Fall 2021

NURS 6437-01 AGACNP Dx & Mgmt: Clinical Application 1

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/.

Any additional expenses that the clinical agency may incur include but are not limited to drug screening, background checks, ID badges, immunizations etc., will be at the students expense.

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

Link to Graduate Clinical Experiences and Typhon guidelines: http://nursing.uthscsa.edu/gradclinical/

Review Canvas prior to the first day of class

FACULTY CONTACT INFORMATION

Amanda S. Bridges, DNP, MSN, RN, ACNP-BC
Assistant Professor/ Acute Care Nurse Practitioner

School of Nursing

UT Health San Antonio

7703 Floyd Curl Drive

San Antonio, Texas  78229-3900

210.450.8026 | bridgesa1@uthscsa.edu

COURSE DESCRIPTION

This course develops clinical competency and emphasizes the integration of theory, assessment and advanced therapeutics for the safe and patient-centered care of adults in a high acuity healthcare setting. Emphasis is placed on the management of acute, complex, and chronic health problems in the young adult, older adult, and elder adults as well as adults with critical illness under the direction of clinical preceptors. In addition, this course emphasizes collaborative partnership development between patients, their families, and inter-professional teams.


CREDIT AND TIME ALLOCATION

Credit hour allocation: 4 semester credit hours
Clock hour allocation: 240 clock hours clinical practicum


PREREQUISITES

PREREQUISITES
NURS 6435 AGACNP Diagnosis and Management: Concepts and Theory 1
NURS 6436 AGACNP Diagnosis and Management: Concepts and Theory 2

PREREQUISITES OR COREQUISITES
NURS 6235 AGACNP Diagnosis and Management: Concepts and Theory 3
NURS 6135 AGACNP Diagnosis and Management: Clinical Seminar 1


PROGRAM OUTCOMES

Upon completion of the Doctor of Nursing Practice (DNP) Program students will:

  1. Integrate nursing science, ethics, biophysical, psychosocial, analytical, and organizational sources to provide the highest level of specialty nursing practices.
  2. Develop, implement, and evaluate healthcare practices in healthcare systems that ensure quality improvement and patient safety.
  3. Use analytic methods and evidence based practices to improve practice outcomes and the practice environment.
  4. Implement and evaluate ethical healthcare information systems and patient care technology to improve the quality of patient health outcomes and care systems.
  5. Advocate for healthcare practices that advance social justice, equity, and ethical policies within all healthcare arenas.
  6. Employ interprofessional collaborative teams to improve patient and population health outcomes and healthcare delivery systems.
  7. Lead the integration and institutionalization of (evidence based) clinical prevention and population based health guidelines.
  8. Use clinical judgment, systems thinking, accountability, and specialized knowledge to design, deliver, and evaluate evidence based, culturally proficient care to improve patient, population, and health systems outcomes.

COURSE OUTCOMES

1.  Provide patient-centered acute care with emphasis on health promotion, disease prevention, health protection, anticipatory guidance, counseling, disease management, and palliative care to patients and families during transitions and life-style adjustments as an integral member of the interprofessional team. (DNP Essentials I, III, VI, VII, VIII; NONPF Competencies: Independent Practice 3, 6)

2.  Apply knowledge of acute, complex, and chronic illnesses to diagnose and manage young adult, adult, and older adult patients in high acuity healthcare settings. (DNP Essentials I, III, VIII; NONPF Competencies: Independent Practice 3, 6)

3.  Create plans of care using evidenced-based guidelines related to patient health, disease management and prevention to impact health outcomes in this diverse population. (DNP Essentials I, III, VII, VIII; NONPF Competencies: Scientific Foundation 2, Independent Practice 3, 4)

4.  Develop appropriate differential diagnoses and implement an evidence-based management plan. (DNP Essentials I, III, VIII; NONPF Competencies: Scientific Foundation 3, Practice Inquiry 6, Independent Practice 8)

5.  Demonstrate core professional values in the implementation of the nurse practitioner role. (DNP Essentials I, II, V, VIII; NONPF Competencies: Ethics 1, 2, 3, Independent Practice 1, 2, 8)

6.  Create a climate of patient-centered care to include safety, confidentiality, privacy, comfort, emotional support, education, mutual trust and respect. (DNP Essentials II, VIII; NONPF Competencies: Quality 1, Practice Inquiry 2, 3, Independent Practice 1, 2, 4, 5)

7.  Analyze ethical principles in clinical decision-making in the implementation of the nurse practitioner role. (DNP Essentials I, II, V, VIII; NONPF Competencies: Ethics 1, 2, 3, Independent Practice 1, 2, 8)

8.  Demonstrate progression in self-directed learning, professional development, competence, and leadership as a member of the interprofessional team in providing care for this diverse population. (DNP Essentials II, III, V, VI, VII; NONPF Competencies: Leadership 2, Independent Practice 1, 2, 5, 6)

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

Clinical Experience is Pass/Fail

Clinical Experience is Pass/Fail

No clinical can be started at any clinical site until an Intent of Relationship (IOR) is completed, submitted to the course coordinator  and approved by the faculty.  d

Clinical Practicum

The student will complete 300 hours of clinical practicum with their assigned preceptor(s) once the Intent of Relationship (IOR) agreement is completed by the student and preceptor, signed, faxed to the School of Nursing, and approved by the graduate faculty.  Students are expected to dress in business casual with white lab coat and UT Health NP Student badge and present a professional appearance while in the clinical setting.   The clinical practicum must be completed no later than the end of the course.  There are no extensions for completing hours except for a major health problem; therefore, the student must plan ahead when negotiating clinical hours with the preceptor.

Clinical Site Visits:

Students will have one scheduled site visits by their assigned faculty and others as necessary.


Preceptor and Faculty Evaluation (Pass/Fail):

Students must pass clinical to pass the course. A written evaluation from the student’s preceptor(s)is/are required at the end of the rotation with the preceptor. If a student has one preceptor the whole semester, then they need a Midterm evaluation and a Final Evaluation completed by the preceptor. If the student has more than one preceptor, then each preceptor needs to do at least one evaluation. Each preceptor is required to sit down with the student to go over the evaluation. Two written evaluations will also be completed by the faculty for each student during the semester. Final grade determination will be made by the faculty of record with input from the preceptor(s).

Clinical Attendance

 

Students are required to attend all clinical experiences. Students are to be prompt, prepared, and appropriately attired. 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. Professional role behavior is expected.  The graduate student will notify the clinical agency and preceptor that she/he is unable to attend and how they will reschedule the missed hours

Practicum Course Policies:

Students are encouraged to have a variety of clinical experiences that will encompass all aspects of their advanced practice role and expose them to patients within different clinic settings.  

1. Students may not have clinical preceptorships at a practice setting where he/she is currently employed, nor may they be paid for clinical as part of their working hours. 

2. Students may not have a clinical preceptorship with a provider with whom they are a patient of that provider.  

3. The majority of clinical experiences during the clinical preceptorship must be at the participation level or higher. Total observation is not acceptable at this level in the program.

4. Students must receive “Minimally Met”  on midterm or "Met Standards" on Final evaluation from faculty during clinical site visits.

5. The preceptorship component must be successfully completed in order to pass the course, regardless of grades received on the didactic components.The preceptorship component consists of:

A. One clinical evaluations through observation by the clinical course faculty and additional clinical evaluations by each preceptor, with each documenting on the clinical evaluation form and;

B. Clinical log documentation of student’s experiences in Typhon,entered at least weekly.  Failure to complete logging Typhon hours by the last clinical day will result in failure of this course.

C. Students who are deemed unsafe or fail to meet the expected clinical course outcomes and clinical competencies in any clinical course in the required program of study will receive a course grade of “F”.  Behaviors constituting clinical failure include, but are not limited to, the following:

a.         Request for removal from clinical site for cause by a clinical agency

b.         Demonstrates unsafe performance and makes questionable decisions

c.         Lacks insight and understanding of own behaviors and behavior of others

d.         Needs continuous specific and detailed supervision

e.         Has difficulty in adapting to new ideas and roles

f.          Fails to submit required written clinical assignments

g.         Falsifies documents

h.         Works as a student in a clinical role for more than 12 consecutive hours in a 24-hour period

D. Procedure:  A student who fails a clinical course may be placed on probation or be dismissed from the program in accordance with set criteria. See Graduate Handbook for further details.

6. There are NO incompletes for clinical courses except for a major health problem. All clinical hours must be completed by the last official class day of the semester. NO extensions for unmet clinical hours will be granted. Failure to complete all clinical hours or falsification of clinical hours will result in failure of the course.

         7.  It is expected that all scholarly papers will be written using APA Format 7th Edition. 

Practicum:

300 clock hour practicum in a hospital, long term care facility, Emergency Room, or specialty clinic.  The focus is the health of the Adult- Gerontology population along the continuum of acute,chronic, and complex disease management. The practicum will be supervised by a faculty member.  

The 300 clock hour practicum will be coordinated by and under the supervision of the UT Health San Antonio School of Nursing Clinical Liaison with physician, physician assistant and nurse practitioner preceptors. Students will be placed in practicum by the clinical liaison in collaboration with the faculty. In the rare event a student requests a change in clinical assignment, the request along with a clear and compelling rationale, must be submitted to the Clinical Liaison and the assigned faculty.  Such requests will be considered on a case by case basis and approval is at the sole discretion of the faculty. 

Typhon Tracking:

Each student is required to maintain an electronic record of all patient encounters using Typhon.  The student will document patient encounters in Typhon in a timely fashion, and as soon as feasible following the clinical experience, but no less than once per week.  The student is responsible for accurate and complete records in Typhon. Failure to do so can result in failure of the course.


Clinical Course Documentation Requirements within Project Concert

Midterm

Final

1.  Preceptor Evaluations of Student

One at midterm (or one per preceptor)

One at final (or one per preceptor)

2.  Faculty Evaluation of Student

One at midterm (or one per preceptor)

One at final (or one per preceptor)

3.  Student Evaluation of Preceptor

One per preceptor (if with that preceptor for more than 16 hours)

One per preceptor if > 16 hrs with that preceptor

4.  Student Evaluation of Clinical Site

One per clinical site

Second if more than one clinical site

5.  Faculty Evaluation of Clinical Site

One for each site visit

Second if went to more than one site

6.  Patient Encounters entered into Typhon

Student to run report and send to faculty instructor

Student to run report and send to faculty instructor

7.  300 approved clinical hours

Send faculty instructor current number of hours completed and approved

Send faculty instructor current number of hours completed and approved

8.  Clinical Group Seminar

Attended seminars

Attended seminars & completed VCCR Module I

 

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 their faculty instructor prior to the scheduled due date and time if they are unable to submit the written work as scheduled.
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 up to 72 hours after the due date with consequences at faculty discretion. Five points will be deducted for each day an assignment is late (up to 15 points). After 72 hours, late assignments will be a grade of zero

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.


ADA Accommodations

 

Any student seeking ADA Accommodations under the American with Disabilities Act should contact the Associate Dean for Admissions and Student Services within the first week of the semester so that appropriate accommodations may be arranged. A Request for Accommodations (Form 100) must be completed. These forms are available in the Office for Students Room: NS 1.106

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 Undergraduate Studies 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.

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

No formal textbook required but recommend reference books and apps based on your clinical area.

MDCalc.com
Uptodate.com

Samford Guide to Anti-infectives

CALENDAR - 1st Day Only

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

Please see canvas for details regarding site visits and Typhon use.

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