Spring 2021

NURS 6110-001 Advanced Health Assessment and Clinical Reasoning: 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.

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

Welcome to Advanced Health Assessment and Clinical Reasoning: Clinical Applications! We look forward to working with you this semester.

Our first class session will be January 12th, Tuesday, at 8 am via a virtual synchronous class.  This course is taken in conjunction with NURS 6210.  Due to the pandemic circumstances, we are devoting all on-campus time to clinical skills practice and patient case simulations. The didactic content and the content we can conduct virtually will be done through Canvas Conference or Microsoft Teams. Please refer to the combined course calendar for specific details of the location of class each week.

Due to the current pandemic situation, this course is designed to limit physical contact as much as possible while still meeting learning objectives. Temperature checks and appropriate PPE are required while on campus.





FACULTY CONTACT INFORMATION

Heidi Worabo, DNP, APRN, FNP-BC, FAANP (CourseCoordinator)

Associate Professor / Clinical

Email: worabo@uthscsa.edu

Office Phone:  210-567-5867

Office Room:  2.380

Office Hours: Tuesdays 3-4pmand by appointment

Amanda Bridges, DNP, APRN, ACNP-BC

Assistant Professor / Clinical

Email: bridgesa1@uthscsa.edu

Office Phone: 210-450-8026

Office Hours: by appointment

Nancy McGowan, PhD, RN, CEN

Associate Professor / Clinical

Email: mcgowann@uthscsa.edu

Office Phone: (210) 567-5310

Office Room: 2.222

Office Hours: By Appointment

COURSE DESCRIPTION

Students will apply advanced health assessment techniques in the performance of focused and comprehensive health assessments of clients across the lifespan. Clinical reasoning, analysis, and synthesis of history and physical assessment data and diagnostic reasoning skills are developed.


CREDIT AND TIME ALLOCATION

Credit Hour Allocation:  1 semester credit hours
Clock Hour Allocation:   60 clock hours lab


PREREQUISITES

Prerequisite
NURS 6338 Advanced Pathophysiology



Concurrent
NURS 6210 Advanced Health Assessment and Clinical Reasoning


PROGRAM OUTCOMES

Upon completion of the Master of Science in Nursing Program (MSN) students will:

  1. Integrate scientific findings from nursing and related sciences, including genetics and genomics, into the delivery of advanced nursing care to populations in diverse settings.
  2. Demonstrate organizational and systems leadership to assure ethical and critical decision-making at all systems’ levels for quality and patient safety.
  3. Incorporate performance improvement strategies for quality, safety, and patient-centered care delivery.
  4. Use improvement science to achieve optimal patient care and care environment outcomes.
  5. Integrate meaningful and usable information systems and healthcare technologies to support safe, quality patient care and healthcare systems effectiveness.
  6. Advocate for policy changes that influence healthcare at appropriate levels.
  7. Lead interprofessional teams using collaborative strategies to effect quality patient care and population health outcomes.
  8. Analyze and incorporate broad ecological and social health determinants to design and deliver evidence-based clinical prevention and population healthcare and services to individuals, families, and aggregates/identified populations.
  9. Integrate the advanced competencies expected of a master’s prepared nurse to design, deliver, and evaluate outcomes of systems of care for individuals, families, and diverse populations.

COURSE OUTCOMES

N/A

CLINICAL OUTCOMES

1.  Apply a holistic patient-centered approach to the collection, synthesis, and communication of data gathered, both oral and written. (DNP Essential VIII; NONPF Competencies: Practice Inquiry 1, 2; Ethics 2, 3; Independent Practice 1, 2 4) 

2.  Collect a comprehensive database, including age-appropriate history, physical examination, laboratory and diagnostic studies. (DNP Essential VIII;; NONPF Competencies: Practice Inquiry 2,3; Independent Practice 1,2 3)

3.  Adapt history and physical examination data, and screening according to age, developmental status, culture, language, and patient needs, preferences, and values. (DNP Essential VIII; NONPF Competencies: Practice Inquiry 3; Ethics 2,3; Independent Practice 1, 2, 4, 8)

4.  Formulate a summary of the database including prioritized differential diagnoses and problem list based on interpretation of a comprehensive assessment. (DNP Essential VIII; NONPF Competency: Independent Practice 1, 2, 3, 5, 8)

5.  Construct an organized and complete oral and written summary of the database, including a prioritized differential diagnoses and problem list. (DNP Essential VIII; NONPF Competency: Independent Practice 1, 2, 3, 5, 8)

6.  Formulate prioritized differential diagnoses and problem lists. (DNP Essential VIII; NONPF Competency: Independent Practice 1, 2, 3, 8)

7.  Utilize motivational interviewing skills. (DNP Essential VIII; NONPF Competencies: Ethics 1, 2, 3; Independent Practice 1, 2, 4, 5)

 


GRADING SCALE FOR GRADUATE 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

DxR Clinician Patient Cases                                20%

SOAP Notes                                                         20%

HEB Clinical Skills Lab Focused Patient Encounters

        HEENT                                                     20%

        Cardiovascular/Pulmonary/Abdomen        20%

        Musculoskeletal/Neuro                             20%

Total                                                                100%

*A cumulative grade of 80% orbetter is required to pass the course.

Grading Scale

Pass/Fail


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. 

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/

School of Nursing Netiquette Guidelines for Online Interaction

Netiquette guidelines provide information for behaving properly online, when using email, tweets or texts so that you may successfully communicate your thoughts in a manner that is respectful and avoids misunderstandings with others.

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

DxR Clinician is a cloud-based, highly interactive application designedfor the purpose of helping students master patient assessment anddiagnostic-reasoning. The link to register and pay the $75 semestersubscription is here:  https://dxrgroup.com/product/uthscsanp/

Bickley, L. (2020). Bates' Guide toPhysical Examination and History Taking. 13th Edition. Philadelphia,PA: Wolters Kluwer. ISBN-13: 9781496398178

Seller, R.H. & Symons, A.B. (2018). Differential diagnosis of common complaints (7thed.). St. Louis, MO: Elsevier.  ISBN: 9780323512329

RequiredSupplies:

Purchase a 3/4 length white lab coat personalized withyour name and current degree (i.e. Jane Smith, BSN, RN with the UT Health SanAntonio School of Nursing Logo.  Labcoats are available at local uniforms stores.

 

RECOMMENDED (OPTIONAL) TEXT / REFERENCE

Hagan, J.H., Shaw, J.S., & Duncan, P.M. (Eds.) Bright Futures: Guideline Pocket Guide.4th ed. American Academy of Pediatrics. ISBN-13:  978-1610020824. 

 


CONTENT OUTLINE

CONTENT OUTLINE

  1. Foundations of Clinical Proficiency, Clinical Reasoning and Recording Findings
  2. Evaluating Clinical Evidence and Differential Diagnoses
  3. Health History and Motivational Interviewing
  4. General Survey
  5. HEENT
  6. Dermatology and Lymphatics
  7. Abdominal and Renal
  8. Cardiovascular
  9. Pulmonary
  10. Musculoskeletal
  11. Neurology and Mental Health
  12. Male and Female Genitourinary, Breasts, Rectal
  13. Special Populations: Pregnancy, Newborn, Pediatrics, Geriatrics

CALENDAR - 1st Day Only

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

The topics we will cover on January 12th from 8 am until 12:50 pm include the following:

Clinical proficiency, Clinical Reasoning, Documenting, Differential Diagnoses, Health History, Motivational Interviewing, The General Survey, Vitals & Pain.

We will also have an orientation to the course(s) (N6210, N6110), orientation to the Center for Simulation & Innovation (CSI) of the School of Nursing, to the HEB Clinical Skills Lab, and to the DxR Clinician program. 

On behalf of all of the faculty, welcome and we look forward to working with you!

Sincerely,

Heidi Worabo, DNP, APRN, FNP-BC, FAAN
NURS 6110 Course Coordinator


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