Fall 2020

NURS 4311-001 Care of the Adult I: Theoretical Foundations

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COVID-19
Students are expected to follow all policies related to COVID-19 found on the university webpage: https://wp.uthscsa.edu/coronavirus/.

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Welcome to Nurs. 4311 Care of the Adult I: Theoretical Foundations!

First and foremost, welcome to your senior semester in nursing school!  This course focuses on theoretical principles regarding holistic care of the adult experiencing chronic health problems within diverse settings.

Due to COVID19 restrictions and the safety of our students, classes and exams will not be on campus.  Classes will be held at the regular scheduled days and times via Canvas Conference. 

Unit One in Canvas will be open a few weeks before the start of class. You will be advantaged to start Unit One readings before the first day.  

The required textbooks will be utilized.

FIRST DAY: 

Classes are scheduled on Thursdays 13:00-15:50 and Fridays 09:00-11:50.  The Thursday before exams 1, 2, & 3 there will not be class.

Exams: 

Again, I welcome you to the semester and look forward to learning with you.

FACULTY CONTACT INFORMATION

Heidi Benavides, MSN, RN, CMSRN - Course Coordinator
Email: benavidesh@uthscsa.edu 
Office Phone: 210-567-5826
Office Room Number: 2.370 (2nd floor, take a right at the top of the stairs and follow the hallway around to the right. It's the very back hallway of offices)
Office Hours: See Starfish for office hours

Gretchel Gealogo Brown, PhD, RN, MHR, MSN, CMSRN 
Email: gealogo@uthscsa.edu
Office Phone: 210-450-8474

Mady Stovall, PhD, ANP-BC
Email: stovallmc@uthscsa.edu
Cell phone: 310-709-4082

COURSE DESCRIPTION

This course focuses on theoretical principles regarding holistic care of the adult experiencing chronic health problems within diverse settings.

CREDIT AND TIME ALLOCATION

3 semester hours (3 hours theory)

PREREQUISITES

Successful completion of Semester 6

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. 
  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. Describe the etiology, clinical manifestations, and nursing management of chronic health problems across the adult lifespan. (Essential I, IX)
  2. Integrate theory and concepts from liberal arts, sciences, and nursing education to plan for holistic, patient-centered, quality care for adult patients with chronic problems. (Essential I, IX)
  3. Examine concepts of quality patient care and safety to improve patient care outcomes in adults experiencing chronic health problems. (Essential II, IX)
  4. Describe partnerships in the development of customized therapeutic care to promote, and restore optimal health within the context of chronic health problems. (Essential VII, IX)
  5. Identify patient care technologies and information systems that support safe, quality nursing care (Essential IV, IX)
  6. Identify therapeutic communication principles used with adults and their support systems. (Essential II, IX)
  7. Evaluate evidence-based practice interventions for managing and promoting health across the lifespan of the adult. (Essential III, IX)
  8. Identify the role of collaborative relationships within the healthcare team in providing care to the adult with chronic health problems. (Essential VI, IX)
  9. Describe the impact of sociocultural, economic, and legal factors influencing nursing practice and healthcare delivery for adults experiencing chronic health problems. (Essential V, VII)
  10. Recognize the relationship of genetics and genomics to health and disease management with adults experiencing chronic illness. (Essential VII, IX)

GRADING SCALE FOR UNDERGRADUATE COURSES

A = 4 points (90-100)
B = 3 points (80-89)
C = 2 points (75-79)
D = 1 point (66-74)
F = 0 points (65 or below)

CRITERIA FOR EVALUATION / GRADES

There is not an ATI Content Mastery Exam in this course 
Students will take the Medical Surgical ATI exam in NURS 4315 (Care of the Adult II)

All assignments are to be completed independently unless otherwise directed.  
Grade Percentages:

20%-Exam 1
20%-Exam 2
20%-Exam 3
30%-Exam 4 (comprehensive)
10%- Assignments & In-Class Activities
100%-Total

1% Optional Extra Credit
101% Potential Total

*There are discrepancies between the Lewis textbook and ATI books.  Exams will be tested on the most current information from the Lewis textbook

Assignments must be completed on time. There is a reduction of 10% for every day the assignment is late with the exception of the unit readiness quizzes.  The readiness quizzes must be on time to receive credit. 

Students must be present to receive a grade for in-class assignments. Any absences should be emailed ahead of time to the course coordinator.   


Students with a failing first exam and/or midterm grade are encouraged to meet with the course coordinator and the Student Success Center to develop a plan to promote student success in the course. 


**Please read below:

1.Completion of Practice A and B exams are required to be eligible to take the ATI Content Mastery Exam. A minimum score is required for the Practice Exams. Practice Exam attempts include a wait period between administration of the exam, so students must plan ahead in order to meet the due date (see the “Assessment Technologies Institute, LLC (ATI) RN Content mastery Series” section of this syllabus for details).

2.Due dates for the practice exams are identified on the course calendar displayed in CANVAS. Consistent with the “Written Work” section of this syllabus, students are expected to submit work by the scheduled date and time.

3.Additionally, per the “Testing Policy” section of this syllabus, students are expected to take examinations at the scheduled time unless there are extenuating circumstances. Failure to complete the practice exams within the timed structure is not an extenuating circumstance.

4.Based on the above-mentioned policies, students who do not meet the requirements for Practice A and B exams by the identified due date are ineligible to take the initial administration of the ATI 0216 Content Mastery Exam and are not eligible to make up this ATI exam attempt. Students who subsequently meet the requirements for Practice A and B exams are eligible to complete the second ATI exam and will earn the score commiserate with the second ATI exam.



CELL PHONE POLICY

TESTING POLICY


    Exam Administration:

    Faculty are dedicated to providing optimum testing environments that demonstrate the values of fairness, honesty, accountability, and integrity, consistent with the School of Nursing Code of Professional Conduct.

    In the School of Nursing Code of Professional Conduct, students vow to promote and maintain an honest and effective physical and online learning environment. As a reminder, all nursing students vow on their honor as a member of the nursing profession to take ownership for their actions and to uphold the values of nursing.

    This is achieved during exams by observance of these instructions:

    All students must present their university photo ID badge for entry into the exam, whether on-campus or remote. For remote exams using ExamMonitor, a baseline photo and biometric data to identify each student is required and established during the mock exam process. For on-campus exams, if the badge is forgotten, the student will present state or government ID. If the student has no ID available, they may be admitted to the exam with a printout of their Starfish Profile picture.

    The immediate testing seating area is limited to: computer, required privacy screen, calculator (if necessary) and pencil. Drinks are allowed only for exams more than two hours in length. For on-campus testing, earplugs and scratch paper are allowed. For remote testing, earplugs and scratch paper are prohibited. Exceptions can be sought through consultation with the Associate Dean.

    Hats, caps, or head coverings may not be worn during exams except those required for religious purposes.

    Students who must leave the room, should notify the proctor. No extra time is provided when a student must leave the room. For remote testing, students without accommodations may not leave the room, take the computer to another room, or use headsets.

    For remote testing, exam behaviors that may be flagged as lacking integrity include:

    excessive eye movement away from the computer screen during the exam

    talking during the exam

    communicating with others during the exam

    other persons in the room


    A post exam review may be conducted. Note-taking during the review is prohibited.

    Discussion of test content should not occur. Any sharing of information related to the exam is grounds for a zero grade for all students involved and may result in further disciplinary actions.


    The following guidelines support a quiet environment, as free from distraction as possible:

    Stored electronic devices must be powered down to reduce distraction and reduce interference with WiFi access. Proctors will take action to remove any items causing noise disturbances during testing.

    Students must move away from the door area as outside conversations can be heard while students are exiting the exam. Repeated violations will be addressed according to the Code of Professional Conduct.

    If testing remotely, the student will secure an off-campus location/environment for testing. The testing environment should be quiet, non-distracting, and well-lit. Overhead lighting in the testing room is recommended. If there is no overhead lighting available, the light should not be behind the student. All background noise (television, music, radio, etc.) must be turned off during the exam. If the student is unable to find an off-campus location/environment for testing, they should notify the course coordinator at least 7 calendar days before the scheduled exam to secure an on-campus location. An on-campus room may not be possible if less than 7 days of notice is given.

    Faculty understand that unexpected events may occur on the day of an exam and offer support in these ways:

    Testing at scheduled times is expected. Please refer to the Excused Absence section in the Undergraduate Student Handbook, for detailed information about notification. Make up exams may contain alternate questions of similar rigor and/or may be a different format.

    It is recommended that students perform periodic computer checks including:

    Recommended to turn off auto update

    Wait to upgrade to any new MacOS version

    Check Examplify’s website for compatibility

    Log in at https://examsoft.com to check minimum system requirements

    Contact UT Health San Antonio Help Desk Phone Number with questions on computer readiness:

    210-567-7777 option 1

    Available Mon - Fri 6:00am - 6:00pm



    In the case of an exam or computer dysfunction, the student may be offered a written paper and pencil test or may be scheduled for a makeup exam. The course coordinator will discuss the options with the student based upon the time left in the exam and related issues.

    If the student has technical issues during remote testing, a phone may be temporarily used to phone the course coordinator for guidance.


    Technical requirements for proctored online exams:

    At least 7 calendar days prior to the exam, students must ensure compliance with all technical requirements and necessary computer updates. Technical requirements include:

    Find a full list of ATI’s technical requirements at: atitesting.com/technical requirements

    Microphone: Any microphone, either internal or external

    Webcam: 320x240 VGA resolution (minimum) internal or external

    Desktop or laptop computer (NO iPads, Tablets, or Phones to be used) with the ability to download Google Chrome

    Completing a Dry Run (Mock Exam)

    ATI uses Proctorio for the remote proctoring. Please review the “Student Start Quick Guide: ATI Remote Proctoring with Proctorio” found at: www.getproctorio.com. Each first time test taker will complete the Dry Run exam prior to taking ATI content mastery exam in 5th semester.

    ExamSoft uses ExamMonitor for remote proctoring. The follow site, www.examsoft.com/community, provides a tutorial for students.



GRADING POLICY GUIDELINES:

  1. To pass the course, a student must have a weighted average of 75% on all graded activities.
  2. Students must make a "C" (75) or higher in all nursing courses to progress in the program.

 ROUNDING POLICY:

The final grade will be calculated to two decimal places and rounded mathematically as follows:

CLASSROOM ATTENDANCE

Attendance in class is an expectation of each student.

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 7th edition is required for use in all nursing school programs. 

Assessment Technologies Institute®, LLC (ATI) RN CONTENT MASTERY SERIES®

             

UTHSCSA School of Nursing utilizes the ATI RN Content Mastery Series®, RN Comprehensive Predictor® practice and proctored exams, and the ATI Virtual "greenlight" program to assist students in preparing for the NCLEX-RN® exam. Through practice and proctored examinations, students are able to assess their own knowledge and receive feedback and direction for content review throughout the program of study.

The ATI RN Content Mastery Exams (CME) are administered in specific courses in both undergraduate tracks


1. For a student to take the ATI content mastery exam:

•Completion of Practice A and B exams with a minimum score of 90% on both exams is required. Practice exam attempts include a 24 hour wait period between attempts.
•Students will be ineligible to take the initial administration of the ATI Content Mastery Exam (CME) if the practice exams are not completed by the due date outlined in the course calendar displayed in the institutional Learning Management System.

oUpon completion of Practice A and B with a 90% or better, student is only eligible to sit for the second CME exam and will receive the score commiserate with the second CME exam. Thus, student will not be eligible for a retake of the CME.

2. To strengthen the Practice A and B review method:

•Students who did not achieve a 90% or greater on the practice exam should understand the rationales for each distracter. It is recommended that students complete a Focused Review for the practice assessment to address gaps in knowledge.


3.Content Mastery Exams will comprise 15% of the total course grade.
The following provides guidelines for inclusion of the CME in the course grade:


oAn exception to this policy applies to NURS 4502 Disease Management II. The Content Mastery Exams which comprises 15% of the total course grade for NURS 4502 Disease Management II is split between the ATI Nursing Care of Children Content Mastery Exam (CME) and ATI Maternal Newborn Content Mastery Exam (CME). Each exam is worth 7.5%.


                   Content Mastery Examinations Requirements


Level

 1st ATI Exam  (15% of Course Points)

2nd ATI Exam      (15% of Course Points)

3

100% of points  

85% of points

2

90% of points

80% of points    

1*

0% of points, complete focused review** and must retake exam

0% of points

Less than Level 1*

0% of points, complete focused review** and must retake exam

0% of points

•If a Level 1* or Less than Level 1* is achieved, an individualized student success plan will be developed and implemented in conjunction with faculty to help student attain content mastery.

o**A mandatory focused review is required to complete before retaking the Content Mastery Examination and consists of:

The RN Comprehensive Predictor will be given twice in NURS 4420 (traditional BSN track) and NURS 4423 (accelerated BSN track). The first RN Comprehensive Predictor will be given at the beginning of the course. The second RN Comprehensive Predictor will be given at the end of the course.

1.Each student will enroll in the designated comprehensive review course.
2.The student will complete two RN Comprehensive Predictor exams.
3.The student is expected to obtain a 74.0% or greater on one of the RN Comprehensive Predictor exams (96% predicted probability of passing the NCLEX-RN).
4.If the student makes less than a 74% on the first RN Comprehensive Predictor, the student will engage in a required handwritten focused review** on all missed items under “Topics to Review”. The student will submit the focused review along with their ATI “Report” to the institutional Learning Management System (LMS) within 10 business days.

•If the student has not completed the required focused review, the student will not be eligible to take the second RN Comprehensive Predictor exam and will not successfully pass the course.

5.A second RN Comprehensive Predictor will be given before the end of the semester. It is not required to complete a focused review however it is encouraged to complete a focused review to improve your comprehension of the content.

•If the student does not achieve the required 74.0% or greater on their individual score with either the first or second RN Comprehensive Predictor (96% predicted probability of passing the NCLEX-RN), the student will complete ATI Virtual Modules 6-9 (Module Six OB, Module Seven Pediatrics, Module Eight Mental Health, and Module Nine Leadership-Management).



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

This course utilizes books that students purchased in previous semesters.

Lewis, S. M., Bucher, L., Heitkemper, M. M., & Harding, M. M. (2017). Medical surgical nursing: Assessment and management of clinical problems (10th ed.). St. Louis: MO: Mosby – Elsevier.
Book: ISBN 9780323328524
e-Book: ISBN 9780323371445

Davis's Drug Guide.  The App (Unbound) is my preferred guide costing about $40) 

Assessment Technologies Institute (ATI) 2019 Materials: RN Medical-Surgical textbook

RECOMMENDED (OPTIONAL) TEXT / REFERENCE

Helpful FREE resources for clinical practice: 

UpToDate (available on the library website [free as a student] and most clinical agencies)

www.labtestsonline.org (gives you a rationale for abnormal results)


CONTENT OUTLINE

Unit 1: Chronic Illness, Peripheral Vascular Disorders, & Cardiovascular Disease

Unit 2: Obesity, Gastrointestinal Disorders, & Cancer

Unit 3: TPN, HIV/AIDS, Chronic Endocrine & Chronic Kidney Disease 

Unit 4:  Chronic Neurological, Chronic Musculoskeletal, Ear & Eye Disorders, & COPD

CALENDAR - 1st Day Only

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

See first day announcements

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