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I. Theoretical Outcomes and Objectives
A. Theoretical Application for Professional Growth
1. Analyze patient needs using the nursing process.
2. Select nursing interventions using critical thinking strategies applied to theoretical
patient scenarios.
3. Incorporate leadership and research principles into nursing practice by integrating best
current evidence.
4. Evaluate health care delivery systems and the ethical and legal roles of professional
nursing within these systems.
5. Provide patient teaching and health resources to promote optimum health.
6. Solve conflict management issues using theoretical scenarios and leadership principles
7. Formulate a plan for professional growth using the Readiness for Practice Theory during
preceptorship.
8. Understanding the rationale for acknowledgement of medical orders.
B. Theoretical Content Application for Clinical Objectives in a Nursing Practice Scenario:
1. Plan for safety needs of more complex patients, patients with multi-system disorders,
and patients with special vulnerabilities.
2. Integrate the knowledge of health care needs into the nursing care of patients with
problems related to altered:
a. Neurological status
b. Respiratory function
c. Immune and endocrine function
d. Mobility
e. Cellular growth
3. Plan home care with patient, family, and health care team.
4. Utilize principles of time management and organization to effectively deliver nursing
care to a group of patients.
5. Utilize professional communication in the nursing care of acutely ill patients.
6. Demonstrate competency by integrating into nursing practice scientific, physiological
and psychosocial concepts:
a. Neurological assessment
b. Tracheostomy care and advanced airway management
c. Performing venipuncture and intravenous access
II. Professional Clinical Practice Objectives in Advanced Medical Surgical Nursing and
Preceptorship
A. Assess patient for physical manifestations of pathophysiological processes and identify
patient self-care deficits.
B. Use information technology to document findings, manage communication, share
knowledge, mitigate error, and support decision making that improves patient outcomes.
C. Initiate and/or maintain a current nursing care plan for assigned patients.
D. Integrate the best current evidence based practice in clinical health care delivery.
E. Implement and evaluate patient and family teaching in a variety of clinical settings.
F. Use the nursing process and critical thinking to provide safe and effective patient care in a
variety of practice settings.
G. Demonstrate delegation and conflict resolution skills.
H. Actively participate in quality improvement activities.
I. Promote physical health and wellness by providing care and comfort, reducing patient risk
potential, and managing health alterations.
J. Collaborate effectively with other member of the multidisciplinary healthcare team.
K. Collaborate with patients and families to provide compassionate and coordinated
care-based on their preferences, values and needs.
L. Function as an entry level RN within guidelines of the Nurse Practice Act and develop a
professional growth plan in preceptorship.
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I. Theory
A. Neurological Assessment of the Patient with Neurological Impairment*
B. Nursing Care of the Patient with Neurological Disease
1. Basic nursing assessment and specific care consideration for patients with neurological
diseases, includes comfort and pain management
2. Seizures
3. Amyotrophic Lateral Sclerosis (ALS)
4. Guillain Barre Syndrome (GBS)
5. Multiple Sclerosis (MS)
6. Myasthenia Gravis (MG)
C. Nursing Care of the Patient with Auto-Immune Disease
1. Basic nursing assessment and specific care consideration for patients with auto-immune
diseases, includes comfort and pain management
2. Human immunodeficiency virus (HIV) care and complications
3. Acquired immunodeficiency syndrome (AIDS) care and complications
4. Lupus care and complications
5. Lyme disease care and complications
D. Nursing Care of the Patient with Respiratory Failure
1. Basic nursing assessment and specific care consideration for patients with respiratory
failure, includes comfort and pain management
2. Signs, symptoms, treatment and supportive therapies
3. Acute respiratory distress syndrome (ARDS) care and complications
4. Tracheostomy care and complications*
5. Ventilator care and complications
E. Nursing Care of the Patient with a Spinal Cord Injury
1. Basic nursing assessment and specific care consideration for patients with a spinal cord
injury, includes comfort and pain management
2. Risks and prevention
3. Signs, symptoms, treatment and supportive therapies
F. Nursing Care of the Patient with Burns
1. Basic nursing assessment and specific care consideration for patients with burns,
includes comfort and pain management
2. Risks and prevention
3. Signs, symptoms, treatment and supportive therapies
G. Nursing Care of the Patient with Endocrine Impairment
1. Basic nursing assessment and specific care consideration for patients with endocrine
impairment, includes comfort and pain management
2. Signs, symptoms, treatment and supportive therapies
3. Thyroid disorders care and complications
4. Addison's Disease care and complications
5. Cushing's Syndrome care and complications
H. Nursing Care of the Patient with Cancer II
1. Advanced nursing assessment and specific care consideration for patients with cancer,
includes comfort and pain management
2. Signs, symptoms and complications
3. Treatment and supportive therapies: Chemotherapy, radiation and immuno-therapies
I. Nursing Care of the Patient with Alterations in Cardiac Perfusion
1. Basic nursing assessment and specific care consideration for patients with alterations in
cardiac perfusion, includes comfort and pain management
2. Signs, symptoms, complications, treatment and supportive therapies
J. Nursing Care of the Patient with Alterations in Tissue Perfusion
1. Basic nursing assessment and specific care consideration for patients with alterations in
tissue perfusion, includes comfort and pain management
2. Signs, symptoms, complications, treatment and supportive therapies
K. Nursing Care of the Patient with Increased Intracranial Pressure
1. Basic nursing assessment and specific care consideration for patients with increased
intracranial pressure, includes comfort and pain management
2. Signs, symptoms, complications, treatment and supportive therapies
3. Head trauma
L. Nursing Care of the Patient with Gastrointestinal Bleeding and Liver Failure
1. Basic nursing assessment and specific care consideration for patients with
gastrointestinal bleeding and liver failure, includes comfort and pain management
2. Signs, symptoms, complications, treatment and supportive therapies
3. Risk factors and prevention
M. Nursing Care of the Trauma Patient in the Critical Care Environment
1. Basic nursing assessment and specific care consideration for patients experiencing
trauma, includes comfort and pain management
2. Signs, symptoms, complications, treatment and supportive therapies
3. Risk factors and prevention
4. Care management in the emergency department (ED) and intensive care unit (ICU)
N. Palliative Care and End of Life Treatment
1. Basic nursing assessment and specific care consideration for patients receiving palliative
care and end of life treatment, includes comfort and pain management
2. Complications, treatment and supportive therapies
O. Alternative and Complimentary Therapies
1. Basic nursing assessment and specific care consideration for patients receiving
alternative and complimentary therapies, includes comfort and pain management.
2. Complications, treatment and supportive therapies
P. Introduction to nursing research methods and evidence-based practice application to
clinical care
Q. Legal Aspects of Nursing Practice - accountability and liability
R. Healthcare Delivery Systems - admission, discharge and case management
S. Homecare and Community-Based Nursing Practice
1. Vulnerable community populations and care needs identification
2. Nursing assessment and care of the home care patient
3. Community health prevention, education and early interventions
T. Cultural and Ethnic Nursing - assessment and specific care consideration for patients in
need of cultural and ethnic nursing, includes comfort and pain management
U. Spiritual Nursing - assessment and specific care consideration for patients in need of
spiritual nursing, includes comfort and pain management
V. Advanced Professionalism in Nursing
1. Quality Improvement
2. Leadership and management
3. Resume writing and job interview strategies
W. Nurse Practice Act
1. State Registered Nurse (RN) licensure regulations
2. RN Intervention Program
3. Supervision and delegation of unlicensed assistive personnel (UAP)
X. Nursing Behavioral Objectives and Conflict Resolution
1. Behavioral objective development and implementation
2. Conflict resolution strategies and application
Y. Orientation to Preceptorship: Preparation for formal preceptorship assignment
1. Preceptee identification of clinical strengths and areas for improvement
2. Preceptor assignment process
3. Clinical objective development to achieve success in preceptorship
*These items are introduced in lecture, and the related skills are performed in the lab
II. Skills
A. All Skills Review of ADN first, second and third semester medical-surgical skills topics
B. Neurological Assessment
C. Advanced airway management and tracheostomy care
III. Clinical
A. Clinical application of advanced medical-surgical nursing practice in the acute care
hospital setting: Standard care and pharmacotherapy
B. Quality improvement, evidence-based practice and informatics application in the care of the
acute care adult population
C. Preceptorship: Novice to entry-level nurse transition experience
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Lecture-Related Assignments:
1. Reading 70-250 pages per week.
2. Unit and standardized exams: 5-7 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 demonstration15-50 pages per skill.
2. Completion of media review prior to each skills lab (1 -2 hours per lab).
3. Practice skills performance in simulated lab.
4. Completion of skills lab quizzes; 1 per skill (ungraded).
5. Demonstrate competency in 2 formal skill check-offs within 3 attempts related to skill
lab topic: Rubric graded 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 on the third attempt will result in a failed grade
and dismissal from the nursing program.
2. Clinical advanced medical-surgical practice in acute care hospital settings (two 8 hour days
per week for 8 weeks), continued application of critical thinking skills, including the use of
evidence-based practice research. Students must meet minimum problem-solving skills and
performance standards to pass this course. Provide safe care to 3-4 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. Development of 1-3 nursing care plans based on assigned patient cases and promotion of
quality patient outcomes. Rubric graded: Achieve score of 75% or better.
5. Development of 1-4 evidence-based practice research article critiques. Rubric graded:
Achieve score of 75% or better.
6. Completion of 6-10 critical thinking journals. Rubric graded: Achieve score of 75% or better.
7. Preparation and participation in a simulation lab scenario (ungraded).
8. Completion of required preceptorship hours.