Clinical Teaching Plan And Schedule Of Activities PDF

MINDANAO STATE UNIVERSITY COLLEGE OF HEALTH SCIENCES MARAWI CITY THE CARE OF CLIENTS WITH LIFE THREATENING CONDITIONS INTENSIVE CARE UNIT (RLE) Nsg. 128.5 CLINICAL TEACHING PLAN AND SCHEDULE...

MINDANAO STATE UNIVERSITY COLLEGE OF HEALTH SCIENCES MARAWI CITY THE CARE OF CLIENTS WITH LIFE THREATENING CONDITIONS INTENSIVE CARE UNIT (RLE) Nsg. 128.5 CLINICAL TEACHING PLAN AND SCHEDULE OF ACTIVITIES CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 1 Republic of the Philippines Mindanao State University COLLEGE OF HEALTH SCIENCES 9700, Marawi City THE CARE OF CLIENTS WITH LIFE THREATENING CONDITION INTENSIVE CARE UNIT (RLE) Nsg. 128.5 CLINICAL TEACHING PLAN SECTION: B5, C1, C2, C3, C4, C5, E3 Room: ICU - APMC DATE: Monday, Tuesday, Wednesday (2 weeks) TIME: 07:00 AM – 03:00 PM (August 26 -28 and September 02 - 04, 2024) CHS Vision: The College of Health Sciences envisions to be the leading college in the country offering various health (paramedical) programs with excellence, undertaking community extension, research and health services, committed to the health development of the global community. CHS Mission: The College of Health Sciences shall be providing a continuous opportunity for quality higher education in the field of nursing to the global community for them to be capable of inculcating values of health and sanitation, prevent illness, and alleviate suffering, cure and rehabilitate the infirmed and the handicapped. College Objectives: 1. To continue offering high quality and relevant, programs in health. 2. To develop new programs to meet the health needs of the people in the global community. 3. To act as catalyst through its graduate students and college manpower inculcating values of health, sanitation, health promotion, illness prevention and alleviation of suffering of the infirmed and handicapped. 4. To conduct health research studies and make data available to concerned or involved population in order to spur health and development. 5. To engage in extension and consultancy, health manpower training and other services that would support the growth of the community. Institutional Outcome: Practice social transformation through excellence in research, extension, instruction, peace education, innovation and collaboration. Values / Attributes of Graduates: Social Transformation, Peace, Competence /Excellence in Instruction, Research, Extension, Innovation, Collaboration. CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 2 Course Title : NURSING 128.5 - THE CARE OF CLIENTS WITH LIFE THREATENING CONDITION - INTENSIVE CARE UNIT (RLE) Course Credit : 3 units (48 HOURS) Placement: 4TH Year, First Semester Course Outcomes: At the end of the course, a group of learners will be able to utilize the nursing process in the care of individuals, families in Critical Care Unit, assess with client/s his/her/their condition/health status, through interview, physical examination, interpretation of laboratory findings, identify actual and potential nursing diagnosis, plan appropriate nursing interventions with client/s and family for identified nursing diagnosis, implement plan of care with client/s and family and evaluates the progress of his/her/their client’s condition and outcomes of care. -Clinical practice Learning Outcomes: At the end of the course and given relevant actual or simulated situations/conditions, the student will be able to: a. Perform thorough and systematic assessments of critically ill patients, including physical, psychosocial, and environmental factors. b. Assess and manage critically ill patients, including monitoring vital signs, interpreting lab results, and recognizing signs of deterioration. c. Demonstrate the ability to prioritize care based on the acuity and urgency of patient needs. d. Demonstrate proficiency in airway management techniques, including endotracheal intubation and care, tracheostomy care and suctioning. e. Recognize and respond to respiratory distress and failure promptly. f. Participate in the Code Blue call and perform cardiopulmonary resuscitation efficiently. g. Administer medications commonly used in the ICU, including high-alert drugs, and understand their effects and potential complications. h. Demonstrate other procedures in the unit such as NGT feeding, Urinary catheter insertion and care, etc. i. Efficienty monitor and record patient’s input and output. j. Promote safety and comfort for both patients and significant others. k. Maintain skin integrity of all patients at all times (adhering to the ICU turning schedule). l. Effectively communicate with patients, families, and members of the healthcare team. m. Advocate for patients' rights and participate in ethical decision-making processes. Grading System Daily Efficiency 30% Terminal Efficiency 20% Case Presentation 20% Project/Requirements 20% Long Exam (Pre & Post test) 10% 100 Passing rate: 75% CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 3  POLICIES AND GUIDELINES A. Uniform  Going to the hospital: School uniform with white closed shoes and white socks for female and duty uniform for male with nameplate and school ID; civilian attire is not allowed. Must only wear prescribed white duty shoes paired with plain white socks.  Inside the ICU: Blue scrub suit under the prescribed PPE gown with nameplate, disposable bonnet (for male and female students not wearing veil/mukna) and white socks with OR/any slippers used in the clinical setting.  Wearing the attire outside the area is prohibited. If the student wishes to go out of the area, he/she must change into school uniform and/or he/she must wear a smock gown over the scrub suit if within hospital premises. B. Attendance Policy 1. The student must attend the orientation during the exposure. NO ORIENTATION, NO EXPOSURE POLICY applies. 2. The orientation is usually conducted in the hospital on the day 1 of the exposure. This activity involves being oriented to the agency’s MVGO, history, rules and regulations, hospital policies, physical set up, organizational charts, personnel and staff, health services, etc. 3. The student must arrive at the area 30 minutes before the duty in appropriate prescribed uniform. 4. Arriving within fifteen (15) minutes after the Pre-Con has already started, a student is considered tardy/late (Refer to the Student Handbook for Sanctions for Tardiness). 5. Arriving beyond thirty (30) minutes after the Pre-con has already started, a student is considered absent. Extension duty policies applies. 6. Absences will only be permitted if with a valid reason. (Extension duty policies applies.) An absence may be considered excused for the following reasons: A. Illness (if accompanied by a medical certificate issued by the attending physician) B. Accidents C. Death of an immediate relative (1st degree consanguinity only) D. Natural disasters and calamities C. ICU Duty Paraphernalia 1. Sphygmomanometer and Sthethoscope 6. Tape measure 11. Towels and Bath soap / Kidney Basin 2. Digital Thermometer 7. Pulse Oximeter 12. Medication Tray / Medication cup 3. Sterile Gloves and Clean Gloves 8. Hypoallergenic Plaster 13. NANDA 4. Bandage Scissors 9. Black ballpens 14. Cotton balls in a clean container (wet and dry) 5. Pen light 10. Drug Handbook 15. Tuning Fork / Reflex Hammer CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 4 D. Requirements in the ICU Duty A. Activity Notebook with (uniform cover page) with Comprehensive General Objectives and 15 daily Specific Objectives covering cognitive, affective, and psychomotor (5 each domain) B. Daily FDAR (total of three (3)) C. 3 priority NCPs D. Drug oral revalidation during medication preparation and administration E. Bedside Conference F. Case presentation / Case Sharing on the last day of the clinical Exposure H. Reflective Narrative Report (Format: Learning Insights, Difficulties Encountered, Resolution & Evaluation of the rotation, group mates, team leader, Clinical Instructor, and individual performance). I. Summative Evaluation (Pre-test and Post-test) Contents of the Case Sharing: a. Patient’s Profile / Past and Present Medical History b. Summary of Medications and IV Fluids c. Disease Process / Ideal and Actual Pathophysiology E. Medication/ Invasive Procedures Policies 1. Under any circumstance, student nurses are not allowed to give medications and perform invasive procedures without the supervision of the Clinical Instructor or any Licensed Nursing/Medical Staff of the unit. 2. The medication policy of Amai Pakpak Medical Center and the Rights of Medication Administration must be followed. 3. All PO or parenteral medications must be checked for accuracy by the clinical instructor or licensed nursing staff before administration. 4. Proper health teaching and/or giving of pertinent information (about the medication and its possible side effects/ procedure and it’s importance) must be provided to the patient prior to medication administration and/or performance of an invasive procedure. F. Common ICU Medications 50% Dextrose Diphenhydramine Midazolam Adenosine Dobutamine Naloxone Amiodarone Dopamine Norepinephrine Atropine Sulfate Epinephrine Omeprazole Calcium Gluconate Heparin Pantoprazole Captopril Hydrocortisone Phenytoin Citicoline Isosorbide Dinitrate Potassium Chloride CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 5  Dexamethasone Ketorolac Sodium bicarbonate Diazepam Lidocaine Vitamin K Digoxin Magnesium Sulfate Warfarin Enoxaparin Mannitol Nicardipine Insulin (NPH, Regular) Anti-infectives Furosemide  The following are the common medications present in the Intensive Care Unit but is not limited to the medications mentioned above. G. Common ICU Concepts and Procedures:  Head-to-toe Assessment  Glasgow Coma Scale, FOUR Score, Pain Scale (Numerical and Behavioral)  Advance Cardiac Life Support (ACLS)  ABG analysis  Basic of Mechanical ventilator (Functions, Set-ups, & Settings)  Medication preparation and 14 rights of drug administration  Drug Calculations  NGT Feedings  Endotracheal Tube & Oral suctioning  Tracheostomy Care Prepared by: Prof. DIONIELEE APRIL D. SANORIA, MAN (c), RN, Prof. JAMAL TANGO P. ALAWIYA, MAN, MAEd, LPT, RN CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 6  CLINICAL ROTATION SCHEDULE DATE ACTIVITIES TIME FRAME EXPECTED OUTPUT DAY 1 A. General orientation & Pre-Conference  Individual General Objectives / Specific  Arrival 06:30 Objectives  Introduction Phase - Students and CI 06:40  Pre - test  Checking of attendance, uniform and paraphernalia  Designation of team leader for the day  Individual patient’s list of medications  Introduction to the ICU supervisor, nurses and other personnel 07:00 (notebook)  Discussion of policies and guidelines for the whole Exposure 07:30  Orientation to the General Set-up of the unit.  Initial V/S, I/O Record, Initial Assessment  Orientation to the Cardiac Monitor, Mechanical Ventilator, IV Infusion Pump (Notebook) and other machines and instruments used in the ICU  Patient’s chart orientation, proper charting / documentation a) Kardex b) ICU Vital Signs, GCS, Input and Output Monitoring Sheet c) Medication Summary Sheet and Medication Administration Sheet d) Nurse’s Notes e) HGT Monitoring Sheet f) Doctor’s order g) Other parts: Laboratory reports, Summary of IV, etc.  Discussion for the Requirements for the whole clinical exposure and grading scheme B. Lunch Break  The group will be divided into 2 11:30 - 12:30 1st six - 11:30 - 12:00 2nd six - 12:00 - 12:30 C. Patient Loading  Patient allocation 12:30- 02:30  Vital signs taking  Initial health assessment and history taking  Priority problem identification and FDAR making  Bedside Care  Familiarization of the patient’s medication  Viewing of patient’s chart (Checking of Medical Diagnosis, Medications, CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 7  Laboratory and Diagnostic Findings) D. Pre - test (student lounge) 02:30 - 03:00 E. Post - Conference  Evaluation by the CI  Selecting cases for the Case Presentation / Case Sharing activity (per pair)  Sharing of expectations for the duty the next day  Designation of the team leader for the next day DAY 2 A. Pre-Conference  Individual General Objectives / Specific  Arrival 06:30 Objectives  Checking of attendance, uniform and paraphernalia  List of Common ICU Medications - Crash B. Endorsement Cart (notebook) (at least 15) (Drug Name,  Attending the nurse’s endorsement and individual nurse’s rounds 06:40 Classification (P/T), Indication, Nursing C. Bedside Care Responsibilities) - to be submitted on the  Vital signs monitoring and assessment for any changes in the patient’s status 07:00 - 09:00 last day of the rotation.  Implementation of Nursing care plan  Nursing Procedures (Morning care and maintenance of hygiene, NGT Feeding,  FDAR to be checked on the third day Turning, Suctioning, Oral Care, Tracheostomy care, changing of bed linens if necessary, HGT monitoring as ordered, Routine ECG Checking)  Individual patient’s list of medications  Monitoring Input and Output (notebook)  Continuous Nursing Care and assessment  Initial V/S, I/O Record, Initial Assessment D. Medication Familiarization and Preparation for the Drug Defense 09:00 - 10:00 (Notebook)  Medication Administration in the ICU has an interval of 2 hours for individual patients (Medication Schedule: 08:00, 10:00, 12:00 and 02:00 respectively  Initial drug defence of common as per the unit’s standards) medications  Review of the Medications to be given to the patient.  Observance of the 14 Rights of Medication Administration  Drug defense will be done during the medication preparation and administration as the case applies. F. Review of the following Concepts: 10:00 - 11:00  Basic ECG Interpretation  Input and output Monitoring  Basic ABG Interpretation  GCS and Four point Scoring  Common Medications used in the ICU  CPR and Emergency Measures CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 8  E. Lunch Break  The group will be divided into 2 11:00 - 12:00 1st six - 11:00 - 11:30 2nd six - 11:30 - 12:00 F. Continuation of Nursing Care  Vital signs monitoring and assessment for any changes in the patient’s status  Implementation of Nursing care plan 12:00 - 1:30  Continuation of Nursing Procedures if any  Monitoring Input and Output  Continuous Nursing Care and assessment G. TPR, GCS, Input and Output Charting and Endorsement  Charting of Vital Signs as per ICU protocol in the patient’s chart  Recording the total Input and Output for the day 02:00 - 02:30  Additional care, data, and assessment endorsement to the ICU Nurse in - charge of the patient. H. Post - Conference  Evaluation by the CI and peers.  Sharing of the day’s experiences including the learning, difficulties encountered 02:30 - 03:00 and resolution.  Sharing of expectations for the duty the next day  Designation of the team leader for the next day. DAY 3 SKILLS ENHANCEMENT A. Pre-Conference  Individual General Objectives / Specific  Arrival 06:30 Objectives  Checking of attendance, uniform and paraphernalia  FDAR B. Endorsement  Attending the nurse’s endorsement and individual nurse’s rounds 06:40  V/S, I/O Record, Initial Assessment C. Bedside Care (Notebook)  Vital signs monitoring and assessment for any changes in the patient’s status 07:00  Implementation of Nursing care plan  Individual Drug Defense  Nursing Procedures (Morning care and maintenance of hygiene, NGT Feeding, Turning, Suctioning, Oral Care, Tracheostomy care, changing of bed linens if necessary, HGT monitoring as ordered, Routine ECG Checking)  Monitoring Input and Output  Continuous Nursing Care and assessment CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 9  D. Medication Preparation and Administration  Medication Administration in the ICU has an interval of 2 hours for individual 08:00-11:30 patients (Medication Schedule: 08:00, 10:00, 12:00 and 02:00 respectively as per the unit’s standards)  Review of the Medications to be given to the patient.  Observance of the 14 Rights of Medication Administration  Drug defense will be done during the medication preparation and administration as the case applies. E. Submission of FDAR for checking by the CI 09:30 - 11:00  Individual Checking and consultation F. Lunch Break 11:00 - 12:00  The group will be divided into 2 1st six - 11:00 - 11:30 2nd six - 11:30 - 12:00 G. Continuation of Nursing Care  Vital signs monitoring and assessment for any changes in the patient’s status 12:00 - 02:00  Implementation of Nursing care plan  Continuation of Nursing Procedures if any  Monitoring Input and Output  Continuous Nursing Care and assessment H. TPR, GCS, Input and Output Charting and Endorsement 02:00 - 02:30  Charting of Vital Signs as per ICU protocol in the patient’s chart  Recording the total Input and Output for the day  Additional care, data, and assessment endorsement to the ICU Nurse in - charge of the patient. I. Post - Conference 02:40 - 03:00  Evaluation by the CI and peers.  Sharing of the day’s experiences including the learning, difficulties encountered and resolution. DAY 4 SKILLS ENHANCEMENT  Individual General Objectives / Specific A. Pre-Conference Objectives  Arrival 06:30  FDAR  Checking of attendance, uniform and paraphernalia B. Endorsement 06:40  V/S, I/O Record, Initial Assessment  Attending the nurse’s endorsement and individual nurse’s rounds (Notebook) CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 10 C. Bedside Care 07:00  Individual Drug Defense  Vital signs monitoring and assessment for any changes in the patient’s status  Implementation of Nursing care plan  Nursing Procedures (Morning care and maintenance of hygiene, NGT Feeding, Turning, Suctioning, Oral Care, Tracheostomy care, changing of bed linens if necessary, HGT monitoring as ordered, Routine ECG Checking)  Monitoring Input and Output  Continuous Nursing Care and assessment D. Medication Preparation and Administration  Medication Administration in the ICU has an interval of 2 hours for individual 08:00 - 11:00 patients (Medication Schedule: 08:00, 10:00, 12:00 and 02:00 respectively as per the unit’s standards)  Review of the Medications to be given to the patient.  Observance of the 14 Rights of Medication Administration  Drug defense will be done during the medication preparation and administration as the case applies. E. Submission of FDAR for checking by the CI 09:30 F. Lunch Break  The group will be divided into 2 11:00 - 12:00 1st six - 11:00 - 11:30 2nd six - 11:30 - 12:00 G. Continuation of Nursing Care  Vital signs monitoring and assessment for any changes in the patient’s status 12:00 - 02:00  Implementation of Nursing care plan  Continuation of Nursing Procedures if any  Monitoring Input and Output  Continuous Nursing Care and assessment H. TPR, GCS, Input and Output Charting and Endorsement  Charting of Vital Signs as per ICU protocol in the patient’s chart 02:00 - 02:40  Recording the total Input and Output for the day  Additional care, data, and assessment endorsement to the ICU Nurse in - charge of the patient. I. Post - Conference  Evaluation by the CI and peers. 02:40 - 03:00  Sharing of the day’s experiences including the learning, difficulties encountered and resolution. CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 11 DAY 5 SKILLS ENHANCEMENT  Individual General Objectives / Specific A. Pre-Conference Objectives  Arrival 06:30  FDAR  Checking of attendance, uniform and paraphernalia B. Endorsement 06:40  V/S, I/O Record, Initial Assessment  Attending the nurse’s endorsement and individual nurse’s rounds (Notebook) C. Bedside Care 07:00  Vital signs monitoring and assessment for any changes in the patient’s status  Individual Drug Defense  Implementation of Nursing care plan  Charting in the Nurse’s Notes  Nursing Procedures (Morning care and maintenance of hygiene, NGT Feeding, Turning, Suctioning, Oral Care, Tracheostomy care, changing of bed linens if necessary, HGT monitoring as ordered, Routine ECG Checking)  Monitoring Input and Output  Continuous Nursing Care and assessment D. Medication Preparation and Administration  Medication Administration in the ICU has an interval of 2 hours for individual 08:00 - 11:00 patients (Medication Schedule: 08:00, 10:00, 12:00 and 02:00 respectively as per the unit’s standards)  Review of the Medications to be given to the patient.  Observance of the 14 Rights of Medication Administration  Drug defense will be done during the medication preparation and administration as the case applies. E. Submission of FDAR for checking by the CI 09:30 F. Lunch Break  The group will be divided into 2 11:00 - 12:00 1st six - 11:00 - 11:30 2nd six - 11:30 - 12:00 G. Continuation of Nursing Care  Vital signs monitoring and assessment for any changes in the patient’s status  Implementation of Nursing care plan 12:00 - 01:30  Continuation of Nursing Procedures if any  Monitoring Input and Output  Continuous Nursing Care and assessment H. FDAR Charting 01:30 - 02:00  Charting of checked FDAR in the Patient’s Chart CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 12  I. TPR, GCS, Input and Output Charting and Endorsement  Charting of Vital Signs as per ICU protocol in the patient’s chart 02:00 - 02:40  Recording the total Input and Output for the day  Additional care, data, and assessment endorsement to the ICU Nurse in - charge of the patient. J. Post - Conference  Evaluation by the CI and peers. 02:40 - 03:00  Sharing of the day’s experiences including the learning, difficulties encountered and resolution. DAY 6 A. Case Presentation / Case Sharing  Case Presentation Print-out and Presentation  Feedbacks and further questions will be provided by the CI.  Submission of 3 NCP’s  Submission of other written outputs B. Post Conference (GOSO/FDAR/Reflective Narrative Individual Evaluation by the CI Report/Common Drugs in the Crash Sharing the student’s experiences including the learning, difficulties Cart - (at least 15) (Drug Name, encountered and resolution. Classification (P/T), Indication, C. Summative Evaluation (Post-test) Nursing Responsibilities) and the Activity Notebook  Post - Test Note: The schedules on this Clinical rotation schedule will be subject to change at any time depending on the schedules and forthcoming activities. I have read and understand this ICU Clinical Duty Policies and Guidelines. I have had an opportunity to review the contents and I agree to adhere to the policies and guidelines set forth. The policies and procedures are subject to change during my course of duty, and it is my responsibility to keep abreast of these changes. _ Student’s Name and Signature CTP - ICU 1ST SEMESTER 2024-2025 Nsg. 128.5 13