healthcare Information Identify an area of nursing care you would like to investigate to learn more as you plan care for your patient today. Conduct an internet search and locate a site with the information you are searching. Complete the table.

Factors to Consider

Comments on that Factor

Will you use this information after considering each

factor?

How will you use this information in planning your patient's care?

Source of the Website

Currency of site

Relevance of the site

Site evaluation (explain if you find the site credible; why or

why not)

Purpose of the website

Accuracy of content

Completeness of content


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Grading Rubric for Electronic Sources of Healthcare Information

Performance Level

S

NI

U

Completes all sections of the tool.

Accurately completes all sections of the tool.

Able to complete some, but not all, all sections of the tool.

Unable to complete all sections of the tool.

Synthesis of information Synthesizes the information to determine how to use the information to plan care.

Able to relate care planning to some of the information learned from the electronic sources.

Unable to synthesize the information to determine how to use the information to plan care.


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The following pages contain the Clinical Activity Portfolio Tools for Advanced Medical/Surgical Nursing and Pediatric Nursing Course Student Learning Outcome #6. Course Student Learning Outcome #6: Interpret ways in which professional standards of legal and ethical conduct are required for safe, quality care of pediatric patients and patients with complex medical/surgical conditions.


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Course Student Learning Outcome #6 competencies:

a. Apply rules and regulations that authorize and define professional nursing practice related to the care of pediatric patients and patients with complex medical/surgical conditions and their families.

b. Demonstrate professional standards of moral, ethical, and legal conduct when providing care for pediatric patients and patients with complex medical/surgical conditions and their families.

Provide examples of how you satisfactorily met this competency each day you cared for patients:

Provide examples of how you satisfactorily met this competency

Medical/Surgical

Pediatrics

Define Moral Conduct

Define Ethical Conduct

Define Legal Conduct


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Tool: Moral, ethical, legal, and professional standards observation rubric

Behavior

Satisfactory

Needs Improvement

Unsatisfactory

Demonstrates application of the professional standards of moral, ethical, and legal conduct in the care of children and patients experiencing medical/surgical interventions.

Applies professional standards and moral, ethical, and legal conduct in the care of children and patients experiencing medical/surgical interventions with no supporting verbal/physical cues.

Applies some but not all professional standards and moral, ethical, and legal conduct in the care of children and patients experiencing medical/surgical interventions and requires supporting verbal/physical cues.

Unable to apply professional standards and moral, ethical, and legal conduct in the care of children and patients experiencing medical/surgical interventions.


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Course Student Learning Outcome #6 competencies:

c. Assume accountability for own behaviors, including a recognition for when to ask for assistance. d. Practice within the parameters of individual knowledge and experience.

Provide examples of how you satisfactorily met this competency may apply to psychomotor skills Reflection Sheet.

Define Accountability

Apply Accountability to Medical/Surgical

Rotation

Apply Accountability to Pediatrics Rotation

Tool: Accountability Observation Rubric

Behavior

Satisfactory

Needs Improvement

Unsatisfactory

Assumes accountability for personal and professional behaviors, including a recognition of when to ask for assistance and recognizing limits of own individual knowledge and experience in the care of children and patients experiencing medical/surgical interventions.

Assumes accountability for personal and professional behaviors, including a recognition of when to ask for assistance and recognizing limits of own individual knowledge and experience in the care of children and patients experiencing medical/surgical interventions with no supporting verbal/physical cues.

Assumes some accountability for personal and professional behaviors, including a recognition of when to ask for assistance and recognizing limits of own individual knowledge and experience in the care of children and patients experiencing medical/surgical interventions. Requires supporting verbal/physical cues.

Unable to assume accountability for personal and professional behaviors, including a recognition of when to ask for assistance and unable to identify limits of knowledge and experience in the care of children and patients experiencing medical/surgical interventions.

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