11/21/2024 2:54:50 AM	NR 75.1C Course Outline as of Fall 2020	New Course (First Version)
CATALOG INFORMATION
Discipline and Nbr:  NR 75.1C	Title:  INTER MEDSURG NRSG
Full Title:  Intermediate Medical Surgical Nursing
Last Reviewed:2/3/2020

Units		Course Hours per Week			Nbr of Weeks	Course Hours Total
Maximum	4.50	Lecture Scheduled	4.50		9 max.	Lecture Scheduled	40.50
Minimum	4.50	Lab Scheduled	0		8 min.	Lab Scheduled	0
		Contact DHR	13.50			Contact DHR	121.50
		Contact Total	18.00			Contact Total	162.00
		Non-contact DHR	0			Non-contact DHR Total	0

Total Out of Class Hours:  81.00

Total Student Learning Hours: 243.00

Title 5 Category:  AA Degree Applicable
Grading:  Grade Only
Repeatability:  42 - One Repeat if Grade was D, F, NC, or NP
Also Listed As: 
Formerly: 

Catalog Description:

Concepts applicable to intermediate level acute care of adult medical-surgical patients, with focus on the Staff RN as a team member, advance intravenous therapy practice, health care informatics, and evidence based practice.

Prerequisites/Corequisites:
Course Completion of NR 75.1B AND NR 75.2B; OR Course Completion of NR 75B

Recommended Preparation:

Limits on Enrollment:
Admission to Program. The healthcare facilities in which students are clinically placed require that the students must comply with all of the following before they are allowed onsite: Currency on all immunizations including annual flu shots; currency on annual tuberculosis clearance; a negative background check, a negative urine drug screen, and possess a current American Heart Association Certified Healthcare Provider CPR/BLS card.

Schedule of Classes Information
Description:

Concepts applicable to intermediate level acute care of adult medical-surgical patients, with focus on the Staff RN as a team member, advance intravenous therapy practice, health care informatics, and evidence based practice.

(Grade Only)
Prerequisites:Course Completion of NR 75.1B AND NR 75.2B; OR Course Completion of NR 75B
Recommended:
Limits on Enrollment:Admission to Program. The healthcare facilities in which students are clinically placed require that the students must comply with all of the following before they are allowed onsite: Currency on all immunizations including annual flu shots; currency on annual tuberculosis clearance; a negative background check, a negative urine drug screen, and possess a current American Heart Association Certified Healthcare Provider CPR/BLS card.
Transfer Credit:CSU;
Repeatability:42 - One Repeat if Grade was D, F, NC, or NP

ARTICULATION, MAJOR, and CERTIFICATION INFORMATION

Associate Degree:		Effective:		Inactive:
Area:
CSU GE:	Transfer Area			Effective:	Inactive:
IGETC:	Transfer Area			Effective:	Inactive:
CSU Transfer:	Transferable	Effective:	Fall 2020	Inactive:
UC Transfer:		Effective:		Inactive:
C-ID:

Certificate/Major Applicable: Both Certificate and Major Applicable

COURSE CONTENT

Student Learning Outcomes:
At the conclusion of this course, the student should be able to:

1.  Provide safe, high-quality intermediate level nursing care that meets the needs of acutely ill medical/surgical patients.  

2.  Demonstrate effective use of the electronic medical record as a tool for patient care and documentation.  

3.  Demonstrate skills needed to find, evaluate, use and communicate evidence-based health care information in print and electronic formats.  

4.  Relate teamwork and collaboration principles to the effective functioning of care team members to insure quality patient outcomes.

 

Objectives:

At the conclusion of this course, the student should be able to:

1.   Assess specific needs for patient care-related informatics retrieval and application.

2.   Formulate a question related to clinical evidence and develop a search strategy.

3.   Critically evaluate evidence-based practice sources using specified inclusion criteria.

4.   Compare and contrast applicability to practice, information resources found in two or more

      online databases.

5.   Recognize situations where patients are at high risk for harm, and use critical thinking and

      agency-developed procedures to protect them.

6.   Identify high priority care needs of medical-surgical patients with selected illnesses.

7.   Collaborate with patients, families and other members of the healthcare team to provide

      patient-centered care.

8.   Incorporate physiological, developmental, psychological, and adaptation concepts into the

      nursing care planning process.

9.   Articulate the scientific rationales for selected nursing and medical-surgical interventions.

10. Demonstrate competency in the safe performance of intermediate medical-surgical nursing

      skills, incorporating scientific, physiological and psychosocial principles.

11. Use prioritization and time management skills to organize care for acutely ill adults.

Topics and Scope

I. Theory

    A. Healthcare informatics

          1. Electronic health records [EHRs]

         2. Meaningful Use

         3. Federal mandates and timelines

    B. Evidence-based practice

         1. Sources and levels of evidence

         2. Libraries and databases, including professional and governmental organizations  

          3. Search strategies

         4. Evaluating evidence quality

         5. Communicating evidence

    C. Team Building and Collaboration for Quality and Safety Assurance

     D. Intravenous Therapy III - Central Vascular Access Devices*

         1. Central venous device care and complications

         2. Intravenous fluids and medications requiring central venous access

    E. Intravenous Therapy IV - Venipuncture*

         1. Peripheral IV catheter insertions

         2. Phlebotomy to procure laboratory specimens

    F. Nursing Care of the Patient Requiring Transfusion Therapy*

         1. Nursing assessment and specific care consideration for patients receiving transfusion

              therapy, includes comfort and pain management

         2. Blood product components

          3. Complications and associated reactions

    G. Nursing Care of the Patient with Chest Trauma*

         1. Nursing assessment and specific care consideration for patients with chest trauma,

              includes comfort and pain management

         2. Thoracic pathophysiology and complications

         3. Chest tube management

    H. Nursing Care of the Patient with Cancer I

         1. Basic nursing assessment and specific care consideration for patients with cancer,

              includes comfort and pain management

         2. Cancer cell pathophysiology and complications

         3. Signs, symptoms, treatment and supportive therapies

         4. Common cancer diagnoses

    I. Nursing Care of the Patient with Sepsis

         1. Nursing assessment and specific care consideration for patients with or at risk for sepsis,

              includes comfort and pain management

         2. Sepsis pathophysiology and complications

         3. Signs, symptoms, treatment and supportive therapies

    J. Nursing Care of the Patient with Male Reproductive Disorders

         1. Nursing assessment and specific care consideration for patients with male reproductive

              disorders, includes comfort and pain management

         2. Male reproductive pathophysiology and complications

         3. Signs, symptoms, treatment and supportive therapies

         4. Benign Prostatic Hypertrophy, Erectile Dysfunction and Fertility Issues

     K. Nursing Care of the Patient with Female Reproductive Disorders

         1. Nursing assessment and specific care consideration for patients with female reproductive

              disorders, includes comfort and pain management

         2. Female reproductive pathophysiology and complications

         3. Signs, symptoms, treatment and supportive therapies

         4. Menopause, Breast Cancer, Osteoporosis, Infections and Fertility Issues

    L. Code Blue and the Deteriorating Patient

         1. Nursing assessment and specific care consideration for patients requiring code blue

              response

         2. Advanced cardio-pulmonary pathophysiology and complications

         3. Signs, symptoms, treatment and supportive therapies

    M. Introduction to Preceptorship: Preparation for novice to

         entry-level nurse transition in final semester of nursing program

 

*These items are introduced in lecture, and the related skills are performed in the lab

 

II. Skills

    A. All Skills Review of ADN first year medical-surgical skills topics

    B. Central vascular access devices

    C. Venipuncture and phlebotomy

    D. Transfusion

    E. Chest tubes

    F. Simulation lab experience

 

III. Clinical

    A. Clinical application of intermediate medical-surgical nursing practice in the acute care

         hospital setting: Standard care and pharmacotherapy

    B. Teamwork and collaboration with healthcare team in care of acute care adult population

         utilizing informatics and evidence-based practice

Assignments:

Lecture-Related Assignments:

1. Reading 70-100 pages per week.

2. Evidence-based practice research group project and presentation.  Rubric graded:  Achieve

    score of 75% or better.

3. Unit and standardized exams: 4-6 per semester. Minimum cumulative score of 75% on four

    unit exams to continue in the nursing program.

Lab-Related Assignments:

1. Reading prior to nursing skills demonstration 15-50 pages per skill

2. Completion of media review prior to each skills lab (1-2 hours per lab)

3. Practice skill performance in simulated lab.

4. Completion of skills lab quizzes; 1 per skill (ungraded).

5. Demonstrate competency in 3-4 formal skill check-offs within 3 attempts related to skill

    lab topic: Pass/fail. Failure of skills competency results in dismissal from the nursing program.

 

Clinical-Related Assignments:

1. Completion of the safe medication dosage calculation exam with a score of 95% or better by

    the third attempt. This assignment is not graded for purposes of this course, but failure to pass

    this assignment with a grade of 95% or better by the third attempt will result in a failed grade

    and dismissal from the nursing program.

2. Clinical intermediate medical-surgical practice in acute care hospital settings (two 8 hour

    days per week), continued critical thinking application in the use of collaborative teamwork,

    hospital EHRs with informatics systems, and evidence-based practice. Students must meet

    minimum problem-solving skills and performance standards to pass this course. Provide safe

    care to 2-3 patients each clinical shift. Rubric graded Pass/Fail. Achieving a pass in clinical

    practice is required to remain in the nursing program.

3. Participation in case conferences for analysis of patient care situations in group setting

    each clinical shift.  

4. Develop clinical portfolio based on assigned patient cases and promotion of quality

    patient outcomes. Rubric graded: Achieve score of 75% or better.

5. Preparation and participation in a simulation lab scenario (ungraded)

Methods of Evaluation/Basis of Grade.

Writing: Assessment tools that demonstrate writing skill and/or require students to select, organize and explain ideas in writing.		Writing 10 - 20%
Clinical portfolio, evidence-based practice group project
Problem solving: Assessment tools, other than exams, that demonstrate competence in computational or non-computational problem solving skills.		Problem Solving 20 - 25%
Clinical patient care: pass/fail, case conferences and analyses
Skill Demonstrations: All skill-based and physical demonstrations used for assessment purposes including skill performance exams.		Skill Demonstrations 10 - 20%
Skills performance competencies
Exams: All forms of formal testing, other than skill performance exams.		Exams 40 - 60%
Unit and standardized exams
Other: Includes any assessment tools that do not logically fit into the above categories.		Other Category 0 - 0%
None

Representative Textbooks and Materials:

California regulations for RN practice: accessible via California Board of Registered Nursing Internet website

Davis's Drug Guide for Nurses. 16th ed. Vallerand, A.H. and Sanoski, C. A. 2018. F.A. Davis. 2018

Gerontological Nursing. 9th ed. Eliopoulos, C. Lippincott. 2018

Varcarolis' Foundations of Psychiatric Mental Health Nursing: A Clinical Approach. 8th ed. Halter, M. Saunders. 2018

Dimensional Analysis: Calculating Dosages Safely. 2nd ed. Horntvedt, T. F.A. Davis. 2019

Pocket Companion for Physical Examination and Health Assessment. 8th ed. Jarvis, C. Saunders. 2019

Pharmacology: A Patient-Centered Nursing Process Approach. 9th ed. McCuistion, L.E. and Dimaggio, K. and Winton, M.B. Elsevier. 2017

Medical-Surgical Nursing. 10th ed. Lewis, S. M. and Heitkemper, M. M. and Dirksen, S.R. Mosby/Elsevier. 2019

Pathophysiology: The Biologic Basis for Disease in Adults and Children. 6th ed. McCance and Huether. Mosby Purnell. 2013 (classic)

Swearingen's Manual of Medical Surgical Nursing Care. 7th ed. Monahan, F. Mosby. 2010 (classic)

Mosby's Nursing Video Skills Student Online Version. 4th ed. Mosby Elsevier. 2013 (classic)

Mosby's Manual of Diagnostic and Laboratory Tests. 6th ed. Pagana, K. and Pagana, T. Elsevier/Mosby. 2017

Clinical Nursing Skills and Techniques. 9th ed. Perry, A.G. and Potter, P.A. and Ostendorf, W. Elsevier/Mosby. 2017

Phillips Manual of IV Therapeutics. 7th ed. Gorski, L. F.A. Davis. 2018

Fundamentals of Nursing. 9th ed. Potter, P.A. and Perry, A.G. Mosby. 2016

Pearson Nursing Diagnosis Handbook. 11th ed. Wilkinson, J.M. Pearson. 2016

Maternal-Child Nursing. 5th ed. McKinney, E.S. and James, S.R. and Murray, S.S.  Elsevier. 2018

Leadership Roles and Management Functions in Nursing: Theory and Application. 9th ed. Marquis, B.L. and Huston, C.J. Lippincott Williams & Wilkins. 2017

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