NUSC 1F18 Course Intro and Nursing Process_2024.pdf

Course Introduction NUSC 1F18 - Nursing Theory: Experiencing Illness & Hospitalization 1 Overview Welcome Review Syllabus Course overview Course Assignments Course Website 2 3 Simulation Lab Lecture Clinical Placements 4 1. Group Presentations Topics Skin cancer Presentation Week Week 2 Varicose ulc...

Course Introduction NUSC 1F18 - Nursing Theory: Experiencing Illness & Hospitalization 1 Overview Welcome Review Syllabus Course overview Course Assignments Course Website 2 3 Simulation Lab Lecture Clinical Placements 4 1. Group Presentations Topics Skin cancer Presentation Week Week 2 Varicose ulcer Fibromyalgia Week 3 Rheumatoid arthritis Vascular Accident Week 4 Heart Failure Chronic obstructive pulmonary disease Week 5 Cystic fibrosis Chron’s disease Cerebral Week 7 Colorectal cancer Congestive Tuberculosis Week 8 Bloodstream infections Cholecystitis Week 9 Pheochromocytoma Acute Kidney Injury Week 10 Polycystic Kidney Disease 5 Group Presentations 10% (5% presentation and 5% peer evaluation) Format: - In person oral presentation (30 min per group) - PowerPoint format - APA (7th ed.) should be used for all citations, pictures, figures used in the presentation - Presentation must include: o A definition/description/explanation of the disease/condition. o How the disease/condition is developed/acquired and prevented (if applicable). o Brief description of relevant diagnostics, laboratory tests, common medications & treatments for disease/condition/illness o Apply nursing process by: § Presenting the nursing assessment relevant to the disease/condition/illness (include objective, subjective data, and focused physical examination details) § Describe how does hospitalization and the disease/condition impact the patient/family § Identify 2 nursing priorities of care, and rationale § Identify and describe 2 nursing interventions § Describe how you would evaluate the interventions 6 Presentation Slides and Evaluation 7 2. Case Studies - - Students should complete the case studies together with their peers in the clinical groups. Students are responsible to ensure equal participation by discussing a fair division of work and making sure the assignment is complete and delivered within the deadline. Note that working in group and conflict resolution are essential parts of Nursing profession and professors will not intervene. Students should discuss and provide written answers to the questions of each study case. Responses should be uploaded into Brightspace by only one of the members of the group. Case description is on Brightspace under the case study folders 8 3. Learning Plan – CI to evaluate - - The learning plan identifies specific learning needs in the practicum and focuses on self-directed learning skills. The learning plan must include 1 learning goal addressing a College of Nurses of Ontario Practice Standard or Guideline relating to your current clinical area of practice (such as i.e., Documentation) The learning plan must be typed, follow APA format (7th edition) and should include: 1) learning objectives; 2) learning resources and strategies; 3) types of evidence to show accomplishment; 4) criteria to evaluate the achievement of the learning plan goals; and 5) dates to be accomplished. The learning plan is an evolving document. Students should submit a Learning plan draft on week 2 and the final Learning plan by week 10. 9 4. Preparation & Engagement Portfolio The purpose of this assignment is for students to demonstrate their preparation for and engagement in labs. The portfolio is a collection of evidence to support weekly preparation and engagement efforts. Activities: Pre-lab quizzes – Ticket to Lab Cultural Humility simulation game Calculate with Confidence workbook Medical Terminology modules Clinical Skill pass 10 Ticket to Lab 11 Cultural Humility Simulation Game Complete game Submit certificate on Brightspace 12 Medication Terminology and Calculate with Confidence Winter 2024: Medical Terminology Online with Elsevier Adaptive Learning for Medical Terminology: A Short Course, 9th Edition. o Course ID: 164345_brockuniversity_1003 If Digital: Submit workbook responses to Lab TA Check in with Lab TA on Weeks 5, 8 and 11 13 Clinical Skill pass Sterile technique - Lab Vital signs – Clinical Placement 14 5. Midterm Exam – Week 6 in class Weight: 25% Format: - In person - The exam will consist of a diverse range of question formats, including multiple-choice, short-answer, and scenario-based questions, carefully crafted to challenge your critical thinking and application skills. Evaluation Overview: - Exam questions will be based on the chapter readings, lectures and discussion/case studies, student presentations and guest lectures - For mathematics the focus will be on abbreviations, interpreting drug labels, military time, conversions 15 6. Final Exam – Brock schedule Weight: 25% Format: - In person - The exam will consist of a diverse range of question formats, including multiple-choice, short-answer, and scenario-based questions, carefully crafted to challenge your critical thinking and application skills. Evaluation Overview: - Exam questions will be based on the chapter readings, lectures and discussion/case studies, student presentations and guest lectures. - For mathematics the focus will be on IV drip and flow rates, fluid balance 16 7. Clinical Placement - MANDATORY Note that as per the student handbook: “Absence from the required theory, clinical and laboratory sessions may prevent students from successfully meeting course objectives, resulting in a failure. Absences in excess of 10% of the scheduled number of hours may result in a failing grade for the course.” 17 Clinical Evaluation Student and CI CI grades on Brightspace Information for completion is in the form 18 8. Simulation Lab - MANDATORY Note that as per the student handbook: “Absence from the required theory, clinical and laboratory sessions may prevent students from successfully meeting course objectives, resulting in a failure. Absences in excess of 10% of the scheduled number of hours may result in a failing grade for the course.” 19 Course Website 20 The Nursing Process NUSC 1F18 - Nursing Theory: Experiencing Illness & Hospitalization 21 Nursing Process 22 Nursing Process & Clinical Reasoning [ADPIE] 23 Assessment 24 Assessment Systematic data collection Determine client current and past status and functional status Critical Thinking – underlying problems? Needs to further assess? Establishing therapeutic relationships helps with data collection 25 Types of Data VS Objective Subjective 26 Sources of Data Primary Secondary Tertiary 27 Interview An organized conversation with the client Ways of Exploring – questions vs statements Therapeutic relationship – orientation, working and termination phases 28 Health History Nursing Health History Family History Documentation of findings 29 Physical Examination Observation of client’s behaviour Diagnostic and laboratory data Interpreting assessment data and making nursing judgements Data validation, analysis and interpretation Steps in data analysis Recognize patterns or trends by cues Compare with normal standards Make a reasoned decision 30 Data Documentation Legal and professional responsibility What to report? Subjective client information should be placed in quotation marks Accurate terminology and abbreviations must be used 31 Considerations in Assessment Cultural assessments Conduct any assessment with cultural safety/ humility Indigenous health assessment: Skills-based training is needed in intercultural competency, conflict resolution, human rights, and antiracism Focus is on building trust and therapeutic relationships 32 Nursing Diagnosis 33 Nursing Diagnosis - NANDA International Means of translating nursing observations and assessments into standard conclusions in a common nomenclature https://nanda.org/ 34 Nursing Diagnosis Nursing Diagnosis Medical Diagnosis O2 % Collaborative Problem 35 Critical Thinking and the Nursing Diagnostic Process Diagnostic reasoning Defining characteristics Clinical criteria 36 Nursing Diagnosis E.g., Deficient knowledge regarding postoperative Pain management related to bowel surgery as evidenced by a numeric rating scale of more than 4. 37 Types of Nursing Diagnosis Actual nursing diagnosis Describes human responses to health conditions or life processes Risk nursing diagnosis Describes human responses to health conditions or life processes that may develop Health promotion nursing diagnosis Clinical judgement of client’s motivation and desire to increase well-being by readiness to enhance specific health behaviours, such as nutrition and exercise Wellness nursing diagnosis Describes levels of wellness in a client that can be enhanced 38 Why to use Nursing Diagnosis Provides direction for the care plan and selection of nursing interventions Provides a precise definition of the client’s needs Gives all members of the health care team a common language to use 39 Planning 40 Planning Begins after identification of a client’s nursing diagnoses and strengths Nurse sets client-centred goals and expected outcomes, plans nursing interventions, and prioritizes interventions 41 Establishing Priorities Helps nurses anticipate and sequence nursing interventions Classification of priorities: High-priority nursing diagnoses Intermediatepriority nursing diagnoses Low-priority nursing diagnoses 42 Phases of Nursing Care Initial Ongoing Discharge 43 Goals of Care Client-centred goal A specific and measurable behavioural response that reflects highest level of wellness and independence Short-term goal An objective client behaviour or response expected within hours to a week Long-term goal An objective client behaviour or response expected within days, weeks, or months 44 Expected Outcomes Specific, measurable change in a client’s status that is expected in response to nursing care Provide focus or direction Determine when a specific client-centred goal has been met Nursing-sensitive client outcome Guidelines for writing goals/expected outcomes client singular observable measurable time-limited mutual realistic 45 Implementation 46 Implementation The implementation step of the nursing process is the initiation or completion of planned actions or nursing interventions Nursing intervention Direct care Indirect care Consultation 47 Types of Interventions Nurse-initiated Independent nursing interventions Do not require orders from other health care providers Physician/practioner-initiated Dependent nursing interventions Require orders from physicians or nurse practitioners Collaborative Interdependent nursing interventions Established in interdisciplinary health care team conference 48 Selection of Interventions nursing diagnosis Feasibility goals and expected outcomes Evidence-based Acceptability Nurse’s competence 49 Nursing Interventions Classification (NIC) A set of nursing interventions that provides a level of standardization, which enhances communication of nursing care across all health care settings and enables health care providers to compare outcomes Three levels: 7 Domains 30 Classes 565 Interventions 50 Critical Thinking in Implementation Reviewing the set of all possible nursing interventions Reviewing all possible consequences associated with each possible nursing action Determining the probability of all possible consequences Determining the effect of the intervention 51 Concept Mapping A visual representation that shows connections between a client’s health problems Allows nurses to obtain a holistic perspective of health care needs 52 Implementation Process Reassessing the client Reviewing and revising the existing nursing care plan Organizing resources and care delivery Equipment Personnel Environment Client 53 Standard Nursing Interventions Clinical practice guidelines and protocols E.g., Best Practice Guidelines (RNAO) Medical directives or standing orders 54 Implementation Process Anticipating and preventing complications Scientific rationale Identifying areas of assistance Implementation skills Cognitive skills Interpersonal skills Psychomotor skills 55 Direct Care Activities of daily living (ADLs) Instrumental activities of daily living Physical care techniques Life-saving measures Counseling Teaching Controlling for adverse reactions Preventive measures 56 Indirect Care Communicating nursing interventions Written or oral Delegating, supervising, and evaluating the work of other staff members 57 Achieving Client-Centered Goals Nurses implement care to meet client-centered goals and outcomes. At times, multiple interventions may be needed. Priorities help nurses anticipate and sequence nursing interventions. 58 Evaluation 59 Evaluation Final step of the nursing process Two components: An examination of a condition or situation A judgement as to whether change has occurred 60 Critical Thinking and Evaluation Evaluation is an ongoing, continuous process Critical thinking involves a purposeful and systematic process of questioning Evaluations are positive when nurses meet desired outcomes 61 The Evaluation Process Based on two actions Identify evaluative criteria and standards: Goals Standard of care Expected outcomes Nursing-sensitive outcomes (Nursing Outcomes Classification [NOC]) Collect evaluative data: Evaluative measures 62 The Evaluation Process Collecting data to determine whether the criteria or standards are met Identifying evaluative criteria and standards Interpreting and summarizing findings Documenting findings and any clinical judgement Terminating, continuing, or revising the care plan Results of Evaluation 63 Written Plans of Care Institutional care plans Computerized care plans Care plans for community-based settings Critical pathways 64 Thank you! Questions? 65