ࡱ> g \6bjbj** HibHibL. RRRRR$vvvPj|v;lfkkkkkkk$mWpkRkRRk"""RRk"k""_ eSee a:k l0;l2bpqptee&pRe"kk!;lp B :  GROSSMONT COLLEGE Official Course Outline NURSING 220 - MEDICAL SURGICAL NURSING II 1. Course Number Course Title Semester Units Semester Hours NURS 220 Medical Surgical 5.5 3 hours lecture: 48-54 hours Nursing II 7.5 hours lab: 120-135 hours 96-108 outside-of-class hours for lecture 264-297 total hours 2. Prerequisites A C grade or higher in Nursing 130 and 132 or equivalent. Corequisite None. Recommended Preparation None. 3. Catalog Description This course addresses patient focused nursing care of individuals with alterations in body organ systems to include endocrine, neurologic, renal, hepatobiliary, and immune diseases or disorders. The care of patients with cancer will also be addressed. The focus is on adult patients throughout the lifespan. The nurse considers the unique characteristics and abilities of the person, including the impact of the environment on the state of health and illness in the context of acute and chronic disorders, with a focus on the effects of aging on organ function. Concurrent clinical experience is in acute settings. This is a required course for the Nursing Program. 4. Course Objectives The student will: Knowledge: Evaluate nursing roles in assuring coordination, integration, and continuity of care for patients with alterations in body organ systems. (N) Analyze how the safety, quality, and cost effectiveness of health care can be improved through the active involvement of patients and families with acute and chronic health conditions. (N, P, E) Distinguish contributions of other individuals and groups in helping patient/family achieve health goals. (H, P, E) Evaluate how the strength and relevance of available evidence influences the choice of interventions in provision of patient-centered care for patients with alterations in body organ systems. (N, E) Skills: a. Plan, implement and evaluate nursing care, setting priorities for complex medical-surgical patients in the context of aging, ethnicity, gender, socioeconomic status, and genetics. (N) b. Assess patient values, preferences, and expressed needs as part of the clinical interview, implementation of the plan of care, and evaluation of care. (N, P, E) c. Implement communication practices that minimize risks associated with handoffs among providers and across transitions in care. (N, E) d. Question rationale for routine approaches to care that result in less-than-desired outcomes or adverse events, with a focus on improving outcomes based on evidence. (N) NURSING 220 MEDICAL SURGICAL NURSING II Page 2 4. Course Objectives: Skills (continued) Create effective boundaries for therapeutic patient relationships when caring for patients with acute and chronic disorders. (N, P) Utilize critical thinking skills in making safe clinical nursing judgments when providing patient-centered nursing care for patients with alterations in body organ systems. (N, P) Design individualized plan of care for patients with alterations in body organ systems, based upon the patient values, clinical expertise and evidence. (N, P) Formulate thorough patient documentation and complete patient documentation in a timely manner. (N) Provide patient-centered care for multiple patients with acute and chronic disorders. (N) Attitudes: a. Willingly support patient-centered care for individuals and groups whose values differ from their own. (N, P) b. Respect the unique attributes that members bring to a team in an acute care setting, including variations in professional orientations and accountabilities. (N) c. Appreciate that continuous quality improvement is an essential part of the daily work of all health professionals. (N, E) d. Value the relationship between national safety campaigns and implementation in local practices and practice settings. (E) e. Value technologies that support clinical decision-making, error prevention, and care coordination when working with patients with alterations in body organ systems. (E) f. Analyze legal and ethical issues pertaining to selected nursing/medical interventions for the patient in the acute and ambulatory care and home health settings. (E) g. Appreciate caring in relationships with patients and families with acute and chronic disorders. (P) KEY: Concept Objective H = Health Domain Knowledge: C N = Nursing Domain Knowledge: A,B,D Skills: A,B,C,D,E,F,G,H,I Attitudes: A,B,C P = Person Domain Knowledge: B,C Skills: B,E,F,G Attitudes: A,G E = Environment Domain Knowledge: B,C,D Skills: B,C Attitudes: C,D,E,F 5. Instructional Facilities Standard classroom. Nursing skills laboratory. Computer laboratory. Selected clinical facilities. High fidelity simulation laboratory. 6. Special Materials Required of Student Digital storage device. ڰAPP nursing student uniform with embroidery. ڰAPP photo ID name badge. Bandage scissors. Watch with second hand indicator. Stethoscope. Penlight. I-clicker2. Reliable transportation to clinical facilities. NURSING 220 MEDICAL SURGICAL NURSING II Page 3 7. Course Content a. Review of chronic illness. b. Nursing management: (1) Fluids and electrolytes and acid base imbalances. (2) Diabetes Mellitus. (3) Renal disorders. (4) Hepatobiliary disorders. (5) Patients with cancer. (6) Endocrine disorders. (7) Degenerative and immune mediated neurological disorders (8) Total parenteral nutrition (9) Cranial and peripheral nerve disorders 8. Method of Instruction a. Lecture. b. Discussion. c. Multimedia resources. d. Demonstration. e. Critical thinking activities such as concept mapping. f. Case studies. g. Role playing. h. Student presentations. i. Supervised nursing care. j. Clinical conferences. k. Clinical simulation. 9. Methods of Evaluating Student Performance a. Written evidence-based research assignments. b. Quizzes. c. Computerized examinations including a final. d. Clinical skills competency testing. e. Verbal questioning. f. Supplementary assignments (See outside assignments). g. Student self-evaluation. h. Clinical evaluation. i. Clinical simulation. j. Written clinical plan of care. k. Clinical written learning activities such as patient data sheets, clinical reasoning questions, and medication information worksheets. 10. Outside Class Assignments Practice of nursing skills. Evidence-based assignments on topics such as nutritional requirements of patients with renal disorders, cultural influences related to specialized diets. c. Clinical skills competency testing such as nasogastric tube insertion. d. Clinical paperwork such as patient data sheets, clinical reasoning worksheets, medication worksheets, and reflections of float experiences such as endoscopy lab. e. Evidence-based plan of care based upon the patient assignments in the clinical setting. NURSING 220 MEDICAL SURGICAL NURSING II Page 4 Outside Class Assignments (continued) f. Video viewing of topics such as nursing management of patients with diabetes, renal failure, and cancer. g. Kaplan focused review exam. h. Remediation assignments based upon NCLEX practice exams such as the Kaplan integrated exam. i. Assigned readings from nursing textbooks and reference articles related to a variety of nursing topics. j. NCLEX practice questions. k. Community service such as blood drives, first aid for public events, and Operation Stand Down. 11. Texts a. Required Text(s): (1) Hinkle, J.L. & Cheever, K.H. Brunner & Suddarth's Textbook of Medical-Surgical Nursing(14th ed.). Philadelphia: Wolters Kluwer. 2018. Karch, A.M. Focus on Nursing Pharmacology, 6th edition. Philadelphia, PA: Lippincott Williams & Wilkins. 2013. Arikian, V.P. et. al. The Basics. Kaplan, Inc. 2015 ڰAPP Nursing Student Handbook, 2018-2019. b. Supplementary texts and workbooks: Pagana, K. D. & T. J. Pagana. Mosbys Manual of Diagnostic and Laboratory Tests. 5th edition. St. Louis, MO. 2014. Daviss Drug Guide for Nurses, 14th edition. Philadelphia, PA: Lippincott. 2015. Matkovich, S. APA Made Easy, 3rd edition. Retrieved from:  HYPERLINK "http://www.youversustheworld.com" www.youversustheworld.com. 2015. Engel, M. Im Here: Compassionate Communication in Patient Care. Orlando, FL: Phillips Press. 2010. Addendum: Student Learning Outcomes Upon completion of this course, the students will be able to do the following: a. Integrate knowledge of biopsychosocial theories and concepts when providing patient care by: (1) applying knowledge of nursing practice utilizing biopsychosocial theories and concepts in performing the professional nursing role. (2) formulating a holistic comprehensive plan of care for acute and chronic patients utilizing the nursing process, principles of health promotion and illness prevention, patient teaching and end-of-life care for patients throughout their lifespan. b. Integrate the skills and attitudes necessary to perform as an associate degree nurse in the professional nursing roles of: (1) Provider of Care, (2) Manager of Care, and (3) Member within a Discipline by satisfactorily performing the complex roles, skills, and responsibilities of a second-year student in the categories of Provider of Care, Manager of Care, and Member within a Discipline. c. Implement critical-thinking skills in the implementation of the nursing process while providing safe patient care and meeting the needs of culturally diverse patients within multidisciplinary health care systems by intervening competently and safely for groups of health care consumers in complex patient care situations within a multidisciplinary healthcare system. d. Select evidence based research to provide quality health care, initiate change and improve nursing practice by: (1) Implementing evidence-based research in the planning and implementation of complex nursing care for individuals, families, and groups of health care consumers. (2) Evaluating the importance and effectiveness of evidence-based research in nursing practice. e. Effectively employ the use of informatics and effective communication skills to manage and coordinate care for the health care consumer in collaboration with other health care professionals by: (1) Integrating communication skills (verbal, nonverbal, interpersonal, and communication technology) into the practice of the professional nursing role. (2) Collaborating with other health team members to organize, manage, delegate and coordinate patient care for the health care consumers and family members across the life span. NURSING 220 MEDICAL SURGICAL NURSING II Page 5 Addendum: Student Learning Outcomes (continued) f. Distinguish the role of the professional nurse as defined by the California Nurse Practice Act and standards of nursing practice by: (1) Assuming responsibility and accountability for the students nursing action(s) as they undertake the role of the professional nurse. (2) Making complex clinical decisions that support health care consumer advocacy based upon the ethical and legal principles as described in the California Nurse Practice Act and the American Nurses Association code of ethics. g. Support the importance of life-long learning and quality improvement as part of their professional commitment to the nursing profession by assuming responsibility and commitment for lifelong learning in the areas of evidence-based healthcare, informatics, practice-based learning, self-reflection and assessment as the student undertakes the role of the professional registered nurse. 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