Fall 2021

NURS 6210-001 Advanced Health Assessment and Clinical Reasoning

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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/.

Welcome to Advanced Health Assessment!




The first class will be on Tuesday, January 11th from 8:00 am- 12:00 pm in classroom 1.211. This course is taken in conjunction with the clinical course, NURS 6110.

Please review the Canvas course modules and calendar for the specific location of class each week.  Each week will be different, but we will expect your availability and attendance for all sessions, which will take place every Tuesday.

This is a busy semester with lectures, labs, and sim center activities. This course explores the foundational health history and physical examination skills needed by all advanced practice nurses. This course requires many hours of time and effort but is very rewarding. 

FACULTY CONTACT INFORMATION

Course Coordinator:


Sarah Knoeckel, DNP, FNP-BC, RN

Assistant Professor/Clinical

Email: knoeckel@uthscsa.edu

Office Phone: 210-450-8974

Office Room: 2.512

Office Hours: Wednesday from 2-3 pm and by appointment

 


 

COURSE DESCRIPTION

This course will build upon health assessment skills developed in the professional nurse's basic educational program. The theoretical and clinical basis for health assessment by the advanced clinician will be developed. The process whereby the advanced clinician utilizes comprehensive hisotry, physical, psychosocial, and cultural assessment across the lifespan to gather specific data relevant to common health problems is demonstrated. Students will develop clinical reasoning skills to begin to formulate differential diagnoses.

CREDIT AND TIME ALLOCATION

Credit Hour Allocations: 2 semester credit hours
Clock Hour Allocation: 2 clock hours class (30 hours class)

PREREQUISITES

Prerequisite
NURS 6338 Advanced Pathophysiology

Corequisite
NURS 6110 Advanced Health Assessment and Clinical Reasoning: Clinical Application

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. Apply advanced knowledge of the problem-solving 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. Compile a comprehensive database, including age-appropriate history, physical examination, laboratory and diagnostic studies. (DNP Essential VIII; NONPF Competencies: Practice Inquiry 1,2; Ethics 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. Compare critical reasoning approaches that guide patient-centered care. (DNP Essential VIII; NONPF Competency: Independent Practice 1, 2, 3, 8)
  5. Present an organized and complete oral and written summary of the database and problem list. (DNP Essential VIII; NONPF Competency: Independent Practice 1, 2, 3, 8)
  6. Select advanced assessment techniques specific to the various systems presented in this course. (DNP Essential VIII; NONPF Competencies: Practice Inquiry 1, 2; Ethics 2, 3; Independent Practice 1, 2, 4)
  7. Formulate prioritized differential diagnoses and problem lists. (DNP Essential VIII; NONPF Competency: Independent Practice 1, 2, 3, 5, 8)
  8. Develop motivational interviewing skills. (DNP Essential VIII; NONPF Competencies: Ethics 1, 2, 3; Independent Practice 1, 2, 4, 5)

CLINICAL OUTCOMES

N/A

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

Grade Percentages


35% Midterm

35% Final Exam

5% Special Population Presentations

25% Quizzes (5 quizzes)

 

100% – TOTAL

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

Laptop for in class quizzes with ExamSoft and Examplify loaded

 

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

 

Gawande, A. (2014). Being Mortal. New York: Metropolitan Books. ISBN: 978-0-8050-9515-9

 

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

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. Can also be viewed as an E-book.

Bickley, L.S. (2020)
Bates' Pocket Guide to Physical Examination and History Taking. 8th ed. LWW


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.

Topics we will cover on January 11th from 8:00 am- 12:00pm:


- Clinical Proficiency, Clinical Reasoning, Documenting, Differential Diagnoses

- Health history, Motivational Interviewing

- The General Survey, Vitals, Pain

- Orientation to DxR Clinician

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