THE UNIVERSITY OF TULSA
College of Business Administration
SCHOOL OF NURSING
Nursing Interventions II
COURSE SYLLABUS
Fall, 2006
Helen Hansen, R.N, PhD

COURSE NUMBER AND TITLE:   Nursing 3174 - Nursing Interventions II

NUMBER OF CREDITS:   4 Hours

ALLOCATION OF CREDIT:   Lab = 12 hours/week for 4 hours credit

PLACEMENT OF COURSE IN CURRICULUM:   Junior Year, Level II, Fall Semester

PREREQUISITE COURSES:   Nursing 2232, 2254, 2264, 2273; Biology 1054

COREQUISITE COURSES:   Nursing 3154 and 3164

COURSE DESCRIPTION:    Laboratory application of the concepts and principles from Applied Science II and Nursing Science II in the care of clients and families across the life span in acute care and community settings.

EXPANDED COURSE DESCRIPTION:   Roy's Adaptation Model nursing process is the basis for this laboratory course - providing experience in the acute health care institutions and in the community. In the course the student focuses on: 1) young, middle aged and aged adult adaptation in an acute care setting, and 2) family adaptation relative to the childbearing process in both the health care institution and the community.

The client's adaptation is promoted and maintained in the physiological, self-concept, role function, and interdependence modes in both health and illness. In the acute care setting, the student utilizes the nursing process in the care of clients during the childbearing process, in the care of young adults, middle aged and aged clients with adaptation problems of hospitalization; alteration in role; coping; grief and loss; pain; wound healing; infection/epidemiology; endocrine disruptions/pituitary; disruptions of circulation/shock and hemorrhage; disruptions of nutrition/ingestion, digestion, absorption and elimination; immobility and fluid, electrolyte and acid-base imbalances.

Research findings and principles of teaching and learning are used in the planning of nursing care. Psychomotor and communications skills related to the theoretical base are developed. The ANA Code for Nursing serves as a guide for performance standards of safe, efficient and effective care. Assumption of accountability and beginning development of leadership skills in patient care management are on-going during this experience.

COURSE OBJECTIVES:

Assessment

1. Collects data in an organized manner from culturally diverse individual, family and community clients in the four adaptive modes by selected techniques of physical assessment, observation and interviewing.
2. Obtains sufficient data to make sound clinical judgments by comparing the assessed data to norms to determine if behaviors are adaptive, adaptive-to-be-supported, or ineffective.
3. Interprets and explains how identified stimuli influence behaviors in each adaptive mode using scientific rationale.
4. Determines adaptive behaviors which require support and ineffective behaviors which require change through anticipatory guidance for health promotion and maintenance.

Diagnosis

5. Identifies priority nursing diagnoses using the adaptive, adaptive,-to-be-supported, or ineffective behaviors related to the focal stimuli.

Goal Setting

6. Establishes measurable outcome criteria for realistic short-term and long-term goals with
   client input and faculty assistance.

Intervention

7. Implements culturally sensitive interventions based on theoretical knowledge to manipulate identified stimuli to accomplish short-and long-term client goals.

8. Uses the Roy Model in problem solving.

9. Uses concepts of therapeutic interpersonal communication when interacting with clients.

10. Assists clients to adapt through preventive and promotive measures.

11. Demonstrates use of principles and concepts while performing skills safely.

12. Utilizes selected community resources to promote client/family adaptation.

13. Communicates and documents nursing care accurately and in a timely manner.

Evaluation

14. Uses stated outcome criteria to evaluate goal achievement and modify plan as needed.

Professionalism

15. Demonstrates responsibility in the care of assigned clients.

16. Functions as a member of the health team caring for assigned clients.

17. Demonstrates self-directed learning.

18. Presents self in a manner that promotes a positive image of nursing.

19. Identifies student role as a health care advocate.

20. Performs nursing actions within legal and ethical standards of care.

Revised 5/04

REQUIRED TEXTS:  JUNIOR LEVEL: 

American Psychological Association. (2001).  Publication manual of the APA (5th ed.)

Aschenbrenner , D. & Venable, S.  (2005).  Drug therapy in nursing.  Philadelphia:  Lippincott Williams & Wilkins.

Bandman, E. & Bandman, B.  (2002). Nursing ethics through the lifespan (4th ed.)  New Jersey: Prentice Hall.

Black, J. & Hawks, J.   Medical-surgical nursing (7th ed.). St. Louis: Elsevier Saunders.

Copstead, L. & Banasik, J.  (2005).  Pathophysiology (3^rd ed.).  St. Louis:  Elsevier Saunders.

Corbett, J. (2004).  Laboratory tests & diagnostic procedures (6th ed.).  Upper Saddle River, NJ:  Prentice Hall Health.

DeLaune, S. & Ladner, P.  (2002).  Fundamentals of nursing (2^nd ed.).  Albany, NY:  Delmar Thompson Learning.

Ebersole, P., Hess, P. Touhy, T. & Jett K.  (2005).  Gerontological nursing & healthy aging (2nd ed.). St. Louis:  Elsevier Mosby.

Fortinash, K. & Holoday-Worret, P.  (2004). Psychiatric mental health nursing.  St. Louis:  C.V. Mosby.

Gahart, B. (2006).  Intravenous medications (22^nd ed.).  St. Louis:  C.V. Mosby.  (PDA version available).  PDA version available.

Guido, G. (2006).  Legal & ethical issues in nursing. (4th ed.). New Jersey: Prentice Hall.

Hansen, H. (2006).  Syllabus for Nursing 3174 - Nursing Interventions II.  Tulsa:  The University of Tulsa.

Hockenberry, M., Wilson, D., Winkelstein, M. and Kline, N. (2003).  Wong’s nursing care of infants and children (7th ed.).  St. Louis:  C.V. Mosby.

Mauer, F. & Smith C.  (2005).  Community/public health nursing practice.  St. Louis: Elsevier Saunders.

Metheny, N.  (2000). Fluid & electrolyte balance.  Philadelphia:  J.B. Lippincott.

Olds, S., London, P. & Davidson, M.  (2004). Maternal-newborn nursing & women’s health care (7^th ed.). New Jersey:  Prentice Hall.

Purnell, L. & Paulanka, B.  (2003). Transcultural health.  Philadelphia:  F.A. Davis.

RECOMMENDED TEXTS:

Barkauskas, V. Baumann, L., Darling-Fisher, C.  (2002).  Health & physical assessment (3^rd ed).  St. Louis:  C.V. Mosby.

Buccholtz, S. and Henke, G.  (2006).  Med-math: Dosage calculation, preparation and administration (5th ed.). Philadelphia:  J.B. Lippincott.

Doenges, M. & Moorhouse, M.  (1999).  Maternal/newborn plans of care:  Guidelines for individualizing care (3^rd ed).  Philadelphia:  F.A. Davis. 

Doenges, M. & Moorhouse, M.  (2006).  Nursing care plans:  Guidelines for individualizing patient care (7^th ed).  Philadelphia:  F.A. Davis.

Lilley, L., Harrington, S. & Snyder, J.  (2005).  Pharmacology and the nursing process (4^th ed.).  St. Louis:  Mosby.

Rolfes, S., Pinna, & Whitney, E. (2006).  Understanding normal and clinical nutrition (7th ed.).  St. Paul, MN: Wadsworth-Thompson Publishing Co.

Roy, C. & Andrews, H. (1999).  The Roy adaptation model (2^nd ed.).  Norwalk:  Appleton-Lange.

Seo-Cho, J.  (1999).  Assessment tool for the Roy adaptation model.  California:  Polaris Publishing.

Smith, S., Duell, D. & Martin, B.  (2004).  Clinical nursing skills:  Basic to advanced. (6^th ed.). New Jersey:  Prentice Hall.

** Taber's Cyclopedic Medical Dictionary (20th ed.). Philadelphia:  F. A. Davis.

**Deglin, J. & Vallerand, A. (2005).  Davis’ drug guide for nurses (9^th ed.).  Philadelphia:  F.A. Davis.

**Wilson, B.; Shannon, M. & Strong, C. (2006). Nurses drug guide.  Norwalk, CT:  Appleton & Lange.

**PDA software from sophomore year 

METHOD OF TEACHING/LEARNING:  Utilize supervised clinical laboratory experiences in the hospital, community, and skills laboratory; pre and post conferences; case studies; teaching plans; and seminars.

METROLOGY: Demonstration of safe nursing care is a required competency for clinical performance. Each semester students must pass a Metrology and Safe Drug Administration exam with a 70% prior to entering the clinical areas and caring for patients. If the student is unsuccessful on the exam, she/he will have a maximum of 2 opportunities to retake a similar exam the following day. The student is responsible for remediation between the testings. If the student does not pass with a 70% or better by the third try she/he will be withdrawn from the course and will not be able to progress in the program.

GENERAL POLICY:  Clinical attendance and participation is expected. All course requirements must be completed to receive a grade. Students are to contact faculty prior to scheduled clinical if you will be tardy or absent. Absences may affect the student's ability to meet objectives. All course requirements must be completed to receive a grade.

CLINICAL ABSENCES AND TARDIES: For each day you are absent from clinical, 5 points may be deducted from your clinical grade and make-up will be at the discretion of the faculty. Additionally, two (2) points will accrue for each tardy and will be deducted from the final grade of the rotation. Written assignments may also be required by some faculty for tardies or absences.

The Skills exam is to be taken on the scheduled date unless prior approval is granted by the Course Coordinator. In the event an examination is not taken at the scheduled time, an essay test, short answer test or a major project may be substituted at the discretion of the faculty. The Skills Test review will be during clinical (within 2 weeks of exam date). If unable to attend the review, you must make an appointment with the Course Coordinator within 2 weeks of the exam.

ACADEMIC MISCONDUCT POLICY:  It is the responsibility of the student to read and honor the Academic Misconduct Policy listed in the yearly University Student Handbook.
SPECIAL EDUCATION OR PHYSICAL NEED:  If you have a special educational or physical need that requires class accommodations, please discuss your academic needs with the course coordinator and contact the Coordinator of Student Advocacy Services.

EVALUATION:  Demonstration of safe nursing care is a required competency for clinical performance. Students must make a grade of “C” or better in all three clinical rotations of medical-surgical, community and obstetrical. Laboratory grades will be given at the end of each fifth-week rotation and will consist of clinical performance evaluations. If a student makes a “D” or “F” in one of the clinical rotations, that grade will be given for the course. If the student elects to complete the clinical course and if the School of Nursing determines such continuation is appropriate, the student will be allowed to complete the course for the experience only. The clinical evaluation tool will not be completed by subsequent rotation faculty. Laboratory requirements will be discussed by each instructor in assigned clinical. Four clinical grades will make up the final course grade based on the following percentages:

CLINICAL GRADING CRITERIA:

Failing Range

1. Performed unsafe nursing practice. (See unsafe nursing practice statement.)
2. Violated clinical site/agency policy.
3. Consistently failed to meet the clinical objectives receiving a score below 70%.

*In order to pass NSG 3174 and progress, all course requirements must be completed and students must demonstrate selected critical behaviors earning a 70% or higher on the clinical evaluation tool, and provide nursing care which prevents real or potential harm to clients and/or their families.

*Skills Exam will cover all of the content covered in the Skills Lab the first two weeks of the semester.

In the course information section of WebCT, the student will find a clinical evaluation tool with percentage weights for each criterion. Students will be held responsible for behavior consistent with policies outlined in the Student Handbook. All course requirements must be completed.

CONCEPTUAL FRAMEWORK IMPLEMENTATION:  This laboratory experience provides the student with an opportunity to apply content from Applied Science II and Nursing Science II to the care of clients with selected acute psychological/physiological disruptions and to the child-bearing family utilizing the nursing process (Roy’s Adaptation Model) to promote adaptation.

UNSAFE NURSING PRACTICE

DEFINITION: Unsafe nursing practice is jeopardizing a client’s life, health or safety, engaging in unprofessional conduct, or violating the ethical code for nurses. Unsafe nursing practice is defined to include, but is not limited to, the following behaviors of a nursing student:
*Jeopardizing a client’s life, health, or safety by conduct that shall include but not be limited to the following:
 

1. Failure to supervise adequately the performance of acts by any person working at the nursing
   student’s direction; or

2. Delegating or accepting the delegation of a nursing function or prescribed health care function when the delegation or acceptance could reasonably be expected to result in unsafe or ineffective client care; or:

3. Unauthorized alterations of medications; or

4. Failure to utilize appropriate judgement in administering safe nursing practice based upon the expected level of nursing preparation.

5. Failure to exercise technical competence in carrying out nursing care; or

6. Performing new nursing techniques or procedures without proper education and preparation; or

7. Failure to report through the proper channels the unsafe or illegal practice of any person who is providing nursing care; or

8. Engaging in activities which do not fall within the realm of standardized nursing practice; or

9. Endangering the welfare of the client through own physiological or mental health status.

*Engaging in unprofessional conduct. Unprofessional conduct is nursing behavior (acts, knowledge, and practices) which fails to conform to the accepted standards of the nursing profession and which could jeopardize the health and welfare of the people which shall include but not be limited to the following:

1. Inaccurate recording, reporting, falsifying or altering client records; or

2. Verbally or physically abusing clients; or

3. Falsely manipulating drug supplies, narcotics or client records; or

4. Appropriating without authority medications, supplies or personal items of a client or agency; or

5. Falsifying documents submitted to the School of Nursing; or

6. Leaving a nursing assignment without properly advising appropriate personnel; or

7. Violating the confidentiality of information or knowledge concerning the client; or

8. Conduct detrimental to the pubic interest; or

9. Discrimination in the rendering of nursing services; or

10. Aiding and abetting the practice of practical nursing, registered nursing or advanced practice nursing by any person not licensed as a Licensed Practical Nurse or a Registered Nurse or recognized as an Advanced practitioner; or

11. Impersonating a licensed practitioner, or permitting another person to use his/her nursing student identification for any purpose; or

12. Aiding, abetting or assisting any other person to violate or circumvent any law or rule or regulation intended to guide the conduct of a nurse or nursing student.

13. Forging a prescription for medication/drugs; or

14. Presenting a forged prescription; or

15. Selling or attempting to sell a controlled dangerous substance or otherwise making such drugs available without authority to self, friends, or family members; or

16. While caring for a client, engaging in conduct with a client that is sexual or may be reasonably be interpreted as sexual, in any verbal behavior that is seductive or sexually demeaning to a client, or engaging in sexual exploitation of a client; or

17. Obtaining money, property or services from a client through the use of undue influence,
    Harassment, duress, deception or fraud; or

18. Engaging in fraudulent billing practices, including violations of federal Medicare and Medicaid laws or state medical assistance laws; or

19. Allowing own value system to interfere with client care/well-being.
    Demonstrating lack of nursing judgment in performing nursing interventions.
     

*Violating the ethical code for nurses which shall include but not be limited to the following:

1. Lack respect for human dignity and the uniqueness of the client, restricted by considerations of social or economic status, personal attributes, or the nature of health problems.

2. Fails to safeguard the client’s right to privacy.

3. Fails to act to safeguard the client and the public when health care and safety are affected by the incompetent, unethical, or illegal practice of any person.

4. Fails to assume responsibility and accountability for individual nursing judgments and actions.

5. Fails to exercise informed judgment and use individual competence and qualifications when seeking consultation, accepting responsibilities, and delegating nursing activities to others.

(Adapted from The Nurse Practice Act of the State of Oklahoma and the Code of Ethics by the American Nurses’ Association.)

A nursing student is a student and not a nurse and is therefore subject to the academic standards review of the Unsafe Nursing Practice Policy. A violation of the Unsafe Nursing Practice Policy is a violation of academic standards. Conduct which falls under the Unsafe Nurses Practice Policy may also be subject to disciplinary action under the applicable University of Tulsa conduct code.

SANCTIONS IMPOSED FOR UNSAFE NURSING PRACTICE:  If a nursing student demonstrates unsafe behavior, the nursing faculty may impose the following sanction(s):

    Immediate suspension from the setting.

Additional learning assignments designed by the faculty to contribute to the achievement of course objectives and change unsafe behavior.

Grade of "F" for course and dismissal from the School of Nursing.

Immediate dismissal from course.

Classroom/conference distractions are to be kept to a minimum. Students, who distract from the presentations and discussions, will be asked to leave the classroom. Personal talking in class/conference is disturbing to other students and faculty. Student(s) with mobile phones and/or pagers are required to 1) turn the device off, 2) select the flashing light option or 3) set phone/pager to vibrate.

Revised 5/00                 

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last update:  9/06/06