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COURSE SYLLABUS VNSG 1327.501 (3:2:2) ESSENTIALS OF MEDICA ESSENTIALS OF MEDICATION ADMINISTRATION ADMINISTRATION Vocational Nursing Health Occupations Technical Education Division Plainview Center SOUTH PLAINS COLLEGE Fall – 2011 1 PLAINVIEW COURSE SYLLABUS COURSE TITLE: VNSG 1327 – ESSENTIALS OF MEDICATION ADMINISTRATION INSTRUCTOR: SUZANNE GRIFFIN, RN, A.A.S., A.D.N. OFFICE LOCATION & PHONE/E-MAIL: PLAINVIEW CENTER 806-296-9611 X 4405 / [email protected] OFFICE HOURS: MONDAY & TUESDAY WEDNESDAY THURSDAY & FRIDAY 8:00 AM – 10:00 AM 8:00 AM – 12:00 PM BY APPOINTMENT SOUTH PLAINS COLLEGE IMPROVES EACH STUDENT’S LIFE ****************************************************************************************** COURSE DESCRIPTION: General principles of medication administration, including determination of dosage, preparation, safe administration, and documentation of multiple forms of drugs will be covered. Instruction includes various systems of measurement. COURSE LEARNING OBJECTIVES: The student will demonstrate accurate dosage calculation; discuss the principles of medication administration safety; and identify the elements of accurate documentation of medication administration. COURSE COMPETENCIES: The student must complete this course with a grade of 75 % or above based on the following objectives: 1. Demonstrate an understanding of pharmacology using the nursing process approach. 2. Be familiar with various sources of drug information and be affluent in the use and interpretation of these resources. 3. Define and demonstrate competency of the six rights of drug administration; knowledge of equipment and basic administration procedure techniques. 4. Demonstrate a workable knowledge of conversion tables and calculation of dosages. 5. Describe safe practices for care and storage of drugs. 6. Demonstrate knowledge of standard abbreviations used in medication therapy. 7. Demonstrate appropriate documentation of a drug order and medication administration. 8. Be familiar with basic terminology in classification of medications, both by action and by body system. 2 ACADEMIC INTEGRITY: Refer to Plainview Student Handbook (page 23) and the SPC Catalog (page 23). SCANS AND FOUNDATION SKILLS: C – 1, 3, 5, 6, 7, 8, 9, 10, 11, 15, 16, 17, 18, 19, 20. F – 1, 2, 3, 4, 5, 7, 8, 9, 10, 11, 12, 13, 16, 17. VERIFICATION OF WORKPLACE COMPETENCIES: NCLEX – PN Licensure Exam eligibility following successful completion of the one-year vocational nursing program. TEXTBOOK: Clayton, B.D., Pharm D, RPh, BS; Stock, Y.N., MS, RN; Cooper, S. D., MSN, RN, CCM (2010). Basic Pharmacology for Nurses, 15th Edition, Mosby Inc., St. Louis. Student Learning Guide to Accompany Text Curren, Anna M. (2009). Math for Meds: Dosages and Solutions, 10th Edition, Cengage Learning, Philadelphia Burton, Marti A., R.N., B.S. and Ludwig, Linda J. May, R.N., B.S., MEd (2011). Fundamentals of Nursing Care – Concepts, Connections, and Skills, F. A. Davis Company, Philadelphia ATTENDANCE POLICY: Refer to SPC Catalog (page 20) and Plainview Student Handbook (page 14). This course is a 3 semester hour course with 6 hours of allowable absence. COURSE REQUIREMENTS: 1. Assignments read prior to class discussion. 2. Participation and demonstrated competency in CAI programs. Instructions and due dates to be announced in class. 3. Participation and demonstrated competency in laboratory practice / return demonstration of all procedures. 4. Demonstrated competency in dosage calculation. (See “Schedule of Classes”) 5. Demonstrated competency in all abbreviations and equivalents and related medication terminology. (See “Schedule of Classes”) 6. Four exams and a comprehensive final exam will be given. Home assignments will include exploring medication administration nursing issues. 7. Written assignments are to be neat and legible. They may be computer generated using black as font color and #12 as font size or hand written using black ink and must be double spaced and on one side of the paper only. Paper edges must be without frayed edges. Points will be deducted accordingly as per instructor discretion. 3 GRADING: 2 UNIT EXAMS, 2 COMPETENCY EXAMS, AND 1 FINAL EXAM PROCEDURE COMPETENCIES CLASS PARTICIPATION 75% 20% A B 5% D F SCHEDULE OF CLASSES: WEEK 1 8 – 30 - 11 Course Introduction Begin Unit I – Foundations of Pharmacology Ch. 1 (text) Definitions, Names, Standards, and Sources 9 – 1 - 11 Complete Chapter 1 Sources review – “Hunt and Find” WEEK 2 9 – 6 - 11 Ch. 2 (text) Principles of Drug Action and Drug Interaction 9 – 8- 11 continue – “Crossword Puzzle Review” WEEK 3 9 – 13 - 11 Ch. 3 (text) Drug Action Across the Life Span 9 – 15 - 11 continue – Workbook Review: Chapters 1 - 3 WEEK 4 9 – 20 - 11 Ch.4 (text) The Nursing Process and Pharmacology 9 – 22 - 11 continue – “Using the Nursing Process in Pharmacology” WEEK 5 9 – 27 - 11 Ch. 5 (text) Patient Education and Health Promotion Team Home Assignment 9 – 29 - 11 Team Discussion of Patient Education and Health Promotion Study Guide for Unit Exam # 1 4 90 - 100 89 - 80 C 79 - 75 74 – 70 69 or below WEEK 6 10 – 4 - 11 UNIT EXAM #1 (CHAPTERS 1 – 5) 10 – 6 - 11 Begin Unit II – Illustrated Atlas of Medication Administration and Math Review Ch. 6 (text) A Review of Arithmetic and Appendix A – Medical Abbreviations Ch. 4 & 5 (Math for Meds) Electronic Study Guide Abbreviation Tables (Fundamentals) – Think: “Pharmacology Abbreviations and Equivalents” CAI Programs (Abbreviations and Equivalents) are available in computer lab. Use in practice as many times as you wish. When ready to test, please inform Mrs. Rogers in order for score to be recorded. Due date: Monday, 10 – 17 - 11 Handout Activity # 1 WEEK 7 10 – 11 - 11 continue – Handout Review / Workbook / CAI Program work Handout Activity # 2 10 – 13 - 11 continue – Handout Review Handout Activity # 3 10 -14 -11 **** FALL BREAK **** WEEK 8 10 – 18 - 11 UNIT EXAM # 2 – COMPETENCY: ABBREVIATIONS & EQUIVALENTS COMPETENCY OF 90% OR ABOVE MUST BE ACHIEVED ON ABBREVIATIONS AND EQUIVALENTS. YOUR INITIAL SCORE IS THE SCORE RECORDED FOR UNIT EXAM # 2 GRADE. YOU WILL HAVE THREE OPPORTUNITIES TO ACHIEVE THIS LEVEL OF COMPETENCY BY TUESDAY, DECEMBER 6, 2011. IF 90% IS NOT ACHIEVED ON THIS EXAM (FIRST ATTEMPT), ARRANGEMENTS MUST BE MADE WITH THE INSTRUCTOR FOR RETAKES. THE RETAKES MAY NOT BE COMPLETED DURING CLASSTIME. SHOULD AFTER THE THIRD ATTEMPT TO MEET COMPETENCY 90% IS NOT ACHIEVED, OBJECTIVES FOR THIS COURSE CAN NOT BE MET AND A FAILING GRADE WILL BE ISSUED. 10 – 20 - 11 Ch. 7 (text) Principles of Medication Administration Ch. 6 (Math for Meds) 5 WEEK 9 10 – 25 - 11 UNIT EXAM # 3 (TEXT: CHAPTERS 6 AND 7 MATH FOR MEDS: CHAPTERS 4, 5, AND 6) Begin working on CAI Programs CAI PROGRAMS (Drugs and Solutions) ON DOSAGE CALCULATIONS AVAILABLE IN COMPUTER LAB. PLEASE MAKE APPOINTMENTS WITH VIRGINIA ROGERS. YOU WILL HAVE SOME CLASSTIME TO DO THESE, AND/OR YOU MAY COMPLETE THESE ON YOUR OWN TIME. ALL STUDENTS TO TURN IN COMPLETION OF THESE PROGRAMS BY MONDAY, 11 – 14 – 11. Dosage Category: Adult, Pediatric, Geriatric Drug Types: General Question Types: Conversions, Calculations, Dosage Based on Weight/BSA, Solutions **** CLINICALS BEGIN **** WEEK 10 11 – 1 - 11 Ch. 7, 8, 9, 10, 11 (Math for Meds) WEEK 11 11 – 8 - 11 Ch. 7 & 9 (Math for Meds) Insulin and Heparin Dosages Ch. 15, 16, 22 (Math for Meds) Pediatric Dosages Continue with Workbook, Worksheet, Computer Lab (Adult & Pedi Calculations) WEEK 12 11 – 15 - 11 UNIT EXAM # 4 – COMPETENCY: DOSAGE CALCULATIONS COMPETENCY OF 90% OR ABOVE MUST BE ACHIEVED ON DOSAGE CALCULATIONS. YOUR INITIAL SCORE IS THE SCORE RECORDED FOR UNIT EXAM # 4 GRADE. YOU WILL HAVE THREE OPPORTUNITIES TO ACHIEVE THIS LEVEL OF COMPETENCY BY TUESDAY, DECEMBER 6, 2011. IF 90% IS NOT ACHIEVED ON THIS EXAM (FIRST ATTEMPT), ARRANGEMENTS MUST BE MADE WITH THE INSTRUCTOR FOR RETAKES. THE RETAKES MAY NOT BE COMPLETED DURING CLASSTIME. SHOULD AFTER THE THIRD ATTEMPT TO MEET COMPETENCY 90% IS NOT ACHIEVED, OBJECTIVES FOR THIS COURSE CAN NOT BE MET AND A FAILING GRADE WILL BE ISSUED. 6 WEEK 13 11 – 22 - 11 Ch. 9 (text) Enteral Administration – PO, NG, Rectal Ch. 10, 11, 12 (text) Parenteral Administration Ch. 8 (text) Percutaneous Administration * Review of text chapters, Video presentations, Order transcriptions, Lab practice 11 / 23 – 25 / 11 **** THANKSGIVING HOLIDAY **** WEEK 14 11 – 29 - 11 Lab practice Final Exam Study Guide WEEK 15 12 – 6 - 11 12 – 8 - 11 12 – 9 - 11 Lab Competencies (PO) Clinical Day Lab Competencies (SC) Clinical Day Lab Competencies (IM) WEEK 16 12 – 13 - 11 FINAL EXAM 7 COURSE OUTLINE: UNIT I FOUNDATIONS OF PHARMACOLOGY Chapter 1 DEFINITIONS, NAMES, STANDARDS, AND INFORMATION SOURCES Objectives: Upon completion, the student should be able to: 1. 2. 3. 4. 5. 6. 7. 8. List four sources of drugs and examples of drugs obtained from each List important literature resources of drug listings and information regarding drugs Identify the difference between generic and brand name of a drug Identify selected federal legislation regulating the distribution of drugs and their use Define specific terms, which describe dosage of a drug Discuss the reasons for standardization of drugs Identify factors, which will determine the amount of a dosage prescribed and/or given Identify seven parts of the PDR; demonstrate ability to utilize various published sources to locate information about classifications of drugs and individual drugs I. Definitions II. Drug Names III. Sources of Drug Standards IV. Sources of Drug Information V. Sources of Patient Information VI. Drug Legislation VII. Effectiveness of Drug Legislation VIII. New Drug Development Chapter 2 PRINCIPLES OF DRUG ACTION AND DRUG INTERACTIONS Objectives: Upon completion, the student should be able to: 1. Demonstrate an understanding of the basic five principles of drug action 2. Discuss nursing assessments necessary to evaluate potential problems with the absorption of medications 3. Describe what is meant by a baseline assessment 4. Describe nursing interventions, which enhance drug absorption 5. List three categories of drug administration 6. Describe drug distribution mechanisms and differentiate between general and selective type 7. Identify the process that inactivates drugs 8. Identify the meaning and significance of the half-life of a drug 9. Define terminology, which applies to drug action and side effects 10. Describe methods of storing drugs and preserving them from deterioration 11. Define what is meant by a drug interaction I. II. III. Drug action in the body Absorption, Distribution, Metabolism, Excretion Classifications 8 IV. V. VI. Chapter 3 Drug Actions Factors Influencing Drug Action Drug Interactions DRUG ACTION ACROSS THE LIFE SPAN Objectives: Upon completion, the student should be able to: 1. 2. Discuss the effects of age on drug action. Cite major factors associated with drug absorption, distribution, metabolism, and excretion in the younger and the older populations as well as in men and women. I. II. III. IV. Changing Drug Action Across the Life Span Age Gender Nursing Implications when Monitoring Drug Therapy Chapter 4 Chapter 5 THE NURSING PROCESS AND PHARMACOLOGY PATIENT EDUCATION AND HEALTH PROMOTION Objectives: Upon completion, the student should be able to: 1. 2. 3. 4. 5. Identify purpose for using nursing process methodology Discuss the application of the steps in the nursing process to pharmacology Identify NANDA accepted nursing diagnoses related to pharmacology Describe evaluation criteria related to outcome of drug therapy Describe an acceptable method of organizing, implementing, and evaluating patient education 6. Identify nursing outcomes related to lab data and drugs 7. Identify principles of learning applicable to patient teaching concerning drug therapy 8. Apply principles of learning to pharmacology through care planning I. Nursing process II. Client education and health promotion 9 UNIT II ILLUSTRATED ATLAS OF MEDICATION AMINISTRATION AND MATH REVIEW Chapter 6 A REVIEW OF ARITHMETIC Objectives: Upon completion, the student should be able to: 1. Learn to calculate dosage preparations with minimum of 90% competency 2. Apply basic mathematic principles to the calculation of problems associated with medication dosages 3. Demonstrate proficiency in performing conversion between household, apothecary, and metric measurements with minimum of 90% competency 4. Correctly identify and write all symbols and abbreviations with minimum of 90% competency I. Systems of measurement II. Conversion between systems Chapter 7 PRINCIPLES OF MEDICATION ADMINISTRATION & MEDICATION SAFETY Objectives: Upon completion, the student should be able to: 1. 2. 3. 4. 5. 6. 7. Cite legal and ethical considerations inherent in medication administration Identify components of Texas Nursing Title Act related to medication administration Describe advantages and disadvantages of various types of drug distribution systems Identify various methods by which standard medication orders are given by physicians Identify advanced practitioners who can legally prescribe drugs Identify parts of a prescription order Define components of a physicians order as written on a patient record; define nursing responsibility related to physicians orders 8. Demonstrate ability to properly document and note a physicians order with 100% competency 9. Discuss nursing responsibilities for safe and competent administration of medications 10. Identify potential areas for medication errors I. Ethics and liability II. Drug labels III. Patient chart IV. Drug distribution systems V. Medication order 10 Chapter 8 PERCUTANEOUS ADMINISTRATION Objectives: Upon completion, the student should be able to: 1. Identify drug dosage forms commonly used for topical application to skin and examples of each 2. Describe procedures by which medications are applied to various body cavities and membranes 3. Describe methods of delivering drug therapy by inhalation 4. Discuss appropriate patient health teaching for various percutaneous dosage forms I. Administration of topical medications - directly to skin (Video - Administering Topical, Suppository, and Inhalant Medications) II. Allergy testing III. Topical application - prepared delivery system IV. Application of powdered medication to skin surface V. Administration of medications to mucous membranes Chapter 9 ENTERAL ADMINISTRATION Objectives: Upon completion, the student should be able to: 1. Discuss advantages and disadvantages of enteral route of administration 2. Differentiate between various oral and rectal dosage forms and techniques involved in the use of each 3. Identify usual equipment used to administer medications by the enteral route 4. Discuss principles of measurement using a medication cup, dropper or oral syringe, and various forms of unit dose packaging 5. Demonstrate procedure for preparing liquid and solid oral medications with 100% competency 6. Identify modifications of procedure in giving oral medications to pediatric clients 7. Identify considerations in giving medications to elderly or the client who has a handicap I. Medicating the patient - preparing medications (Video - Administering Oral Medications) II. Advantages/Disadvantages of Enteral Route III. Administration of Solid Oral Dosage Forms IV. Administration of Liquid Oral Dosage Forms V. Equipment VI. Procedure VII. Nasogastric Tube/Gastrostomy Tube/Jejunostomy Tube Administration VIII. Rectal Suppositories/Medicated Enemas IX. Precautions and Contraindications 11 Chapter 10 PARENTERAL ADMINISTRATION: SAFE PREPARATION OF PARENTERAL MEDICATIONS Chapter 11 PARENTERAL ADMINISTRATION: INTRADERMAL, SUBCUTANEOUS, AND INTRAMUSCULAR ROUTES Chapter 12 PARENTERAL ADMINISTRATION: INTRAVENOUS ROUTE Objectives: Upon completion, the student should be able to: 1. Cite advantages and disadvantages of using the various parenteral routes of drug administration 2. Read calibrations and units on various types of syringes 3. Correctly calculate dosages with all types of syringes 4. Describe various types of syringes and needles used for giving injections; determine appropriate syringe and needle for a particular medication and/or patient 5. Give examples of volumes of medication best measured in a smaller barrel syringe or larger barrel syringe 6. Compare usual volume of medication that can be safely administered at one site with each route 7. Demonstrate competency in using various types of pre-filled cartridge delivery methods 8. Describe criteria used to select a correct needle gauge and length for an individual 9. Demonstrate correct technique for preparing drugs from an ampule or vial with 100% competency 10. Describe and demonstrate proper preparation of patient for ID, SQ, and IM injections 11. Describe and demonstrate proper procedure for Z-track injection; indications for use 12. Describe modifications of injection procedure for use with pediatric patients 13. Describe precautions and demonstrate technique used in preparing two drugs in one syringe 14. Identify various equipment used to administer IV medications / fluids I. Parenteral route (Video – An Introduction to Parenteral Medications) II. Advantages / disadvantages III. Syringes IV. Needles V. Dosage forms / routes VI. Preparation of medication VII. Administration 12 13