Spring 2018

NURS 3110-001 Health Assessment: Clinical Application

All students are responsible for checking their UTHSCSA Livemail account regularly (i.e., daily or several times every week) to obtain Official University Communication regarding their courses, program and student status.

NOTE: Our campus has enabled the CANVAS MOBILE LEARN application. CANVAS tools such as discussions, quizzes or videos May or May NOT function on all mobile devices. This is because mobile devices are available with rapidly changing and different configurations. Hence, students must not depend on only a mobile device to access course materials. Students must have access to a laptop or desktop device to access course materials and complete assignments.

This course is Web Enhanced with WebCT icon
Please be sure to check the Current Computer Requirements

Dear Students,


Welcome to NURS 3110 Health Assessment: Clinical Application. This course focuses on acquiring knowledge and skills to perform a health history and physical assessment across the lifespan of your patient, with an emphasis on the adult and geriatric population. You will learn interviewing and health assessment skills then practice those skills in laboratories and selected settings. One of the most important skills for you to develop as a nurse is how to thoroughly examine your patients to assess their health care needs. I am looking forward to meeting with all of you and to facilitate your learning.


 

This is a 3 hour/week lab in which you will spend 2 hours/week in the lab and one hour outside the lab preparing for it. During your preparation time, you are required to spend at least 1 hour total on Shadow Health Digital Experience and course videos.


Wendy Lee, DNP, FNP-BC, FAANP

NURS 3110 - Course Coordinator   


   

FACULTY CONTACT INFORMATION

Wendy Lee, DNP, FNP-BC, FAANP

Course Coordinator

 

Clinical Associate Professor

E-mail: leewj@uthscsa.edu

Office Phone: (210) 567-5102

Office Room: 2.358

Office Hours: After Class and By Appointment

Office of Faculty Affairs and Diversity 

 

Clinical Advisors:

 

Moonju Lee, PhD, RN

Email: leem9@uthscsa.edu

 

Nancy McGowan, PhD, RN

Email: mcgowann@uthscsa.edu

 

David Vasquez, MSN, PMHNP-BC, RN

Email:  VASQUEZD@uthscsa.edu

 

COURSE DESCRIPTION

This course provides an opportunity for application of health assessment theory and skills in a simulated practice setting with emphasis on the adult and geriatric populations.

CREDIT AND TIME ALLOCATION

1 semester hour (1 hour clinical skills laboratory)

PREREQUISITES

Admission to the Traditional Undergraduate Program is required.
Co-requisite: NURS 3204: Health Assessment-Theoretical Foundations.

PROGRAM OUTCOMES

At the completion of the baccalaureate program the student will demonstrate the following:

  1. Incorporate knowledge, skills, and attitudes from the liberal arts and sciences in professional nursing education and practice.
  2. Apply knowledge and skills of organizational and systems leadership, quality improvement and patient safety in promoting safe, high-quality care for diverse patients across healthcare systems and environments.
  3. Analyze and apply evidence from research and other information sources as a basis for nursing practice.
  4. Incorporate knowledge and skills in using information systems and a range of patient-care technologies to facilitate delivery of quality patient care.
  5. Advocate for financial and regulatory healthcare policies, processes, and environments that improve the nature and functioning of the healthcare delivery system and nursing practice.
  6. Collaborate and communicate effectively with healthcare professionals to promote positive working relationships, improve patient health outcomes, and deliver quality, safe patient care.
  7. Promote individual and population health by assessing factors that influence individual and population health and apply principles and culturally appropriate health promotion and disease-prevention strategies. Demonstrate consistent application of the core values of the discipline of nursing and the professional standards of moral, ethical, and legal conduct.
  8. Demonstrate consistent application of the core values of the discipline of nursing and the professional standards of moral, ethical, and legal conduct.
  9. Integrate the knowledge, skills, and attitudes expected of baccalaureate prepared nurses by providing professional nursing care to diverse patients and populations across the lifespan, healthcare settings, and healthcare environments.

COURSE OUTCOMES

  1. Collect and record a complete health history. (Essential VI, VII, IX)
  2. Demonstrate application of selected assessment tools. (Essential VI, VII, IX)
  3. Use effective interviewing and communication skills when conducting a health history and performing physical examination. (Essential VII, IX)
  4. Demonstrate physical examination of each designated body system. (Essential IX)
  5. Demonstrate an integrated head-to-toe physical examination. (Essential IX)
  6. Apply principles of infection control and patient safety during the assessment process. (Essential IX)

CRITERIA FOR EVALUATION / GRADES

Criteria for Evaluation/Grades:

Skills Lab Attendance / Participation

30%

 

Shadow Health Digital Experience

10%

Peer to Peer Evaluation at Midterm

complete or incomplete

Vital Signs Test

10%

 

Vital Signs Log

complete or incomplete

 

Regional Write-ups:

--Spector’s Heritage Assessment/Health Illness Belief and Practices

--Complete Health History with Health History Interview Self Assessment

--Regional Write-up #1: (Nose, Mouth, and Throat)                       

--Regional Write-up #2 (Thorax/Respiratory)

--Regional Write-up #3 (Cardiovascular)

--Regional Write-up #4 (Abdomen)

 

20%

 

Final Head to Toe Physical Assessment

30%

Total     

100%

 

 *A cumulative grade of 75% or better is required to pass the course.


Grading Scale:  Pass/Not Pass


Skills Labs Participation:  Attendance is a large percentage of your grade.  Your participation/attendance is imperative to success in this course. You must complete all assigned readings (textbook and lab skill sheets) prior to the skills lab and arrive prepared to perform the skills of that day.  If a skills lab is missed, it is your responsibility to acquire the information outside of class. 


Shadow Health Digital Experience:  You must earn an 80% or better to receive any credit in each Shadow Health module. Anything less an 80% will be given a zero and anything above an 80% will be given the % score earned according to the Performance Index Score for Concept labs or Digital Clinical Experience score for all others. You can take the module as often as you want to before the deadline for a higher score.

 

Write-upsThe write-ups need to consist of proper terminology and answers to all questions.  5% will be deducted off the grade every day that the assignment is late.  If later than three days, the grade will be a zero.  The assignment must be turned and meet the clinical faculty's expectations even if the grade is a zero. 

 

Final Physical Exam: Students will record their final physical exams but may ask to be graded face-to-face live if the clinical advisor can accommodate the request. If you earn a grade of 85% or less on the Final Head-to-toe Physical Exam, you are required to repeat the graded exam—only one repeat is allowed. Repeated physical exam observations will have a maximum score of 80%. All observation remedials must be scheduled within 24 hours from the original testing and testing date will be coordinated with faculty. You will arrange time to practice before retesting. The scheduled testing day must be 1 week from the original testing day.  

 

 

Required items that must be completed: (ungraded assignments but mandatory):

 

Peer to Peer evaluation at midterm: This assessment will be a peer-to-peer evaluation, meaning one or two student(s) will evaluate each other’s performance, while taking turns as a nurse or patient role, using the Mid-term Return Demonstration Tool (abbreviated version of the Head to Toe Final Physical Exam).  You will receive a "completed" or incompleted grade upon assignment completion or an incomplete if you are absent or did not participate in the role as a nurse. It is the clinical faculty's discretion to request that the assignment is completed if missed.


Clinical Evaluation Tool: Progression through the course is imperative. Students will document progress weekly using date and examples of how the course objectives were accomplished. In addition, faculty will provide feedback about their performance, strengths, and areas that need improvement. This feedback using the Clinical Evaluation Tool will be provided at midterm and end of course.

 

Passport: Undergraduate students are required to maintain a clinical passport. At each lab, students will date the nursing skill accomplished for that week. Please have your passport readily accessible for your course faculty and/or CSI staff to sign for each lab. It is your responsibility to have your passport signed weekly.

CELL PHONE POLICY

CLASSROOM ATTENDANCE

Attendance in class is an expectation of each student.

CLINICAL ATTENDANCE

The School of Nursing faculty expects that its students will recognize that they have entered a profession in which commitment to full participation in clinical experiences is an essential component as students are considered to be part of the nursing team. Therefore, regular attendance in clinical, laboratory and simulation experiences is mandatory.

Missed hours can prevent adequate development and assessment of the required knowledge, skills, attitudes and clinical judgment. Absence from clinical/lab/simulation jeopardizes the student’s ability to successfully meet the required clinical course outcomes and competencies.

Punctuality is expected in professional workplaces. Students are expected to arrive on time for clinical/lab/simulation experiences and stay for the entire time allotted for that clinical/lab/simulation experience. Important information affecting patient care is communicated to students at the start of clinical experiences. Therefore, tardiness for clinical/lab/simulation experiences jeopardizes the student’s ability to give safe nursing care.

CLINICAL ABSENCES:
Absences from clinical experience are closely monitored by faculty and should occur only in rare circumstances. Clinical absences will be evaluated on an individual basis. If the student has any clinical absences during the semester, clinical may be made up through a plan developed by the clinical/lab instructor. However, the opportunity to make up absences may not be possible, depending on the length of the clinical rotation, the availability of the faculty and/or the agency to which the student is assigned and may result in inability of the student to meet course outcomes.

If it is determined by the faculty team that a student will be unable to meet course objectives due to clinical absences or if a pattern of absence develops or excessive absences exist, the appropriate course coordinator will refer the student the Associate Dean for Academic Affairs to determine progression in the program.
 
NOTIFICATIONS:
A student who is unable to attend a clinical experience must contact the clinical faculty personally prior to the beginning of the clinical experience. Leaving a message or e-mail for the faculty is not acceptable. Faculty will share specifics regarding appropriate means of communicating during orientation.

Travel to surrounding communities may be necessary.

PATIENT SAFETY:
Students are expected to demonstrate achievement of clinical objectives by the end of a clinical course. If, in the instructor‘s professional judgment, a student is consistently unable to provide safe nursing care to patients and cannot remedy the deficit in the given clinical time, the student will receive a grade of ―F for the course. Faculty, or staff in the clinical agency, has
the right to remove a student from the clinical area at any time for any cause.

CLINICAL PASSPORT:
Students are required to maintain a clinical passport and have this on their person at all times while in the clinical setting.

CPR REQUIREMENT:
Students are required to maintain American Heart Association Health Care Provider Basic Life Support certification.

WRITTEN ASSIGNMENTS

  1. If written assignments are made in a course they are required.
  2. Students are expected to submit written work on the scheduled date and time.
  3. The student must notify the course coordinator prior to the scheduled due date and time if they are unable to submit the written work as scheduled. Failure to make this notification in advance will result in a "zero" for that written work.
  4. If the excuse is accepted as reasonable and necessary, arrangements will be made for an alternative due date and time.
  5. Each student is responsible for making sure that he or she has completed the written work prior to submission.
  6. Late work will be accepted with consequences as outlined per course syllabi.

APA GUIDELINES

The APA Publication Manual 6th edition is required for use in all nursing school programs. 

SCHOLASTIC DISHONESTY

Students are expected to be above reproach in all scholastic activities. Students who engage in scholastic dishonesty are subject to disciplinary penalties, including the possibility of failure in the course and dismissal from the university. "Scholastic dishonesty includes but is not limited to cheating, plagiarism, collusion, and submission for credit of any work or materials that are attributable in whole or in part to another person, taking an examination for another person, any act designed to give unfair advantage to a student or the attempt to commit such acts." Regents Rules and Regulations, Part One, Chapter VI, Section 3, Subsection 3.2, Subdivision 3.22.



PROFESSIONAL CODE OF CONDUCT

Students who are nurses or are preparing to enter the profession of nursing are expected to treat others with respect and compassion. “The principle of respect for persons extends to all individuals with whom the nurse interacts. The nurse maintains compassionate and caring relationships with colleagues and others with a commitment to the fair treatment of individuals, to integrity-preserving compromise and to resolving conflict. This standard of conduct precludes any and all prejudicial actions, any form of harassment or threatening behavior, or disregard for the effects of one’s actions on others” (American Nurses Association Code for Nurses, Interpretive Statement 1.5).

The students, faculty, Department Chairs, Associate Deans, and the Dean of the School of Nursing of the University Texas Health Science Center San Antonio subscribe to the highest standards of conduct. Our aim is professional behavior beyond reproach. Failure to abide by the signed code of professional conduct may lead to suspension and/or permanent dismissal from the UTHSCSA SON. In particular, we subscribe to the provisions of the Code of Ethics for Nurses (http://bit.ly/1mtD5p2) and the following points of conduct.

http://catalog.uthscsa.edu/schoolofnursing/policiesandprocedures/

ADA ACCOMMODATIONS

Any student seeking reasonable accommodations through the Americans with Disabilities Act (ADA) should contact either the Associate Dean for Admissions and Student Services within the first week of the semester or schedule a meeting with the UTHSCSA ADA Compliance Office so that appropriate accommodations may be arranged. A request for accommodations (Form ADA-100: http://uthscsa.edu/eeo/form100-Faculty-student-resident.pdf) must be completed and submitted to the Executive Director of the ADA Compliance Office before accommodations can be provided. Additional information can be provided in the Student Success Center, Room 1.118 or through the ADA Compliance Office website: http://uthscsa.edu/eeo/request.asp.

REQUIRED TEXT / REFERENCE

Required Text:

1.  Jarvis,C. (2016). Physical Examination and Health Assessment, 7th edition: ISBN:9780323265324 

2.  Required Student Account Setup for Shadow Health:

Students can create their accounts by visiting

http://app.shadowhealth.com/  and enrolling in NURS3110 course- specific PIN:  January2018-5346-6195-8101-6276


Course Setup

 

The Support Team is available to help address any technicalissues or questions that a student might have.  Support can be reached viasupport.shadowhealth.com, through email support@shadowhealth.com, or by calling(800) 860-3241.

RECOMMENDED (OPTIONAL) TEXT / REFERENCE

Jarvis, C. (2016). Laboratory Manual for physical examination & health assessment (7th ed.). St. Louis: Saunders Elsevier. ISBN: 9780323265416





CONTENT OUTLINE

    1. General Survey, Measurement, Vital Signs &Pain Assessment

    
2. Cultural Interview


    3. The Complete Health History

    4. Skin, Hair, and Nails Assessment

    
5. Neck, Including Regional Lymphatics

    6. Eyes, Ears, Nose, Mouth, and Throat Assessment

    7. Respiratory Assessment

    8. Cardiovascular and Peripheral Vascular Assessment

    9. Peer to Peer Evaluation for Midterm Head to toe assessment

    10. Abdomen Assessment

    11. Breast Assessment

    12. GU Assessment

    13. Musculoskeletal

    14. Mental Health and Neurological Assessment

    15. Focused Assessments

    16. Final Head to Toe Assessment

     








CALENDAR - 1st Day Only

Please check the schedule for recent updates on Class Dates & Room.


NURS 3110

Lab 1: 0915-1110

Lab 2:  1120-1315

Location: Clinical Skills lab

Assignments for NURS 3110



Before class review:

Lab Course Orientation video online
Shadow Health Orientation online


Lab topic:

1. Location ATC 3.301

Class Orientation to be in AL&TC 3.301

Lab 1 & Lab 2: 0900-0930


2. Location: SON Clinical Skills lab


Orientation to Skills lab by CSI staff


General Survey, Measurements, Vital signs & Pain

Lab 1: 1000-1130

Lab 2: 1145-1315


Shadow Health Assignment due January 13 at 11:59 pm:

Digital Clinical Experience Orientation (10 min)

Conversation Concept Lab (30 min)

Please check the Canvas calendar for recent updates on Class Dates & Rooms. Bring your Jarvis text or e-book, laptop, and wear your clinical uniform


















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