Download Skills N124IN

Basic Skills Lab
N124IN
Spring 2013
SUB-SYLLABUS
Nursing 124IN
Skills
INSTRUCTOR:
Camille Jackson MSN, RN
OFFICE INFO:
RM 919 (575)769-4987
E-MAIL:
[email protected]
OFFICE HOURS:
As posted by instructor
TEXT(S):
Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2013). Fundamentals of nursing (8th
ed.).
St. Louis, MO: Elsevier
Williams, L. S. & Hopper, P. D. (2011). Understanding medical surgical nursing
(4th ed.). Philadelphia, PA: F. A. Davis
COURSE DESCRIPTION:
Clinical skills and procedures are learned and practiced in the classroom and laboratory setting.
UNIT DESCRIPTION:
Nursing Principles and Skills N124IN is one of the first courses taken within the nursing
curriculum. The course presents first level nursing procedures. These procedures are mastered
within the laboratory and later demonstrated in the clinical setting. Along with learning safe
performance of psychomotor skills, each student must rationalize their skills performance based
on evidence-based practice and scientific principles. Written modules will be provided for the
theory and demonstration.
TEACHING STRATEGIES: Videos, demonstrations, discussions, and hands-on learning.
ATTENDANCE REQUIREMENTS:
Attendance is required at all class sessions. Students are expected to attend all classes, be
on time, and prepared to learn. This includes bringing their textbook, syllabus, notebook,
writing instruments, have completed assigned reading and any assigned learning activities.
If a student is more than five minutes late for class, he/she will be considered tardy. If a
student leaves class early, he/she will be considered the equivalent of tardy. Any three
instances where a student has left early and/or been tardy will equal one absence. For
every absence, one point will be deducted from the final course grade. If a circumstance
arises which makes attendance impossible, the student needs to discuss this absence with
the instructor as soon as possible. Absences related to late registration will be considered
the same as absences after registration.
SCHEDULE/CALENDAR: Weekly computerized exams are given for N124IN Nursing
Procedures & Skills. If you are unable to sit for the exam at the designated time, the instructor
Basic Skills Lab
N124IN
Spring 2013
must be notified as above and you will be rescheduled. Rescheduling of any exam (prior to or
later than designated time) results in a ten (10) points deduction from the exam grade.
INSTRUCTIONAL GOAL:
The student will utilize learned clinical skills and procedures in order to provide safe and
proficient nursing care to patients/residents in nursing settings. Concepts of elementary
pathophysiology, diet therapy, cultural diversity throughout the life span will be the focus. In
addition, the student will be able to recognize and remedy potential safety hazards and
participate in a team approach of care for patients/residents served.
Academic Dishonesty :
See the 2011-2013 CCC Catalog General Information section (under Academic Integrity) for the
current Guide for Student Nurses.
Should a student turn in any paper work that appears strikingly similar to any student ( past,
present, or current); including your own work from previous semesters; that individual will earn
a zero ( “0”) on that assignment.
Plagiarism:
As per the 2011-2013 Clovis Community College Catalog plagiarism is defined as follows:
Plagiarism which include but is not limited to: a) offering the work of another as
one’s own: b) offering the work of another without proper acknowledgment; and/
c) failing to give credit for quotations or essentially identical expression of material
taken from books, encyclopedias, magazines, reference works, Internet sources,
term papers, reports, or other writings of another individual.
Plagiarism will not be tolerated. If work is proven to be plagiarized the offering student(s) will
receive a grade of zero (“0”) for the assignment(s) and will be referred to the appropriate College
authority for disciplinary action which may include failure for the section and/or course,
suspension, and/or expulsion. In order to avoid plagiarizing, the student should state their own
thoughts in their own words, provide adequate citations within assignments and if in doubt, ask
questions.
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996
(HIPAA) CONFIDENTIALITY
The U.S. Department of Health and Human Services (2003) issued the Standards for Privacy
of Individually Identifiable Health Information (the Privacy Rule) under the Health Insurance
Portability and Accountability Act of 1996 (HIPAA). These new standards provide the first
comprehensive federal protection for the privacy of personal health information allowing
patients access to their medical records and more control over how their personal health
information is used and disclosed. The final rule went into effect in April, 2003. The Privacy
Rule requires healthcare providers to take reasonable actions to safeguard protected health
information (PHI) and to discipline individuals who violate privacy policies. The Department
of Health and Human Services is charged with enforcing the HIPAA legislation. External
consequences can mean fines levied on the organization and the individual(s) involved and
can include jail time for disclosing PHI.
Basic Skills Lab
N124IN
Spring 2013
All patient information is confidential. You may not share any patient related information via
word of mouth, by any social network, or electronically. You will not photocopy or
reproduce in any form the patient’s medical record(s). Failure to maintain patient
confidentiality may result in a grade of not more than “76” for the course and could result in
dismissal from the CCC Nursing Program.
Related to confidentiality of lecture discussion and topics, no recording is permitted.
Grade:
The grade for this course will be derived from the exam grades of four skills taught and
demonstrated. An additional exam grade will be recorded from an individually assigned project
presentation. The total grade will be the five (5) grades averaged together and represent 4% of
the overall N124IN grade.
*********** there will be six (6) grades average together to arrive at the grade *********
Skills taught and tested will be:
Sterile Technique (1)
Foley catheter insertion (2)
Nasogastric Tube insertion (3)
Medication administration oral (4)
Medication administration parenteral (5)
PRMC Presentation will equal 1 exam grade (6)
Individual Assigned Project Grading Rubric:
Addresses all Required Topics: 6 per presentation
1. Credentials of person interviewed
10 points
2. Number of employees in the department
10 points
3. Who are the department’s internal/external customers
10 points
4. How does the department affect patient care
10 points
5a. If non-nursing department how does the department interact with
10 points
nursing
5b. If nursing department how do you interact with non-nursing
10 points
departments
6. If you had one piece of advice to students or new employees coming to 10 points
PRMC for the first time, what would that be?
Presentation Skill to include: eye contact; interactive; interesting
15 points
Professionalism in presentation and interview (signed form)
15 points
Presentation time: 15 minutes total with 3-5 min discussion
10-12 minutes total
0-10 minutes total
>15 minutes total
10 points
7.5 points
5 points
0 points
*******Amended 4/18/13***********
Basic Skills Lab
N124IN
Spring 2013
INDIVIDUALLY ASSIGNED PRMC PROJECT
PURPOSE: To acquaint students enrolled in N124IN at Clovis Community College (CCC) with
the functions of a hospital. In particular the hospital where clinical experiences will be held
during their nursing education at CCC.
Randomly each student in N124IN will be assigned a various department/s at Plains Regional
Medical Center in Clovis.
The student will be given a contact name and phone number for the department contact assigned
and designated by the hospital. The student will be responsible for contacting the designated
assigned person and setting up an appointment to meet with the designee to conduct a brief
interview. The student is to ask the prescribed questions. During the conversation, additional
information may be obtained, this should be at the discretion of the designee being interviewed.
The goal is for the interview to take no more than 30 minutes unless the designee desires the
interview to take longer.
The assigned student is to develop a presentation to be given to the class at scheduled time
beginning week 9 (March 21, 2013). The presentation is to be no more than 15 minutes in
length, this is including 3-5 minutes for questions from the rest of the class. Use of power point,
or other type presentation platforms is encouraged. To receive full credit for the presentation
skill the student must make the presentation entertaining and engaging to the class.
A signature page is included, the assigned student must have the designee sign at the completion
of the interview. This signature page must be submitted with the completed assignment at the
time of the presentation to the class.
On the day of the presentation the student will provide an overview of the presentation to the
instructors, i.e., handouts for a power point, or an outline of the questions and responses. Also,
the student will provide the signature page from the designee documenting when the interview
was conducted.
Rubrics will be completed by the instructor after each presentation and results of grades will be
provided to the students no later than the following Monday of the student’s presentation. These
presentations will take place on Thursdays during the scheduled “skills” time for N124IN.
Basic Skills Lab
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Spring 2013
N124IN INDIVIDUAL STUDENT PRESENTATION PROJECT
QUESTIONNAIRE
Start time_____________________
End time_____________________
Department/s__________________________________________________________________
Designated Department Representative____________________________________________
Designated Department Representative phone number_______________________________
Questions:
1. What is your title and what is your educational level?__________________________
___________________________________________________________________________
___________________________________________________________________________
2. How many employees are in this department?________________________________
___________________________________________________________________________
___________________________________________________________________________
3. Who are the department’s internal and external customers?____________________
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________________
4. In what ways does this department affect patient care?_________________________
____________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________________
5a. If this is a non-nursing department, how does the department interact with
nursing?______________________________________________________________________
____________________________________________________________________________
_____________________________________________________________________________
___________________________________________________________________________
____________________________________________________________________________
5b. If this is a nursing department how does the department interact with non-nursing
departments?_______________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
6. Ask the person you are interviewing “If you had 1 piece of advice to students or new
employees coming to PRMC for the first time, what would that be…….______________
___________________________________________________________________________
___________________________________________________________________________
____________________________________________________________________________
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PRMC Individual Student Presentation
Department Assigned: ______________________________________________________
Designated Contact: ________________________________________________________
Designated Contact phone number: ____________________________________________
Date of Contact_____________________________________________________________
Start time interview ___________________ Ended interview ________________________
Conducted themselves professionally in person and on the phone Yes____ No______
___________________________________________________________________________
____________________________________________________________________________
Dressed appropriately, in CCC uniform? Yes ________ No __________
Maintained full attention on the process (did not have cell phone with them?, or other
students?) Yes___________
No________________
Appeared to understand the purpose of the visit and maintained the interview in a
professional manner. Yes _____________
No____________________
Signature of designated contact person
_______________________________________________
Date of signature
__________________________________________________________________
Basic Skills Lab
N124IN
Spring 2013
COURSE TITLE:
NURSING 124IN
MODULE #:
1A
MODULE TITLE:
VITAL SIGNS
CONTENT AREA:
Correctly obtaining temperature, pulse, respirations, and
blood pressures
INTRODUCTION:
Accurately assess body temperature, pulse, respirations, oxygen saturation, and blood pressure.
Explain the physiology of normal regulation of blood pressure, pulse, oxygen saturation, and
respirations.
GOAL STATEMENT:
Upon completion of this module the student will be able to explain the principles and
mechanisms of thermoregulation, describe nursing measures that promote heat loss and heat
conservation, describe factors that cause variations in body temperature, pulse, oxygen
saturation, respirations, and blood pressure, identify ranges of acceptable vital sign values for an
infant, a child, and an adult, and explain variations in technique used to assess an infant’s, a
child’s, and an adult’s vital signs.
ENABLING OBJECTIVES:
The student will:
1.
Identify when to take vital signs
2.
Accurately record and report vital sign measurements
3.
Appropriately delegate measurement of vital signs to nursing assistive
Personnel
DEFINE KEY TERMS:
 Afebrile, p. 445
 Blood pressure, p. 458
 Bradycardia, p. 455
 Celsius, p. 447
 Core temperature, p. 442
 Diaphoresis, p. 444
 Diastolic pressure, p. 458
 Fahrenheit, p. 447
 Febrile, p. 445
 Fever, p. 445
 Hypertension, p. 460
 Hyperthermia, p. 446
 Hypothermia, p. 446
 Orthostatic hypotension, p. 461
 Oxygen saturation, p. 457
 Perfusion, p. 456
 Sphygmomanometer, p. 461
 Systolic pressure, p. 458
Basic Skills Lab
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 Tachycardia, p. 454
 Ventilation, p. 456
 Vital signs, p. 441
DIRECTIONS AND LEARNING ACTIVITIES:
1. Read prior to class: as assigned
2. Complete computerized exam as scheduled
TERMINAL PERFORMANCE OBJECTIVES:
The student will:
1. Demonstrate proficiency of all skills.
2. Score 77% or above on all written exams.
3. Apply knowledge gained in the lab to the clinical setting.
Basic Skills Lab
N124IN
Spring 2013
COURSE TITLE:
Nursing 124IN
MODULE #:
1B
MODULE TITLE:
Health Assessment
CONTENT AREA:
General Survey; Assessing Body Systems
INTRODUCTION:
Nurses perform assessments regularly on their patients in every setting in which they are
employed. Varied types and styles of assessments are performed pertaining to the nature of the
care being rendered. The frequency with which these assessments are performed and their timing
are specified by the location of the care being provided. This module will give the student nurse
the overview of the various type of assessments to perform, as well as a systematic manner in
which to conduct the assessment to assure accuracy and completeness.
GOAL STATEMENT:
Upon completion of this module the student should be able to demonstrate a general survey, as
well as assess various body systems. Once the assessment is complete, the student will be able to
concisely document the assessment performed into the charting record.
TERMINAL PERFORMANCE OBJECTIVES:
The student will:
1. demonstrate proficiency of all skills.
2. score 77% or above on all written exams.
3. apply knowledge gained in the lab to the clinical setting.
ENABLING OBJECTIVES:
The student will:
1. understand the general survey.
2. Discuss the purpose, elements, and techniques of a health
assessment.
3. Identify measures to provide privacy, promote patient dignity, and
prevent patient discomfort during a health assessment.
4. Identify methods of preparing patients of different ages and cultural
backgrounds for a health assessment.
5. Identify what information from the health assessment needs to be
reported immediately.
6. Discuss communication techniques for sue during the health
assessment.
7. Demonstrate what circumstances may alter the usual sequence of a
health assessment.
8. Understand the elements of the following:
a. Sequence of assessment
b. Patient positioning
c. Techniques
d. Expected findings
e. Documentation
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9. Identify how standard precautions are applied throughout the health
assessment.
10. Understand the principles of intake and output by identifying what
should be included in the calculation as well as teaching for patient
family, and nursing assistive personnel.
DIRECTIONS AND LEARNING ACTIVITIES:
1. Read prior to class: As on schedule
2. Perform in Lab: Complete assessment of a patient and
document the same on charting document.
3. Take computer exam
Basic Skills Lab
N124IN
Spring 2013
COURSE TITLE:
NURSING 124IN
MODULE #:
1C
MODULE TITLE: NEUROLOGICAL CHECK
CONTENT AREA: Neurological/Neurovascular Assessment
Equipment/Procedures
INTRODUCTION:
Trauma, disease and developmental abnormalities are related to impairment of the neurological
functioning. Impaired neurological functioning is of particular significance to nursing, as the
client's safety and freedom from injury depends on intact neurological functioning. It is,
therefore, a primary nursing responsibility to be able to assess accurately, the neurological
function of the client in order to plan nursing interventions, which meet basic needs and promote
safety.
GOAL STATEMENT:
Upon completion of this module the student will be able to perform the neurological on the client
and discuss interventions, which are appropriate in certain clinical situations.
TERMINAL PERFORMANCE OBJECTIVES:
The student will:
1. Demonstrate proficiency of all skills.
2. score 77% or above on all written exams.
3. apply knowledge gained in the lab to the clinical setting.
ENABLING OBJECTIVES:
The student will:
1. define the following:
 consciousness
 motor
 paralysis
 stuporous
 alert




paresis
lethargic
pupillary
accommodation



sensory
consensual
comatose
2. describe the neurological exam.
3. identify at least two circumstances in which a neurological check would be performed on
a patient.
4. explain the Glasgow Coma Scale.
5. describe selected components of the cranial nerve portion of the neuro check, specifically
the "pupil check."
6. demonstrate a brief examination of sensory/motor and muscle function.
7. list the instruments and tools used to perform the neurological exam.
DIRECTIONS AND LEARNING ACTIVITIES:
1. Read prior to class: As assigned
2. Practice in lab:
 Neurological exam
3. Perform in lab:
 Neurological exam with documentation.
Basic Skills Lab
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Spring 2013
4. Take:
 Computer test according to class schedule.
To test the pupillary reaction to light, bring
the light source in from the side.
Glasgow Coma Scale
Stimuli
Eye Opening
Spontaneously
To sound
To pain
Never
Verbal Response
Oriented
Confused conversation
Inappropriate words
Incomprehensible sounds
None
Motor Response
Obeys commands
Localizes pain
Normal flexion (withdrawal)
Abnormal flexion
Highest possible
Extension
score is 15
None
Score
4
3
2
1
5
4
3
2
1
6
5
4
3
2
1
Basic Skills Lab
N124IN
Spring 2013
COURSE TITLE:
NURSING 124IN
MODULE #:
1D
MODULE TITLE: NEUROVASCULAR Exam
CONTENT AREA: Neurovascular Assessment
INTRODUCTION:
The neurovascular assessment is performed on the extremities. It can be performed in the general
assessment on all four extremities to assess general function or to assess an impaired extremity
usually caused by an accident or surgery. It is to detect if there is impairment in the blood supply
or nerve function on an extremity. In order to detect if an impairment is occurring, the nurse
must compare the extremity with the non-impaired extremity. Examples of reasons for
performing a neurovascular check would be after someone has had a hip replacement. Because
the blood supply could be cut off, neurovascular exams are usually ordered every hour for a day
or two. Any changes must be given to the physician immediately in order to ensure the survival
of the extremity. It is imperative that the nurse recognizes when a neurovascular exam is
warranted.
GOAL STATEMENT:
Upon completion of this module the student will be able to perform the neurovascular check on
the client and discuss interventions, which are appropriate in certain clinical situations.
TERMINAL PERFORMANCE OBJECTIVES:
The student will:
1. demonstrate proficiency of the skill.
2. score 77% or above on all written exams.
3. apply knowledge gained in the lab to the clinical setting.
ENABLING OBJECTIVES:
student will:
DIRECTIONS AND LEARNING ACTIVITIES:
1. Read prior to class: As assigned
2. Practice in lab:
 Neurological exam
3. Perform in lab:
 Neurological exam with documentation.
4. Take:
 Computer test according to class schedule.
Basic Skills Lab
N124IN
Spring 2013
COURSE TITLE:
Nursing 124IN
MODULE #:
1E
MODULE TITLE:
OXYGEN THERAPY
CONTENT AREA:
Purpose of Oxygen Therapy
Methods of Oxygen Administration
Safety Considerations
Techniques to Enhance Ventilation
INTRODUCTION:
The process of respiration by which oxygen and carbon dioxide are exchanged is essential for
life. Respiratory function is complex involving the musculoskeletal, neurological, respiratory and
cardiovascular systems. During illness and surgical intervention it may be necessary to assist the
patient in meeting his/her oxygen needs. It is important that the nurse is able to assess the
patient's respiratory status, intervene when necessary using safe techniques, and maintain a
patient on oxygen when indicated.
GOAL STATEMENT:
Upon completion of this module the student should be able to discuss and demonstrate
appropriate techniques and procedures for safely and effectively administering oxygen therapy
and maintaining optimum respiratory function of patients.
TERMINAL PERFORMANCE OBJECTIVES:
The student will:
1. demonstrate mastery/proficiency of all skills.
2. score 77% or above on all written exams.
3. apply knowledge gained in the lab to the clinical setting.
ENABLING OBJECTIVES:
The student will:
1. define the following terms:
 abdominal pursed-lip
diaphragmatic
breathing
 postural drainage
 flow meter
 dyspnea
 atelectasis
 breathing
 respiratory
therapist
 humidifier
2.
3.
4.
5.
6.
7.
8.
chest percussion
 room air/ambient air
 incentive spirometer
 hypoxia
/
hypoxemia
 ventilation/respirati
on





cough
nebulization
SAO2
deep breathing
review and describe the respiratory anatomy and explain the physiology of breathing.
assess oxygenation, breathing, circulation and gas exchange.
be familiar with diagnostic test related to respiratory function
name conditions that could contribute to a person's risk of hypoxia & hypoxemia.
state the reasons and purposes for initiating oxygen therapy.
name and discuss the types of oxygen equipment used in the hospital and home.
describe the methods of oxygen administration and the reasons for the specific use of
each method:
Basic Skills Lab
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a. nasal cannula
b. standard face mask
c. Venturi mask
d. non-rebreathing mask
e. oxygen tent/hood
9. discuss the safety measures that must be carried out when administering oxygen.
10. list the commonly used equipment for maintaining a patent airway:
a. oral airway
b. nasal airway/trumpet
b. endotracheal tube
c. tracheostomy tube
11. describe and demonstrate techniques to enhance patient's ability to draw air into and
expel air out of the lungs.
a. positioning
b. relaxation exercises
c. controlled breathing techniques
DIRECTION AND LEARNING ACTIVITIES:
Read prior to class: As on schedule
Handouts and appropriate chapters as assigned
Practice in lab:
O2 therapy
1. Take:
 Computer test according to class schedule.
Basic Skills Lab
N124IN
Spring 2013
COURSE TITLE:
MODULE #:
Nursing 124IN
2A
MODULE TITLE: GASTROSTOMY & NASOGASTRIC TUBE PROCEDURES
CONTENT AREA: NG & Gastrostomy Tubes
Care of Tubes
INTRODUCTION:
When patients are unable to take fluid or food by mouth, gastrostomy or nasogastric tubes (N.G.
Tubes) are used to maintain nutrition. An N.G. tube is used when there is no difficulty passing a
nasal/gastric tube. If there is an obstruction between the oral cavity and stomach, frequently a
gastrostomy tube is used for giving nourishment. Either method used, the nurse has the
responsibility to administer the feeding correctly and provide comfort for the patient.
Gastrostomy and N.G. tubes are also used for other purposes such as: a) obtaining specimens, b)
relieving gastric distention, c) removing stomach contents, and d) lavage (irrigation).
GOAL STATEMENT:
Upon completion of this module the student will be able to administer N.G. and gastrostomy
feedings and medications correctly and safely. Further, the nurse will be able to safely maintain
the tubes when they are used for other purposes besides feeding the patient. Finally, the nurse
will be able to safely remove an N.G. tube.
TERMINAL PERFORMANCE OBJECTIVES:
The student will:
1. demonstrate proficiency of all skills.
2. score 77% or above on all written exams.
3. apply knowledge gained in the lab to the clinical setting.
ENABLING OBJECTIVES:
The student will:
1. define the following terms:
 nasogastric tube
 gastric gavage
 gastrostomy
 gastric lavage
2. explain the rationale for using nasogastric and gastrostomy tubes.
3. explain why a gastrostomy tube might be used as opposed to a nasogastric tube.
4. demonstrate the following procedures while adhering to accepted principles: nasogastric
tube insertion and removal of NGT.
5. explain why oral care is essential for patients with NG or gastrostomy tubes.
6. discuss & demonstrate 4 ways to check the tube for patency and placement.
7. Discuss correct administration of medications through a gastric tube.
DIRECTIONS AND LEARNING ACTIVITIES:
1. Read prior to class:
2. View video prior to class
3. Practice in lab:
Basic Skills Lab
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Spring 2013
a. Insertion of NG tube
b. Removal of NG tube
4. Take:
Computer test according to class schedule
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N124IN
Spring 2013
COURSE TITLE:
Nursing 124IN
MODULE TITLE: CARE OF INTESTINAL AND URINARY STOMAS
MODULE#
2B
CONTENT AREA: Purpose of an Ostomy
Colostomy Care
Ileostomy Care
Colostomy Irrigation
INTRODUCTION:
In some instances a portion of the bowel or urinary tract becomes diseased and has to be
removed. The removal of a portion of the bowel or urinary tract may require that a new means
for the elimination of waste be provided. When this occurs an abdominal stoma will be made to
provide for a means of elimination of waste products. A patient who has undergone a surgical
procedure resulting in an ostomy must make new adjustments. A skillful and understanding
nurse can do a great deal to help the patient through this adjustment period. It is important that
the nurse is competent in using ostomy appliances, in giving skin and stoma care, and assisting
the patient in learning to control his/her ostomy.
GOAL STATEMENT:
Upon successful completion of this module the student should be able to differentiate between
the care of intestinal and urinary ostomies and demonstrate the correct technique for changing an
ostomy appliance and irrigating a colostomy.
TERMINAL PERFORMANCE OBJECTIVE:
The student should be able to:
1. score 77% or above on a post-tests.
2. Demonstrate understanding of the correct technique for ostomy care
ENABLING OBJECTIVES:
The student will:
1. define the following terms:
ostomy
double-barreled colostomy
stoma
urostomy
ileostomy
ileal conduit
colostomy
urinary conduit
ascending colostomy
transverse colostomy
sigmoid/descending colostomy
2. differentiate between various types of bowel diversions.
3. analyze abnormal conditions of stoma and skin upon inspection.
4. describe various appliances that are available for client use.
5. describe steps in order that are used to change a colostomy pouch.
Basic Skills Lab
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Spring 2013
6. demonstrate a colostomy or ileostomy pouch change correctly.
7. discuss colostomy irrigation using appropriate technique including correct volume and
distance of catheter insertion into stoma.
8. state rationale for exceptional cleanliness during care of urinary drainage appliance.
Basic Skills Lab
N124IN
Spring 2013
Nasogastric Tube Insertion
Supplies
Gathers all supplies NGT, lubricant, gloves, tape, towel, syringe, cup of H2O
Missed one or more supplies.
Identification
Identifies patient correctly (checks arm band, ask for name, verifies with picture).
Identifies patient incorrectly (calls patient by name)
Does not identify patient.
Explanation
Explains procedure to patient using correct terms the patient can understand (if
skill requires nurse to keep mouth closed, must inform patient of the reason for
limited talking).
Explains procedure to patient using medical terms that might be difficult for the
patient to understand.
Gives wrong information to patient.
Does not explain procedure to patient.
Skill
Prepares patient for NG insertion; equipment; position; nostril selection, instruction
Measures NGT from tip of nose and marks tube; Lubricate tube; insert tube
At back of throat, have pt drop head forward and swallow water as tube advances
When reach mark temporarily anchor tube with tape, look in throat w/penlight
Aspirate with syringe, test with pH strip, and observe color, re-instill aspirate
Confirm placement by 2 methods; Secure tube
Demonstrate flushing; checking residuals and when, how and why these are done.
Demonstrates suction and discusses important point of suction.
Removal of NGT all aspects necessary to insure safe removal
Provide oral care, clean pt and area
Not prepared for skill requires “re-do”
Interactions
Able to respond appropriately with instructor on specific questions asked of skill
Requires leading by instructor to respond to questions.
Unable to correctly respond to key questions by instructor
Safety
Necessary items within reach including call light. Side rails up, as appropriate, bed
in low position before leaving room, verifies patient has no further needs.
Misses one of the above
Misses more than one of the above.
Hand washing
Washes hands before and after skill.
Washes hands before or after (misses one time).
Does not wash hands.
Charting
Documents skill in narrative format Includes all pertinent data required.
Misses 1-2 pieces of charting information
Misses 3 pieces of charting information
Fails to provide date and time of entry
Fails to sign the documentation and provide title.
Misses more than 3 pertinent pieces of information and fails to sign the document.
Faculty Signature ______________________ Student Signature _____________________
Basic Skills Lab
N124IN
Spring 2013
COURSE TITLE:
Nursing 124IN
MODULE #:
3A
MODULE TITLE:
INTRODUCTION TO SURGICAL ASEPSIS
CONTENT AREA: Principles Related to Surgical Asepsis
INTRODUCTION:
Harmful and beneficial microorganisms are naturally present in our environment. It has been
found that some microorganisms are harmless to certain people but may cause disease in others.
Other microorganisms may only be harmful under specific environmental conditions. In many
instances we are concerned primarily with reducing the number of organisms and hindering their
transfer. At other times it is important that certain objects and areas are free from all
microorganisms. It is important that the nurse know the principles and correct techniques related
to maintaining sterility when indicated.
GOAL STATEMENT:
Upon completion of this module the student should be able to apply stated principles of aseptic
technique in the performance of sterile procedures with safety and efficiency.
TERMINAL PERFORMANCE OBJECTIVES:
The student will:
1. Demonstrate proficiency of all skills.
2. score 77% or above on all written exams.
3. apply knowledge gained in the lab to the clinical setting.
ENABLING OBJECTIVES:
The student will:
1. define the following terms related to surgical asepsis:
 antiseptic
 infection
 spores
 asepsis
 contamination
 sterile technique
 disinfectant
 unsterile
 sterilization
 sterile
 aseptic technique
 microorganism
 clean technique
 contaminated

2.
3.
4.
5.





surgical asepsis
medical asepsis
isolation
technique
sterile field
pathogens
describe specific instances in which the principles of surgical asepsis are used
discuss factors that place individuals at increased risk for infection
differentiate between medical asepsis and surgical asepsis.
demonstrate correct technique for:
a. opening a commercially prepared package of sterile supplies.
b. opening a package of hospital wrapped sterile supplies.
c. preparing a sterile field.
d. placing sterile supplies on a sterile field.
e. applying sterile gloves.
6. Identify standard precautions to prevent transmission of infection
7. discuss common ways to identify/assess sterility of sterile supplies.
8. discuss various types of isolation, how, when and why to employ
Basic Skills Lab
N124IN
Spring 2013
DIRECTIONS AND LEARNING ACTIVITIES:
1. Read prior to class:
On Schedule
View video as on schedule
2. Practice in lab
 Surgical asepsis
 Sterile gloving
3. Perform in lab:
 Surgical Asepsis
 Sterile Gloving
 Standard precautions
4. Take:

Computer test according to class schedule
Basic Skills Lab
N124IN
Spring 2013
ASEPTIC REVIEW
All item used in a sterile field must be
sterile. (Make sure the package is intact and
the expiration date has not been reached or
exceeded.)
A sterile barrier that is torn or wet is no longer
sterile.
If fluid wicks through the sterile barrier the
field is considered contaminated.
Never touch the inside of a sterile package with
your bare hands. If you must retrieve an item
from within the sterile package it must be lying
on top and easily accessible with your bare
hand, then and only then, retrieve the item
using a “pinching” type grab.
The edges of a sterile container are unsterile
once they are opened.
There is an imaginary 1 inch border on the
barrier field but not on containers.
It is only sterile if you can see it. You must
keep your eyes on your sterile field, never turn
your back to the sterile field, or distract your
eyes from the sterile field.
Never cough, sneeze or talk over a sterile field.
Instruct your patient prior to establishing the
sterile field that you will no longer be able to
talk to them while procedure is performed, to
minimize the risk of contaminating the sterile
field.
Never reach across a sterile field. This
constitutes contaminating the sterile field.
Once you touch a patient with an object, it is
no longer sterile.
Basic Skills Lab
N124IN
Spring 2013
Sterile Field/Donning Sterile Gloves
Supplies
Gathers all supplies sterile pack, sterile gloves, clean gloves, solution
Missed one or more supplies.
Identification
Identifies patient correctly (checks arm band, ask for name, verifies with picture).
Identifies patient incorrectly (calls patient by name)
Does not identify patient.
Explanation
Explains procedure to patient using correct terms the patient can understand
interacts with pt throughout procedure appropriately
Explains procedure to patient using medical terms that might be difficult for the
patient to understand.
Gives wrong information to patient, or does not interact during procedure
Does not explain procedure to patient.
Skill
Using clean gloves, remove dressing from wound, inspect for drainage
Measure wound, determine documentation points; wash hands
Prepare clean, dry work surface at or above waist level, check exp. dates,
Open sterile kit outermost flap away from you, do not contaminate sterile field
Maintain a <1 inch border do not allow tails of drape to touch uniform
Remove gloves without contaminating sterile field; Glove non-dominate hand
Using unsterile hand pour solution Don second glove maintaining sterile technique;
Prepare sterile tray for procedure
Cleanse suture line from top to bottom discard swab, hands do not fall below field
Cleanse along side of incision w/separate swab for each side dispose of ea. swab
Apply dry sterile gauze cover with pressure dressing, apply tape window pane
Initial/date/time drsg; dispose of items in app. receptacle; remove gloves correctly
Not prepared for skill requires “re-do”
Safety
Necessary items within reach including call light. Side rails up, as appropriate, bed
in low position before leaving room, verifies patient has no further needs.
Misses one of the above
Misses more than one of the above.
Hand washing
Washes hands before and after skill.
Washes hands before or after (misses one time).
Does not wash hands.
Charting
Documents skill in narrative format Includes all pertinent data required.
Misses 1-2 pieces of charting information
Misses 3 pieces of charting information
Fails to provide date and time of entry
Fails to sign the documentation and provide title.
Misses more than 3 pertinent pieces of information and fails to sign the document.
Faculty Signature ______________________ Student Signature _____________________
Basic Skills Lab
N124IN
Spring 2013
COURSE TITLE:
Nursing 124IN
MODULE
4A
MODULE TITLE: URETHRAL CATHETERIZATION
CONTENT AREA: Urinary Catheters
INTRODUCTION:
Elimination of wastes through the urinary tract is one of the essential needs of the body. In most
instances we are able to eliminate on our own, however, during illness or when particular
diagnostic procedures are being performed it may be necessary for the nurse to intervene and
facilitate the elimination of waste products through the urinary tract. Urethral catheterization is
one of the most frequent methods the nurse uses to facilitate bladder elimination. Thus, it is
important that the nurse has an understanding of the principles and practices related to the safe
performance of this skill.
GOAL STATEMENT:
Upon completion of this module the student will be able to discuss the principles and safety
practices related to urethral catheterization and demonstrate the technique of inserting and
removing a urethral catheter in both male and female.
TERMINAL PERFORMANCE OBJECTIVES:
The student will:
1. demonstrate proficiency of all skills.
2. score 77% or above on all written exams.
3. apply knowledge gained in the lab to the clinical setting.
ENABLING OBJECTIVES:
The student will:
1. define the following terms:
 void
 meatus
 sphincter
 penis
 dysuria
 foreskin
 perineum
 catheter
 urethra
 catheterization



straight catheter
indwelling catheter
Foley catheter
open system
 closed system
 intermittent
catheterization
 irrigation
 coude

2. discuss factors that effect urinary elimination and reasons for catheterizing a client.
3. state the rationale for using sterile technique when performing a urethral catheterization.
4. discuss the length of urethra for the male, female, and child in order to estimate length of
urinary catheter insertion.
5. state 2 reasons why a catheter should be taped or strapped to the leg or abdomen.
6. differentiate between the use of the straight and indwelling catheters.
7. discuss common urinary elimination problems and diagnostic test used.
8. discuss the procedure and rationale related to inserting an indwelling catheter in a female
and male.
9. describe the procedure and rationale for performing catheter care.
10. demonstrate the correct technique for:
Basic Skills Lab
N124IN
Spring 2013
a. inserting an indwelling Foley catheter in a female.
b. inserting an indwelling Foley catheter in a male.
c. anchoring the catheter with tape or use of a catheter strap
d. performing catheter care
e. removing Foley catheter
11. list four points of health teaching to the client who has a Foley catheter removed.
DIRECTIONS AND LEARNING ACTIVITIES:
1. Read prior to class: as on schedule
2. View video prior to class:
3. Practice in lab:
 Urinary catherization
 Catheter care
 Catheter removal
4. Perform in lab:
 Urinary Catherization and Removal
5. Take:
 Computer test according to class schedule.
Basic Skills Lab
N124IN
Spring 2013
Foley Catheterization
Supplies
Gathers all supplies catheter kit; clean gloves; sterile gloves;
Missed one or more supplies.
Explanation
Explains procedure to patient using correct terms the patient can understand
interacts with pt throughout procedure appropriately
Explains procedure to patient using medical terms that might be difficult for the
patient to understand.
Gives wrong information to patient, or does not interact during procedure
Does not explain procedure to patient.
Skill
Assess perineal area looking for landmarks; drainage or discharge; Position pt
Wash hands establish sterile field; Apply sterile gloves set up catheter kit
Test integrity of the catheter balloon with provided saline; lubricate tip of catheter
Sterile drape hold create cuff over gloves drop open, place on bed between legs
Using nondominant hand separate labia to expose meatus;or hold shaft or retract
foreskin. This hand must remain in this position until catheter is in place
Use 3 cleansing solution coated cotton balls/swabs to cleanse meatus and
surrounding structures. Female 1st edge of meatus and labial lips furtherest from
nurse; 2nd same nearest nurse; 3rd through middle and meatus; Male use circular
motions starting at meatus and working outwards repeat X3 (always disposing of
used cotton or swab after the pass, never going back up with motion)
Pick up catheter maintaining sterility insert tip into meatus advance till see urine
When urine appears, advance another 1-2 inches, do not force
Grab catheter w/nonsterile hand hold while inflating balloon noting amount of
saline used
Secure catheter to pt thigh, place drainage bag on bed frame; Date and initial the
catheter bag; note amount, character of urine for documentation
Instruct patient need to consume 6-8 glasses of additional fluid
Demonstrate removal of catheter maintaining privacy; include instructions to pt.
Not prepared for skill requires “re-do”
Charting
Documents skill in narrative format Includes all pertinent data required.
Misses 1-2 pieces of charting information
Misses 3 pieces of charting information
Fails to provide date and time of entry
Fails to sign the documentation and provide title.
Misses more than 3 pertinent pieces of information and fails to sign the document.
POSSIBLE DEDUCTIONS
Failure to identify patient
Failure to wash hands before and after procedure
Failure to provide safety of patient during and after procedure
Dressed inappropriately in uniform per CCC student nurse’s handbook
Faculty Signature ______________________ Student Signature _____________________
Basic Skills Lab
N124IN
Spring 2013
COURSE TITLE:
Nursing 124IN
MODULE #:
5A
MODULE TITLE: ADMINISTRATION OF NON-PARENTERAL MEDICATIONS
CONTENT AREA: Preparing & Administering Alternate Route Medications
INTRODUCTION:
Drug therapy is a method for treating disease which does the nurse carry out a vitally important
function. This module will teach you the procedures for giving non-parenteral medications.
GOAL STATEMENT:
Upon completion of this module the student should be able to demonstrate the correct techniques
for preparing and administering non-parenteral medications.
TERMINAL PERFORMANCE OBJECTIVES:
The student will:
1. demonstrate proficiency of all skills.
2. score 77% or above on all written exams.
3. apply knowledge gained in the lab to the clinical setting.
ENABLING OBJECTIVES:
The student will:
1. identify nursing considerations particular to the administration of each method, such as
positioning.
2. describe nursing assessment before, during and after administration.
3. analyze the local vs. systemic action of each of the methods mentioned in #1.
4. describe correct documentation of the various types of topical medications including
abbreviations when appropriate for route or site.
5. discuss the following methods of administering the following medications:
a. topical medications
b. eye/ear medications
c. inhalants
d. suppositories (rectal and vaginal)
e. oral medications
f. NG tube medications
6. discuss the nurse’s legal responsibilities in drug prescription and administration.
7. differentiate the roles of the physician, nurse, and pharmacist in medication
administration.
8. analyze factors, which influence the status of the patient who is receiving oral
medications.
9. describe the unit dose system of supplying medications to patients who are hospitalized
apply three checks and the six rights of drug administration in simulated lab setting
Basic Skills Lab
N124IN
Spring 2013
10. identify correct procedure for preparation and administration of oral medications per
mouth and per nasogastric tube.
11. correctly document required information on the patient’s medication record for oral
medications administered.
DIRECTIONS AND LEARNING ACTIVITIES:
1. Read prior to class:
As on schedule
View videos prior to class: As on schedule
2. Practice in lab:
 Role-play administration of oral medications with one lab partner. There will
be “medications” available on the drug cart along with med cards to use in
role-play.
3. Perform in lab:
 Demonstrate setting-up oral medications using the 7 rights & 3 safety checks.
4. Take:
 Computer test according to class schedule.
Basic Skills Lab
N124IN
Spring 2013
COURSE TITLE:
Nursing 124IN
MODULE #:
5B
MODULE TITLE:
ADMINISTRATION OF INJECTABLE MEDICATIONS
CONTENT AREA:
Guidelines For Preparing & Administering Injections
Charting Medications Administered
INTRODUCTION:
Injections instill medications into body tissues for systemic absorption. Injected drugs act more
quickly than oral medications and these routes may be used when clients are vomiting, cannot
swallow, and/or are restricted from taking oral fluids. Injections are invasive, and strict aseptic
technique is required during preparation and administration to minimize the risk of injection.
Injections involve some discomfort. Since risk of tissue or nerve damage exists, site selection is
an important nursing concern. The nurse must monitor the client’s response closely and be
aware of potential side effects or allergic reactions. This module will teach the student to
prepare and administer intramuscular, subcutaneous and intradermal injections in a laboratory
situation. The action of drugs will be addressed in NSG 129.
GOAL STATEMENT:
Upon completion of this module the student will be able to demonstrate the correct techniques
for preparing and administering parenteral medications and tests.
TERMINAL PERFORMANCE OBJECTIVES:
The student will:
1. demonstrate proficiency of all skills.
2. score 77% or above on all written exams.
3. apply knowledge gained in the lab to the clinical setting.
ENABLING OBJECTIVES:
The student will:
1. appropriately use the key terms listed.
 syringe
 hub
 plunger
 needle
 shaft
 gauge
 barrel
 lumen
 luer-lok
 bevel





viscosity
ampule
tubex
vial
aspirate





intradermal
wheal
subcutaneous
intramuscular
z-track
1. explain the purpose of all parts of a syringe.
2. correctly determine the appropriate needle and syringe for Sub Q, IM, Z-track and
intradermal administration.
3. identify appropriate sites for administering a subcutaneous injection, intramuscular
injection, intradermal injection and a Z-track.
4. accurately demonstrate the appropriate procedure for preparing injectable test materials
and medications.
Basic Skills Lab
N124IN
Spring 2013
5. accurately demonstrate the appropriate procedure for administering parenteral and
medications.
6. accurately demonstrate the appropriate procedure for charting parenterally administered
medications.
DIRECTIONS AND LEARNING ACTIVITIES:
1. Read prior to class: As on schedule
2. View video prior to class:
 As on schedule
3. Practice in lab:
4. The student must identify intradermal site and technique, SQ sites and technique,
and 3 IM sites and technique, using anatomical landmarks. Each student will
correctly administer an IM injection on a student partner.
5. Take:
 Computer test according to class schedule.
Basic Skills Lab
N124IN
Spring 2013
Parenteral and Non-Parenteral Medication Administration
Supplies
Gathers all supplies
Missed one or more supplies.
Stopped skill more than once to obtain additional supplies
Explanation
Explains procedure to patient using correct terms the patient can understand
interacts with pt throughout procedure appropriately
Explains procedure to patient using medical terms that might be difficult for the
patient to understand.
Gives wrong information to patient, or does not interact during procedure
Does not explain procedure to patient.
Skill
Identifies medication action; route; common side effects; nursing implications
Checks for allergies able to discuss teaching information for pt
Prepares medication for proper route at med cart
Follows the 6 rights (7 in our program)
Prepares meds from blister package
Properly prepares liquid medications for administration
Displays understanding of oral; buccal; sublinqual;
Prepares crushed medication correctly
Discusses correct administration of topical medications
Discusses correct administration of eye drops/ointments
Discusses correct administration of ear medications for adult and child <3 y/o
Safely and correctly administers an IM injection pre order
Discusses unique conditions necessary to administer subcutaneous injections
Discusses unique conditions necessary to administer Ventrogluteal identifies
landmarks
Discusses unique conditions necessary to administer Vastus lateralis landmarks
Discusses correct administration of intradermal injections
Identifies areas of concern and what steps to take for patient safety
Not prepared for skill requires “re-do”
Charting
Documents skill in narrative format Includes all pertinent data required.
Misses 1-2 pieces of charting information
Misses 3 pieces of charting information
Fails to provide date and time of entry
Fails to sign the documentation and provide title.
Misses more than 3 pertinent pieces of information and fails to sign the document.
POSSIBLE DEDUCTIONS
Failure to identify patient
Failure to wash hands before and after procedure
Failure to provide safety of patient during and after procedure
Dressed inappropriately in uniform per CCC student nurse’s handbook
Faculty Signature ______________________ Student Signature _____________________
Basic Skills Lab
N124IN
Spring 2013