Fall 2020

NURS 4314-001 Care of the Adult I: 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.

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

Welcome to Care of the Adult I: Clinical Application.  This course will guide students in the integration and application of content learned in previous courses and in the Care of the Adult I: Theoretical Foundations course. 

This course begins on Monday, August 24, 2020.  Course and clinical group orientation sessions will be held online.  Refer to the course Canvas page for additional information. 

Students will attend two clinical rotation days per week.  Clinical days may be scheduled for Monday/Tuesday, Tuesday/Wednesday, or Saturday/Sunday.


Course Coordinator:
Gretchel Gealogo Brown, PhD, RN, MHR, MSN, CMSRN
Email: gealogo@uthscsa.edu
Office phone: 210-450-8474
Office room number: NSG 2.326
Office hours:  Online or in person by appointment


This course provides opportunity for clinical application regarding holistic care of the adult experiencing chronic health alterations.


3 Semester hours (3 hours Clinical)


 Co-Requisite: NURS 4311 Care of the Adult I:  Theoretical Foundations


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.


  1. Describe the etiology, clinical manifestations, and nursing management of chronic health problems across the 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 health problems. (Essential I, IX)
  3. Apply concepts of quality patient care and safety to improve patient care outcomes in adults experiencing chronic health problems. (Essential II, IX)
  4. Participate as partners in the development of customized therapeutic care to promote, and restore optimal health within the context of chronic health problems. (Essential VII, IX)
  5. Demonstrate appropriate use of patient care technologies and information systems that support safe, quality nursing care. (Essential IV, IX)
  6. Demonstrate therapeutic communication principles with adults and their support systems. (Essential II, IX)
  7. Implement evidence-based practice for managing and promoting health across the lifespan of the adult. (Essential III, IX)
  8. Facilitate collaborative relationships within the healthcare team in providing care to the adult with chronic health problems. (Essential VI, IX)
  9. Identify the impact of sociocultural, economic, and legal factors influencing nursing practice and healthcare delivery for adults experiencing chronic health problems. (Essential V, VII, IX)
  10. Demonstrate the professional nursing role in caring for the adult with chronic health problems. (Essential I, VIII, IX)
  11. Recognize the impact of genetics and genomics in caring for the adult experiencing chronic illness. (Essential VII, IX)


This course is a Credit / No credit course based on student achievement of clinical objectives.


Students receive a formative evaluation at the mid-course point and a summative evaluation after the last clinical day.

Formative evaluations at mid-course are designed to provide an opportunity for the faculty and student to discuss student progress and areas of improvement in order to successfully achieve the clinical objectives. Students failing to achieve satisfactory progress toward any clinical objectives at the mid-course point must provide a written plan to the clinical instructor outlining goals and methods to improve performance.

Summative evaluations at the end of the course are a cumulative assessment of the student's performance. The summative evaluation will indicate the student's earned grade of Credit or No credit for the course.

Formative and summative evaluations will be documented by faculty and students on a course-specific Clinical Evaluation Tool. Specific due dates and requirements will be provided by clinical faculty to their assigned student groups.


Dosage Calculation and Reasoning Assessment

Students must pass the Dosage Calculation and Reasoning Assessment with a score of 100% prior to administering medications in the clinical setting. Remediation is available. Clinical faculty will work with their assigned students to schedule the remediation assessment.

Clinical Skills Lab

Students are required to attend two clinical skills lab sessions prior to the first hospital rotation day.  Refer to Canvas for additional information about the skills lab format, schedule, and related assignments.

Weekly Clinical Assignments

Students must demonstrate satisfactory progress throughout the course on weekly clinical assignments.  Refer to the course Canvas page for additional information about these assignments.  Clinical faculty will provide specific requirements and due dates to their assigned student groups.



Attendance in class is an expectation of each student.


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.

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 Undergraduate Studies to determine progression in the program.
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.

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.

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

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


  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.


The APA Publication Manual 7th edition is required for use in all nursing school programs. 


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.


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.



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.


Because students will be integrating and applying knowledge and skills learned in previous courses and the Care of the Adult I: Theoretical Foundations course, materials required for those courses will be referenced in this course. These include:

Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., Bucher, L., & Harding, M.M. (2017). Medical-surgical nursing: Assessment and management of clinical problems (10th ed.). St. Louis: Elsevier.

Potter, P.A., Perry, A.G., Stockert, P.A., & Hall, A.M. (2017). Fundamentals of nursing (9th ed.). St. Louis: Elsevier/Mosby.

Skidmore-Roth, L. (2018). Mosby's 2018 nursing drug reference. St. Louis, MO : Elsevier.

Ackley, B. J., Ladwig, G.B., & Makic, M.B.F. (2017). Nursing diagnosis handbook: An evidence-based guide to planning care (11th ed.). St Louis, MO: Elsevier.

ATI Tutorials, Simulations and Quiz Banks modules:

ATI review modules for the following assessments:




Students will learn to integrate and apply the following course content through a combination of clinical skills lab, simulation and patient care experiences:

CALENDAR - 1st Day Only

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

Course Orientation

An online Course Orientation session will be hosted online by the course coordinator, Dr. Gretchel Gealogo Brown, on Monday, August 24, 2020 from 1000-1130.  Students are also expected to complete online course orientation activities.  Refer to course Canvas page for additional information on course orientation activities.

Clinical Group Orientation

Clinical Group Orientation sessions will be hosted online.  Refer to the course Canvas page for specific information on session times. 

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