Spring 2022

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

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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 didactic course, NURS 6210. 
 
Please review the Canvas course modules and calendar for the specific location of class each week.   

FACULTY CONTACT INFORMATION

Section 01: Nancy McGowan, PhD, RN, CEN 

Associate Professor / Clinical 

Office Phone: (210) 567-5310 

Office Room: 2.222 

Office Hours: by Appointment 

 

Section 02: Amanda Bridges, DNP, APRN, ACNP-BC 

Assistant Professor / Clinical 

Office Phone: 210-450-8026 

Office Hours: by appointment 

 

Section 03: Sarah Knoeckel, FNP, APRN, FNP-BC (Course coordinator) 

Assistant Professor / Clinical 

Office Phone: 210-450-8974 

Office Room: 2.512 

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 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

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


 Weekly Attendance 

 10% 

 Bates Lab Sheet Checklist 

  5% 

 DxR Clinician Patient Cases 

 10% 

 HEB Clinical Skills Focused Patient Encounter

 55%

 SOAP Notes  

 15% 

 Neuro Exam Recorded Video 

  5% 

 Total  

 100% 



*A cumulative grade of 80% or better 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 designed for the purpose of helping students master patient assessment and diagnostic-reasoning. The link to register and pay the $75 semester subscription is here:https://dxrgroup.com/product/uthscsahw/   

 

1. Bickley, L. (2021). Bates’ Guide to Physical Examination and History Taking. 13th Edition. Philadelphia, PA: Wolters Kluwer. ISBN-13: 9781496398178 

 

 

Required Supplies: 

Purchase a short white lab coat personalized with your name and current degree (i.e. Jane Smith, BSN, RN with the UT Health San Antonio School of Nursing Logo.  Lab coats are available at local uniforms stores. We suggest having the logo placed on the lab coat by Sunshine Medical Uniforms: 7330 Louise Pasteur, San Antonio TX 78229 


 


RECOMMENDED (OPTIONAL) TEXT / REFERENCE

1. 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.

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

3. Dermatology DDX Deck, 3rd edition [Cards] by Thomas P. Habif MD, James G.H. Dinulos, M. Shane Chapman, Andrew Eugene Werchniak, Dorothea Torti Barton, Thomas P. Habif ISBN-13: 978-0323608299 ISBN-10: 0323608299


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 

 

Preparation for class: 

Readings: 

Bates (2021) Chapters 1, 2, 3, 4, 5, 7.  

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