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1 College of Nursing Pediatric Skills Laboratory Pediatric Lab Coordinator Dr. Ahlam Mohammad Hussien 2 Table of Contents Section # Items 1. Title Page 2. Undergraduate Program Vision, Mission & Goals 3. Pediatric Nursing Unit Vision and Mission 4. Guidelines of Pediatric Nursing Skill Lab 5. Goal & Philosophy 6. Objectives 7. Documents ( OSCE requirements , clinical rotation , first weeks lab plan ) 8. Schedule of occupancy 9. Lab Activities 10. Pediatric Checklists 11. Simulation lab Skill 12. Assessment tool 13. Pediatric Skill Lab Inventory 3 4 Undergraduate Program Vision: To be an innovative cornerstone of nursing education nationally, regionally; and internationally through the use of technology within a caring context. Undergraduate Program Mission: To offer dynamic, comprehensive and innovative educational experience that will enable students to expand their nursing knowledge and enhance their professional skills to meet the health care needs of the community within the context of Islamic culture, beliefs and values. Goals of the Program 1. Provide quality education in nursing to graduate Saudi nurses with high scientific and clinical competencies. 2. Utilize concepts from humanities and behavioural sciences in nursing practice. 3. Practice legal and ethical standards in nursing profession. 4. Develop professional knowledge and practice through problem-solving approach and evidence-based learning. 5. Utilize electronic administration and health information resources. 6. Apply leadership and managerial skills to attain quality care. 7. Focus on the commitment to the principle of “lifelong learning”. 5 6 Vision and Mission of Pediatric Nursing Unit Based on the vision and mission of Nursing College, Dammam University, the vision and mission of Pediatric Nursing Department will be as follow: Vision: Providing the Saudi community with a high qualified professional nurses in pediatric care and who are unique on national and international levels. Sharing in an enhancement of children's health through the application of nursing education and researches in pediatric field. Mission: The pediatric nursing unit , college of nursing, university of Dammam (UOD) prepares the Saudi graduate and postgraduate candidates to be an competent, skillful and creative in delivering the needed nursing care for healthy and sick children from birth to adolescents in different pediatric settings. These are derived from recent national and international nursing strategies within the framework of Islamic belief and moral values. 7 8 Lab Guidelines The pediatric nursing skills lab at the nursing college provides nursing students with an additional learning resource to meet their educational goals. The lab is equipped with instructional videos and DVDs, supplies and equipment, as well as practice manikins including Baby sim Simulator, Pediatric manikins, CPR manikins, Physical examination manikins, as well as high fidelity child simulator. The lab provides students with a realistic, simulated clinical environment to practice and demonstrate competency of selected nursing skills. Open lab times are posted at the beginning of each semester. Please keep in mind that the following guidelines should be followed during your attendance in the nursing skills open lab: • No eating or drinking in the lab. • Please turn your cell phone off or on vibrate before entering the lab. • PLEASE clean up after yourself. • Keep all beds in appropriate positions with linens straightened before leaving. • Students are required to return clean equipment to its proper place after use. • All simulated practice needles are to be disposed in sharps containers. • Needles and syringes are not to be discarded in trash containers. • If you are accidently stuck with a non-sterile needle or your skin comes in contact with contaminated material, you must immediately go to the Lab Coordinator. • Lab resource books, movies and supplies MUST NOT leave the lab. • Please return all media to proper storage areas or to lab personnel after use. • Please save equipment obtained in labs for practice during open lab times. • Report any incidents or malfunctions to the Lab Coordinator immediately. • Do not move mannequins. If a mannequin needs to be move contact lab coordinator. • Keep personal belongings with you during the lab session, please take them with you when leave. *If a latex or betadine allergy exists or is suspected, please notify your clinical instructor or lab coordinator. 9 10 11 Newborn and pediatric Skill Laboratory “I hear, I forget; I see, I remember; I do, I understand” – Confucius Goal The goal of the Pediatric Nursing Skills and Simulation Laboratory is to promote safe, knowledgeable and effective nursing care by demonstrating and reinforcing the highest level of performance and readiness. Introduction/Philosophy The Pediatric Nursing Skill and Simulation Laboratory is here to make the student’s clinical experience educational and enlightening and to promote empowerment of the student. Scenarios and simulation experiences relate to the pediatric nursing Lab objectives. Students will be oriented to simulations instructions prior to running a scenario. If the student is not comfortable, learning will not take place and scenario objectives may not be met. Simulations and case scenarios mimic the clinical setting and are designed to help the student develop problem-solving and decision-making skills. Simulations include all environmental factors to make students’ learning realistic and authentic. These simulations help students think on their feet and help the transition from lab to clinical. For an enhanced learning experience, students must come to the lab prepared. The faculty will provide debriefing and positive feedback; students will self-analyze their performance and use critical thinking during the reflection process. 12 General Information The pediatric Nursing Skill and Simulation Laboratory is located in University of Dammam, College of Nursing, C3. Room # has an Interactive Child critical mannequin/Simulator (High Fidel Mity simulator), Infant Baby sim Simulator. . The pediatric Skill Lab is fully equipped to practice all pediatric. nursing clinical skills served both undergraduate and postgraduate students. A variety of task trainers are also accessible as well as the ability to view a variety of media. Mentoring and tutoring are also available. The pediatric. Lab is opening 5 days a week (Sunday to Thursday) according to the students’ schedule and either they are undergraduate, post graduate & bridging students. The lab schedule is subjected to change: The calendar for the pediatric Nursing Skill and Simulation Laboratory is posted on pediatric lab. Bulletin. Confidentiality All simulation scenarios practice sessions involving students and/or recordings are considered confidential. All mannequin accessibility should be treated as a real patient (including inappropriate viewing). Discussion of scenarios or information is considered a violation of Practical Nursing Program privacy policy. All students will need to sign a confidentiality lab form. 13 14 Pediatric Nursing (NURS: 1610-431) First Semester Academic Year 2015 – 2016 Pediatric Lab unit Clinical training in Pediatric Lab equips students with essential knowledge, skills, and attitude needed to provide accurate, safe, and comprehensive nursing care for normal child. Training in such fields of nursing enables student to function within the framework of family centered care. Learning Objectives: At the end of this rotation the student nurse will be able to: 1. Assess physical and behavioral states of child. 2. Monitor and interpret vital signs. 3. Measure weight, height as well as head and chest circumferences. 4. Provide immediate and daily care for child. 5. Apply the nursing process in caring for normal child. 6. Assist in administration of medications via different routes. 7. Follow the universal infection control precautions. 8. Encourage mothers to breast feed whenever possible. 9. Maintain optimal nutrition for children either enteral or parenteral. 10.Encourage and facilitate parent child bonding. 11.Asses and manage pain. 12.Record and report any detected abnormality. 13.Prepare parents for discharge and home care. 15 14.Provide health education concerning child care & follow up 15.Documents findings, nursing care & abnormalities 16 17 Pediatric Nursing (NURS 1610-431) Frist Semester-4th Year/7th Level Academic Year 2015/2016-G (1436/1437-H) First four Weeks' Plan 1st Week Date/ Time Group Lecture & Procedures Venue Tuesday. 25/ 8/2015 1 –4 pm All Groups Course Syllabus & Introduction to Pediatric Nursing Hospital Building ( B ) F22 -23 All Groups Introduction, principles &Factors affecting G&D Assessment of growth & Development and Newborn G&D Growth and Development of infant and toddler Wednesday. 26/ 8/2015 8 – 10 am 10 – 12 pm Staff members Dr. Awatef El-Sayed Dr. Ahlam Hussien Dr. Laila Abu Salem C 1: (Class 5- 1) C 1: (Class 5- 1) Dr. Huda Nafee Break 12-1 pm G1, G2& G3 Physical Assessment Part I Newborn lab Mrs. Ibtihal AL moamin G4, G5 & G6 Medication Part I Pediatric lab Dr. Awatef El-Sayed 1-3 pm Thursday: 27/8/2015 8-10 am All Groups 10 -12 pm All Groups 12-1 pm All Groups Growth and development of Preschool, school and adolescent children Re-Demonstration Physical Assessment Part I Medication Part I C 1: (Class 5- 1) Dr. Awatef Al Sayed Newborn lab Pediatric lab All Staff Break G4, G5 & G6 Physical Assessment Part I Newborn lab Mrs. Ibtihal AL moamin G1, G2& G3 Medication Part I Pediatric lab Dr. Awatef El-Sayed 1-3 pm. 18 2nd Week Date/ Time Tuesday. 1/ 9 /2015 1 - 4 pm Wednesday. 2/9/2015 8 – 11 am 11 – 12 pm Group Lecture & Procedure Venue Staff members All Groups Feeding of infants & Children Hospital Building ( B ) F22 -23 Dr. Huda Nafee Dr. Awatef ElSayed All Groups Assessment and management of high risk neonates. C 1: (Class 5.1 All Groups Re-Demonstration Physical Assessment Part I Medication Part I Newborn lab Pediatric lab All Staff Newborn lab Dr. Huda Nafee Pediatric lab Mrs. Ghada Al Ghamdi Break 12-1 pm Physical Assessment Part II G1, G2& G3 1-3 pm Medication Part II G4, G5 & G6 Dr. Ahlam Thursday: 3/9/2015 8 – 11 am All Groups 11 – 12 pm All Groups 12-1 pm Congenital Anomalies Re-Demonstration Physical Assessment Part II Medication Part II C 1: (Class 51) Hussien Miss.Tahani AL-Shammari Newborn lab Pediatric lab All Staff Newborn Lab Dr. Huda Nafee Pediatric Lab Mrs. Ghada Al Ghamdi Break G4, G5 & G6 Physical Assessment Part II 1-3 pm G1, G2& G3 Medication Part II 19 3rd week Date/ Time Tuesday. 8/ 9 /2015 1 - 2 pm 2- 4 pm Wednesday. 9/9/2015 8 - 12 am Group Venue Staff members Hospital Building ( B ) F22 -23 Dr. Huda Nafee C 1: (Class 51) Dr. Laila AbuSalem CPR for Infant Newborn Lab Dr. Laila AbuSalem CPR for Children Pediatric Lab Miss Tahany Al-Shemary Respiratory disorders C 1: (Class 51) Dr. Laila Abu-Salem Newborn Lab Pediatric Lab All Staff Lecture & Procedures Quiz1+ All Groups All Groups GastrointestinalDisorders Cardiovascular disorders Break 12-1 pm G1, G2 & G3 1-3 pm G4,G5 & G6 Thursday: 10/9/2015 8 – 11 am All Groups 11 – 12 Pm All Groups Re-Demonstration CPR for Children CPR for Infant Break 12-1 pm G4,G5 & G6 CPR for Infant Newborn Lab Dr. Laila AbuSalem CPR for Children Pediatric Lab Miss Tahany Al-Shemary 1-3 pm. G1, G2& G3 20 4thweek Date/ Time Tuesday. 15/ 9 /2015 1 - 4 pm Wednesday. 16/9/2015 8 – 11 am 11 – 12 pm Group All Groups Lecture & Procedures Nutritional disorders Venue Staff members Hospital Building ( B ) F22 -23 Dr. Huda Nafee All Groups Hematological disorders C 1: (Class 51) Dr. Laila AbuSalem All Groups Re – demonstration CPR for Children CPR for Infant Newborn Lab Pediatric Lab All Staff Newborn Lab Dr. Sanaa Ghareeb & Mrs. Hanan Abu Gurain Pediatric Lab Miss Tahany Al-Shemary C 1: (Class 51) Dr. Awatef ElSayed C 1: (Class 51) All Staff Newborn Lab Dr. Sanaa Ghareeb Mrs. Hanan Abu Gurain Pediatric Lab Miss Tahany Al-Shemary Break 12-1 pm G1, G2& G3 Suctioning & Oxygen Therapy 1-3 pm G4,G5 & G6 Thursday: 17/9/2015 8 – 10 am 10 – 12 pm All Groups All Groups Gavage Feeding & bottle feeding Urinary tract Disorders Re-demonstration Suctioning & Oxygen Therapy Gavage Feeding & bottle feeding Break 12-1 pm. G4,G5 & G6 Suctioning & Oxygen Therapy G1, G2& G3 Gavage Feeding & bottle feeding 1-3 pm. 21 22 PEDIATRIC NURSING (NURS 1610- 431) 1st Semester- 4th Year/ 7th Level Academic Year 2015/2016-G (1436/1437-H) Simulation and skills lab rotation plan Time Experience o 08001200 Skills lab o o o o o 12000100 01000300 Details Day 1 Nebulizer medication administration. NG and bottled feeding. O2 administration and suction. IM medication administration IV Medication administration. CPR. Location Instructor Pediatric lab/ Newborn Lab Mrs. Ghada AL-Ghamdi Break Simulation Bronchial Asthma and Shock overview /Demonstration Newborn Lab Mrs. Ghada AL-Ghamdi Day 2 08001100 11001200 12000100 01000300 Simulation Simulation Bronchial Asthma Simulation and Debriefing CC1 Shock Simulation Newborn Lab Mrs. Ghada AL-Ghamdi Break Simulation Cont. Shock Simulation and Debriefing Newborn Lab Mrs. Ghada AL-Ghamdi Day 3 08001000 10001200 Skill lab Skill lab evaluation Skill Lab Simulation Evaluation 12000100 01000300 Pediatric Lab/ Newborn Lab Pediatric Lab/ Newborn Lab Mrs. Ghada AL-Ghamdi Mrs. Ghada AL-Ghamdi Break Simulation Simulation Evaluation Pediatric Lab/ Newborn Lab Mrs. Ghada AL-Ghamdi 23 College of Nursing Pediatric Nursing (NURS 1610-431) First Semester AY 2014-2015 First Two Weeks' Plan 1st Week Date/ Time Group Procedure Venue Staff members Wed. 3/9/2014 8 - 10 am All Groups Course Syllabus & Introduction to Pediatric Nursing C2: Class 4 Dr. Magda Essawy Dr. Awatef El-Sayed G1, G2& G3 Physical Assessment Part I C2: Class 4 Dr. Huda Nafee G4, G5 & G6 Medication Part I C3: Blue hall Dr. Awatef El-Sayed 10-12 am. Break 12-1 pm. G1, G2& G3 Physical Assessment Part II C2: Class 4 Dr. Magda Essawy G4, G5 & G6 Medication Part II C3: Blue hall Mrs. Juliet 1-3 pm. 3 – 4 pm. Thursday: 4/9/2014 8-10 am. Re-demonstration All clinical staff G4, G5 & G6 Physical Assessment Part I C2: Class 4 Dr. Huda Nafee G1, G2& G3 Medication Part I C3: Blue hall Dr. Awatef El-Sayed G4, G5 & G6 Physical Assessment Part II C2: Class 4 Dr. Magda Essawy G1, G2& G3 Medication Part II C3: Blue hall Mrs. Juliet 10-12 am. Break 12-1 pm 1-2 pm. 2-5 pm Re-demonstration All Groups Theory All clinical staff C2: Class 4 Dr. Awatif El Said 24 2nd Week Procedure Venue Staff members CPR for Infant Newborn Lab Dr. Laila AbuSalem CPR for Children Pediatric Lab Miss Tahany Al-Shemary Gavage Feeding OBG. Lab Dr. Yousr Gaafar Date/ Time Group Wed. 10/9/2014 8 - 9 am 9 – 10 am 10-11 am 8 - 9 am 9 – 10 am 10-11 am 8 - 9 am 9 – 10 am 10-11 am G1 & G2 G3 & G4 G5 & G6 G3 & G4 G5 & G6 G1 & G2 G5 & G6 G1 & G2 G3 & G4 11-12 am. All Groups Re-demonstration Break 12-1 pm 1-4 pm. All clinical staff All Groups Theory C2: Class 4 Dr. Yousr Gaafar Newborn Lab Fathia Al Somaly & Ghada Al Ghamdy Pediatric Lab Latifa AlDossary & Ebtihal Al Moamen Thursday: 11/9/2014 8 –9.30 am 9.30 – 11 am G1, G2& G3 G4,G5 & G6 8 –9.30 am 9.30 – 11 am G4,G5 & G6 G1, G2& G3 Restraint 11-12 am. All Groups Re-demonstration Suctioning & Oxygen Therapy All clinical staff Break 12-1 pm. 1-2 pm. All Groups Re-demonstration 2-5 pm. All Groups Theory All clinical staff C2: Class 4 Dr. Yousr Gaafar 25 Pediatric Nursing (NURS: 1610-431) First Semester Academic Year 2014 - 2015 26 Pediatric nursing, 2014-2015 Summary of OSCE for pediatric nursing: * OSCE will be done in one day schedule staring from 8.30 am up to 2.30 pm, on Wednesday 24-12-2014. * Three nursing labs will be used in OSCE exam, newborn, infant & children and simulation lab. Four stations will be prepared in each lab and 5 minutes will be allowed for each station. * Students will be divided into nine groups 12 students for each (total students No. is 95). * OSCE will be carried out in eight cycles, each cycle will consist of 12 students (4 students in each lab), every student will get 5 stations as a hall (two stations in newborn lab, two stations in infant & children lab and one station in simulation lab) , each station will consume 5 minutes. 5- If students require assistance or need a bathroom, please inform the instructor. 6-At the end of exam, student will move to a classroom and please, avoid contacting with other students. 27 Preparation of OSCE exam, pediatric nursing: Three nursing labs will be used in OSCE exam, newborn, infant & children and simulation lab. Four stations will be prepared in each lab, the clinical exam will be done in one day schedule staring from 8.30 am up to 2.30 pm, students will be divided into eight group’s 12 students for each (total students No. is 95). The distribution of stations will be as following: Nursing labs Staff members Newborn lab: Stations one & two: estimation of gestational age Stations Three & four: Bottle feeding Dr. Laila Younis & Mrs. Fathia Al Somali Dr. Yousr Gaafer & Dr. Moma Gamal Infant & children lab: Stations one & two: Traige Stations three & four: Congenital anomalies photos Dr. Awatif El Said Dr. Hoda Nafa & Dr.Ahlam Hussen & Mrs. Ebtihal Al Moamen Simulation lab: Stations one & two: Bronchial asthma scenario Dr. Magda Essawy, Mrs Tahany Al Shemery & Mrs Ghada Al Dossary 28 Students Organizers: 1. 2. 3. 4. General students organizer, Dr. Magda Essawy Time keeper , Mrs rabhaa & Miss Anood Students in classroom, Dr. July Student’s attendance and student’s simulation lab organizer Mrs. Hellen. 5. Student’s organizer for newborn lab, Mrs Zenab. 6. Students organizer for infant & children lab Mrs. Samia Points should be considered in performing the pediatric OSCE 1- Every student will get 5 stations as a hall (two stations in newborn lab, two stations in infant & children lab and one station in simulation lab), each Station will consume 5 minutes. 2- Mobile phones, printed or written materials are not allowed during the exam. 3- Bell ring signal will be done on the beginning of the OSCE, on the starting and ending of each station. 4- After finishing two stations from each lab, the student will move to the next lab according to the preset map. Map of student’s movement in each cycle: * Starting in newborn lab * Starting in simulation infant& children lab newborn lab * Starting in infant& children lab simulation lab simulation lab infant& children lab newborn lab 29 30 Occupancy of Pediatric Nursing Lab in the 1st Semester of Academic year 2015-2016 Day/Time Sunday 8:00-12:00N 12:001:00PM Break Medical &Surgical Nursing Monday Medical Break &Surgical Nursing Tuesday Maintenance Wednesday Pediatric Nursing Break 1:00-3:00 Medical &Surgical Nursing Medical &Surgical Nursing Pediatric Nursing Health Assessment ( Bridging course) 3pm-6:30pm Thursday Pediatric Nursing Break Pediatric Nursing Clinical skill laboratories Coordinator /Dr. Radwa Hamdi Bakr Coordinator of Pediatric Nursing Lab/Dr. Ahlam hussien Pediatric Nursing Lab Manager/ Mrs. Sara Al abdali 31 32 Report about workshop for how to conduct CAE BabySim in Newborn lab Date / 5 May 2015 Venue/Newborn lab Attendants: 1-Dr. Magda Essawy. 2-Dr.Ahlam Hussien. 3-Dr. Laila Abu Salem. 4-Dr.Awatef Al Sayed. 5- Hoda Nafee 6- Mrs. Liali 7- Mrs. Ghada al Ghamdi *Engineer Wael from Eman Health Care Company came to conduct a training on how to handle and maintain the BabySim SCE developmental software. 33 34 PEDIATRIC NURSING (NURS 1610- 431) 1st Semester- 4th Year/ 7th Level Academic Year 2015/2016-G (1436/1437-H) Body Temperature Measurement Check List Date: ____________________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1 -Wash hands. 2-Explain the procedure to the child or to his parents. 3-Check thermometer to see the reading. 4-Clean thermometer from tip to the bulb. 5-Shake the level of mercury down to below 35°C. Oral Temperature: 6-Place thermometer in the mouth far back under the tongue. 7-Tell the child to keep mouth closed, breath through the nose and not to talk. 8-Hold thermometer in place for 3 minutes. Remove thermometer and wipe it from up down to the bulb Rectal temperature: 9-Rinse and dry the anal area. 10-Lubricate the bulb of the rectal thermometer. 11-Place child in side-lying or prone position. 12-Place infant prone across mother’s lap or supine with knee flexed toward abdomen Done complete ( 2) Done incomple te ( 1) Not done ( 0) 35 13-Insert the lubricated thermometer 2.5 cm in the rectum and hold it for one minute. 14-Remove the thermometer and wipe with swab from up down to the bulb. 15-Take the reading. 16-Wash thermometer with soap and water and disinfectant. Axillary temperature: 17-Rinse and dry axilla. 18-Place thermometer under arm with tip in center of axilla and keep it close to skin not clothing. 19-Hold child’s arm firmly against side for 5 minutes. 20-Remove thermometer and wipe it from up down to the bulb. Total marks Signature of faculty member: Date: / out of 40 36 Heart rate Measurement Check List Date: ______________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the procedure Done complete (2) 1- Hand washing. 2-Explain the procedure to the child and infant’s family. 3-Wipe earpieces and diaphragm with alcohol swabs. 4-Expose the chest over the apex of the heart. 5-Wipe earpieces and diaphragm of stethoscope alcohol swab. with 6-Place the stethoscope between the fourth and the fifth intercostal spaces just below the left nipple. 7-Listen to the heart sound and count for one full minute. 8-Wipe the earpieces and the diaphragm with alcohol swab Total marks Signature of faculty member: Date: / out of 16 Done incomple te (1) Not done (0) 37 Respiratory Rate Measurement Check List Date: ___________________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure Done complete (2) 1- Expose the chest. 2-Observe abdominal movement in infants & young children 3- Observe thoracic movement in older children. 4-Count respiration for one full minute. 5-Report any abnormality Total marks Signature of faculty member: Date: / out of 10 Done incomplete (1) Not done ( 0) 38 Blood Pressure Measurement Check List Date: ___________________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure Preparation: 1- Select the appropriate cuff size. 2-Attach the tube from the BP cuff. 3-Open the cock. 5-Close the valve of bulb. Procedure: 6-Expose the upper arm. 7-Apply the cuff evenly over the upper arm with the lower edge about 1.5 cm above the antecubital space 8-Position the sphygmomanometer on a level surface at approximately the level of heart. 9- Palpate the radial artery and inflate the cuff until the palpated pulse is lost then pump for additional 20 mmhg. 10-Position the bell of the stethoscope over the area where the brachial pulse is felt. 11- Slowly deflate the cuff and listen to the sounds. 12- Deflate the bp cuff & remove it. 13- Record the reading & report for any abnormality. Total marks Signature of faculty member: Date : / out of 26 Done complete (2) Done incompl ete ( 1 ) Not done (0) 39 Chest Circumference Measurement Check List Date: ________________ Student'sName:______ ______________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Remove infant’s clothes of upper half. 2.Place on a flat table in supine position. 3. Place tape across the nipple line. 4 Measure mid way between inspiration and expiration. 5. Record. Total marks Signature of faculty member: Date: / out of 10 Done complete (2) Done incompl ete ( 1 ) Not done (0) 40 Height Measurement Check List Date: _________________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1-Remove the child’s shoes and socks 2-Stand as tall and straight as possible with head in midline and the line of vision parallel to the floor. 3-The child’s back should be to the vertical flat surface with heels, buttocks and back of the shoulder touching the surface. 4-Any flexion of the knees, lumping of the shoulders or raising of heels of the feet is checked and corrected. 5-Move the board on the top of the head. 6- Read and record. Height “using measuring tape” 7-Attach a measuring tape to the wall. 8-Place the child adjacent to the tape. 9- Place a three dimensional object, such as thick book or box on the tape of the head. 10-The side of the book must rest firmly against the wall to form a right angle. 11-Length or stature is measure to the nearest 1 ml. 12-Record. Total marks Signature of faculty member: Date: / out of 24 Done compl ete ( 2) Done incompl ete ( 1 ) Not done ( 0) 41 Length Measurement Check List Date: ________________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1- Place the towel on the board. 2- Remove the infant clothing. 3- Place infant on center of board firmly in supine position. 4-Hold the head against headboard firmly. 5-Grasp the knees together gently. 6-Push down in knees until the legs are fully extended &hold the legs firmly. 7-Bring the headboard against the soles of heals firmly. 8- Read and record. Length “using measuring tape” 9-Place the infant on a proper covered hard surface. 10-Push down the knees and head against a firm surface. 11-Make points of the top of the head and heel of the feet by a point. 12-Remove infant from his place. 13-Measure between these two points. 14-Record. Total marks Signature of faculty member: Date: / out of 28 Done compl ete ( 2) Done incompl ete ( 1 ) Not done (0) 42 Weight Measurement Check List Date: _________________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1-Place the scale horizontally. 2- Check to see that scale is balanced by sitting it to the zero, and noting if the balance registers exactly in the middle of the mark. 3-Make the patient room warm. 4-Wipe the scale with cotton with alcohol. 5-Remove the infant clothing. 6-Put a scale paper on the scale. 7-Gently lift the infant from the bed and place him in the scale basket. 8- hold hand over the body of the infant for safety, 9-Adjust the weight to balance the scale by right hand. 10-Read the scale when infant is lying still. 11-Remove and dispose the scale paper. 12-Record the weight. Weight “for older children” 13-Balance the scale. 14-Place a paper towel on the scale for the child to stand on. 15- Keep child privacy. 16-Child usually weighed while wearing their underpants or light gown. 17-Remove shoes of the child. Done comp Done in comp. (2) (1) Not done ( 0) 43 18- Read and record. Total marks Signature of faculty member: Date : / out of 36 44 Physical Assessment Check List Date: _______________ Student's Name :_ __________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1.History Taking: Biographic data. Chief complaint. Present illness. Past health history. Family health history. Previous hospitalization. Immunization received. Feeding pattern Allergies. Activity pattern. 2.Growth Measurement: Length / height. Weight. Head circumference. Chest circumference. Arm circumference. 3.Physiological Measurement: Temperature. Pulse. Respiration. Blood pressure. 4.General Appearance: Inspect for: Posture. Facial expression. Hygiene. Nutritional status. Level of child activity. Child’s reaction to stress. 5.Skin: Inspect color. Palpate texture. Palpate Turgor. Done comple te ( 2 ) Done Not incomp done lete ( 1) (0) 45 Lymph nodes. Inspect & palpate. Size Temperature. Tenderness Any abnormality. 6.Head: Inspect: Shape. Control. Posture. Inspect and palpate: Fontanels Examine: range of motion 7.Scalp: Inspect & palpate: Cleanliness. Trauma. Lesions Hair texture. Hair loss. Hair discoloration 8.Face: Inspect - symmetry. - Facial. Expression 9.Neck: Inspect - Size - Trachea. - Thyroid - Carotid arteries Palpate thyroid glands. 10.Eyes: Test visual activity. Inspect - Placement. - Lids. - Conjunctiva. - Eyelashes. - Eye brows. - Cornea. 46 - Pupils. - Iris. - Lens. Examine – pupils Reaction to light. 11.Ears: Inspect - Pinna External canal. 12.Nose & Sinuses: Inspect - External nose. Nasal mucosa Nasal septum. Palpate - Sinuses for tenderness. 13.Mouth and Tthroat: Inspect - Lips - Pharynx Tongue. Gums Teeth Roof of mouth - color - exudate - tonsils 14- Chest: Inspect chest Palpate chest. Percuss chest. Ansultate the chest. 15- Nails: Finger nails and toes nails. Inspect for color and shape Palpate for lesions. 16- Heart: Inspect heart. Palpate for: Pulse Tactile fremitus. Auscultate for heart sounds (S1 / S2). 17- Back: 47 Inspect back for: Color Symmetry. Lesions. Palpate back for lesions. 18- Genitalia: Male: Inspect and palpate: Penis Scrotum Tests Female: Inspect: Labias Urethral meatus Urethral meatus Vaginal orifice 19- Anus: Inspect: - Opening Skin condition. 20- Extremities: Range of motion Inspect: Upper and lower extremities for: Color Symmetry Lesions Bowlegs / knock knee. Palpate: Pulse Oedema - Lesions 21- Neuromascular system: Test for: Activity – mobility Level of consciousness Reflexes Sensation Total marks Signature of faculty member: Date : / out of 42 48 Formula Preparation Checklist Date: __________________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the procedure Done Done complete incomplete (2) (1) 1- Wash all utensils used for bottle feeding with warm soapy water. 2- Rinse with running water 3- Place all equipment except rubber articles in a covered container, boil for 10 minutes. the rubber teats should be boiled for 3 minutes 4- Wash hands 5- Boil in the kettle fresh water and pour it into the graduated bottle 6- Leave the water to cool 6- Loosely fill the scoop with milk powder after checking the expiry date on the formula tin 7- Add scoops of powder to the bottle of cooled boiled water. 8- Seal the bottle with the disc, screw ring and cap then shake the bottle to dissolve the milk powder. 9- Change the infant diaper 10-Check the temperature of the milk feed by dropping a few drops on to the inside of your wrist 11-A plastic apron may be worn 12-Infant should wear a bib 13-The care giver should sit down in a comfortable chair with the infant's head supported in the upright position. 14-Tilt bottle to keep the nipple full at all times. 15-Stimulate rooting reflex by rubbing nipple along lower lip or tickling side of cheek. 16-Place nipple on top of tongue 17-After 5 minutes, stop feeding and burp infant by placing over the shoulder and moderately patting the infant's back with a cupped hand 18-Burp infant again at the end of feeding 19-Place infant in safe and secure supine position in the crib or bassinet. 20-Discard bottle and formula remaining in bottle at the end of feeding 21-Hand washing 22-Record: time, type, and amount of fed as well as problems encountered Total marks : out of / 44 Signature of faculty member: Date: Not done ( 0) 49 Nasogastrlc Tube Feeding Checklist Date: _______________Student's Name:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the procedure 1. Wash hands& wear a plastic apron .2. prepare equipment 2. Explain the procedure to the mother. 3.Postion the child conceding the developmental approach 4. Measure the tube for approximate length of insertion and mark the point with a small piece of tape. 5. Place a towel over child's gown 6. Were gloves 7. Lubricate the catheter with sterile water or water soluble lubricant. 8. Insert the tube gently and firmly through either the mouth or one of the nares to the predetermined mark 9. Check the placement of the tube 10.Tape the tube securely & closed it by clamp . 11.. Elevate head of the bed up 30 degrees 12. Measure prescribed amount of enteral formula in graduated measuring cup or catheter tip syringe . 13. Place a towel under the child's chin &chest 14. Connect catheter tip syringe to the tube push gently with the plunger to start flow of food, then remove the plunger and allow the food to flow by gravity . 15. After finishing, gently clear tubing &catheter –tip syringe by warm water flush then Clamping it . 16.. Hold , cuddle and burp the child 17. Dispose the equipments, 18. wash hands 19. Documentation (type of feeding ,amount &child reaction ) Total Marks: / out of 38 Signature of faculty staff : Date: done done Complete In complete (2) (1) Not done (0) 50 Gastrostomy Feeding Checklist Date: ______________Student's Name:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the procedure 1. Wash hands 2.Gather the necessary equipments 3.Wear gloves 4.Measure prescribed amount of formula into clean graduated cup or catheter tip syringe 5.Tell the mother what is going to be done. 6.Inspect and palpate abdomen for distention 7.Place child in a supine position with the head of bed up 30 degree 8.Check residual stomach contents by attaching syringe to the tube and aspirating 9.Attach 60mL catheter-tip syringe with plunger removed to the end of the feeding tube 10.Elevate catheter-tip syringe to a level to deliver the feeding Allow feeding to flow slowly by gravity; 11.Allow feeding to flow slowly by gravity; 12.After feeding is complete, gently clear tubing and catheter-tip syringe with warm water flush. 13.Withdraw the tubing with a slow, smooth, steady movement 14.Dispose of equipment and waste in appropriate receptacle 15.Remove gloves and wash hands 16.Record: time, type, amount of fed, amount of gastric residual and color, child's tolerance of the procedure and presence of bowel sounds - Total Marks: / out of 16 - Signature of faculty members : - Date : Done complet e (2) Done incom plete (1) Not done ( 0) 51 Jacket Restraints Checklist Date: ________________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the procedure 1. Wash hand 2. prepare the necessary equipments 3. Explain to the mother what is going to be done and encourage her to ask questions 4. Stay with distressed child 5. Place the jacket on the child with the ties positioned in the back 6. Secure each tie to unmovable portion of the bed, secure the shoulder straps to the head of the bed 7. Secure the straps over the abdomen to the spring underneath the mattress on either side of the bed 8. Ensure that patient's gown and jacket arenot wrinkled 9. Waist-length, sleeveless jacket with back closure fastened with ties 10. Long ties on bottom of jacket secure child to crib ,chair ,or bed 11. Recording any observation Total Marks: Faculty Member Name : Date : out of 22 Done comp. (2) Done In-comp (1) Not done (0) 52 Mitt or Hand Restraints Checklist Date: __________________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Wash hand 2. prepare the necessary equipments 3.Explain to the mother what is going to be done and encourage her to ask questions 4. Stay with distressed child 5. Place a large folded dressing in patient's palm 6. Separate the fingers with a pieces of large dressing 6. A padded dressing around the wrist 7.Place two large dressings over the hand, one is first placed from the back of the hand over the fingers to the palm and the other is the wrapped from side to side around the hand 8. Cover these dressing by placing stocknette dressings over the hand or elastic bandage, using the recurrent pattern 9. Secure the stroknette or elastic bandage with adhesive tape or apply a commercially made restraints 10. If mitts are worn for several days remove them at least every twelve hours, wash and exercise the hand, then reapply the restraint 11. Recording any observation Total Marks: out of 22 Signature of the Faculty Member : Date : Done comp. (2) Incomp. (1) Not done (0) 53 Elbow Restraints Checklist Date: _______________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Wash hand 2. prepare the necessary equipments 3. Describe to the mother what is going to be done and encourage her to ask questions 4. Stay with distressed child 5. Make sure that the tongue depressors are intact and in place 6. Apply elbow restraint over the gown sleeves 7. Place child’s elbow into the middle of the elbow restraint 8.. Wrap the cloth around the arm 9 . Make sure that the restraint not too tight 10. Secure restraint with safety pins or ties 11. Remove restraints at least every 2 hours to prevent impairment of the circulation 12. Recording any observation Total Marks: out of 2 4 Signature of the Faculty Member Date : Done comp. (2) Done Incomp. (1) Not done (0) 54 Clove Hitch Restraints Checklist Date: ________________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Wash hand 2. prepare the necessary equipments 3. Describe to the mother what is going to be done and encourage her to ask questions 4. Stay with distressed child 5. Pad the wrist or ankle with the gauze dressing 6. Tape the dressing to secure it in place, make sure is not too tight 7. Tie the bandage to the wrist or ankle using a clove hitch as the following: Make a double loop Pick up the loops Slip the wrist or ankle through the two loops Tie the ends to the bed frame under the mattress using a square knot 8. Check every two hours 9. Perform range of motion 10. Recording any observation Total Marks: out of 2 0 Signature of the Faculty Member: Date : Done comp. (2) Done Incomp. (1) Not done (0) 55 Arm and leg Restraints Checklist Date: ___________________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Wash hand 2. prepare the necessary equipments 3. Describe to the mother what is going to be done and encourage her to ask questions 4. Stay with distressed child 5. Place opened sheet or blanket on flat surface with one corner folded to the center 6. Place infant on blanket with shoulders at blanket fold and feet toward opposite corner 7. Place infants right arm Straight against side of body 8. Pull side of blanket on right side firmly across right shoulder and chest 9. Secure beneath left side of body 10. Place left arm straight against side 11. Being remaining side of blanket across left shoulder and chest 12. Secure beneath body 13. Fold lower corner , bring up to shoulders and secure ends beneath body 14. Fasten in place with safety pins or tape 15. Modification for chest examination: Left and right corners are brought over arms only to , but not including , chest and secured under body 1 6. Bottom corner is secured at waist rather than at shoulders 1 7. Recording any observation Total Marks: out of 34 Signature of the Faculty Member : Date: Done comp. (2) Done In-com. (1) Not don (0) 56 Mummy Restraints Checklist Date: ______________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Wash hand 2. prepare the necessary equipments 3. Describe to the mother what is going to be done and encourage her to ask questions 4. Stay with distressed child 5. Place opened sheet or blanket on flat surface with one corner folded to the center 6. Place infant on blanket with shoulders at blanket fold and feet toward opposite corner 7. Place infant’s right arm straight against side of the body 8. Pull side of the blanket on right side firmly across right shoulder and chest 9. Secure beneath left side of body 10. Place left arm straight against side 11. Bring remaining side of blanket across left shoulder and chest 12. Secure beneath body 13. Fold lower corner and bring up to shoulders and secure ends beneath body 14. Fasten in place with safety pins or tape 15. Recording any observation Total Marks: Out of : 30 Signature of the Faculty Member : Date : Done comp. (2) Done In comp. (1) Not done (0) 57 Crib Restraints Checklist Date: _______________Student'sName:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Wash hand 2. prepare the necessary equipments 3. Describe to the mother what is going to be done and encourage her to ask questions 4. Stay with distressed child 5. Keep crib and bedside rails up when the child in the bed 6. place wheel of crib or bed in a locked position. 7. Ensure that the catches on the crib are in good working condition 8 . Place the net over sides and ends of the crip. 9 . Secure the tie to bed frame 10. Tie the strap in half-bow knot 11. Add net or bubble tops to the crib as needed. High- low beds should remain in the low position 12. Recording any observation Total Marks: out of 24 Signature of the Faculty Member: Date : Done Done comp. Incomp. (2) )1( Not done (0) 58 Oral Drug Administration Checklist ( using dropper, syringe, cup or spoon) Date: _____________Student's Name:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Check the medication’s order accuracy( medication’s card) it should contains : the child name, drug name, time for administration, route of administration, and dose to be administered 2. Wash hands 3. Prepare and arrange the required equipment.( dropper ,syringe, cup or spoon) 4. Prepare the prescribed medication. If syrups check the bottles on top of the cart For infant, crush the tablet or open the capsule and add to adequate amount of water or juice 5. Take the necessary dose of medicine using the dropper, syringe, cup or spoon 6. Bring the medication tray directly to child's bedside. 7. Explain to the child and parent what you will do 8. Elevate the infant's head and depress his, chin with your thumb. 9. Drop the liquid medication slowly on the middle of the tongue using dropper or syringe. - Put the cup to his lips and slowly expel the medication into the child's mouth. - Put the spoon to the middle of the tongue and slowly expel the medication into the child's mouth 10. If rubber tipped dropper is used the infant may be allowed to suck and swallow the medication as it slowly passes into his mouth. 11. Make sure that the child swallow the medicine 12. Dispose the solid equipment 13. Wash hands 14.Record: Date, Time, Name of medication, Dose, Route, presents of adverse effect, child response, and Signature Total Marks: out of 28 Signature of the Faculty Member: Date: Done comp Done in comp (2) (1) Not done (0) 59 Rectal Medication Administration Checklist Date: __________Student's Name:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure Done comp (2) 1 Check medication order. 2. Wash hands 3. Prepare the needed equipments. 4. Explain the procedure to the child or his/her parent. 5. Provide privacy by draping the child with his anus exposed and closed curtains around the bed. 6. Position the child in a left lateral position with the right flexed or in the knee-chest position 7. Put on gloves. 8. Clean and dry the anal area 9. Remove the suppository packaging 10. lubricate the suppository with a water-soluble lubricating jelly 11. Gently insert the suppository past the internal anal sphincter 12. Hold the child's buttocks together until the child relaxes 13. Remove gloves 14. Wash hands and dispose equipments. 15.Document : Date, Time, Name of medication, Dose, Route, presents of adverse effect, child response, and Signature Total Marks: /30 Signature of the faculty member: Date Done in comp (1) Not done (0) 60 Enema Administration Checklist Date: _______________Student's Name:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Wash hands 2. Check medication order. 3. Prepare the needed equipments. 4. Explain the procedure to the child or his/her parent. 5. Provide privacy by draping the child with his anus exposed and closed curtains around the bed. 6. Assure the child that a bed pan will be kept at bedside 7.Place the waterproof pad under the child. 8. Position the child: a-For infants; placed on his back and legs are lifted to expose the anal orifice. b-For older children; semi's position or knee-chest position. 9. Put on gloves. 10. Lubricate the catheter. 11.Introduce the catheter through the anal sphincter into the anal canal and the lower rectum. Insertion distance ranges from 2.5 to 10 cm according to the child's age. 12. Hang solution container on a bedside stand elevated 30-45 cm above the child's abdomen. 13.Allow solution to flow until finished. Stop the flow fluid if any symptoms of distress appear such as abdominal pain, shortness of breath or chest pain. 14. Hold the buttocks together. 15. Let the child defecates and expels the content of the enema on bedpan or clean diaper for infants. 16. Clean the perineum 17. Help the child resume a position of comfort 18. Assess the return for amount and character 19. Wash hands and dispose equipments. 20. : Date, Time, Name of medication, Dose, Route, presents of adverse effect, child response, and Signature Total Marks: /40 Signature of the faculty member: Date Done complet e (2) Done incompl ete (1) Not done ( 0) 61 Instillation of Nose Drops Checklist Date: ________________Student's Name:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Wash hands 2. Check medication order. 3. Prepare the prescribed medication 4. Give honest explanation to the child and/or parent. 5. Wear gloves 6. Hold the infant in the cradle position place toddler's head over a pillow 7. Squeeze the drops into each nostril 8. keep the child in his position at least 1 minute 9. Remove gloves and wash hands 10. Record : Date, Time, Name of medication, Dose, Route, presents of adverse effect, child response, and Signature Total Marks: /20 Signature of the faculty member Date : Done complete (2) Done Not incomplete done ( 0) (1) 62 Instillation of Ear Drops Checklist Date: _________________Student's Name:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Wash hands 2. Check medication order. 3. Prepare the prescribed medication 4. Give honest explanation to the child and his parent. 5. Wear gloves 6. Position infants and toddlers on their sides, The pinna of the ear is to be pulled down & back For children over 3 years, pull the pinna up and back 7. Hold the dropper 1/2 inch above the ear canal 8. Administered the ordered amount of drops into the ear canal 9. Have the child remain in the supine position with the head turned for 3-5 minutes 10. A cotton pledged placed into the canal 11. Remove gloves and wash hands 12.Record : Date, Time, Name of medication, Dose, Route, presents of adverse effect, child response, and Signature Total Marks: /24 Signature of the faculty member Date : Done complet e (2) Done incompl ete (1) Not done ( 0) 63 Instillation of Eye Drops Checklist Date: __________________Student's Name:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the procedure 1. Wash hands 2. Check medication order. 3. Prepare the prescribed medication 4. Give honest explanation to the child. 5. Site the child in an upright position the head hyperextend. 6. Provide the child with tissues. 7. Restrain the child if necessary. 8. Place finger or thumb on lower bony orbit and gently pull the lower eyelid down. 9. With other hand resting the patient's forehead, instill the required dose, release the lower lid, and allow the child to close eyes for a few minutes. 10. Wash hands 11.Record : Date, Time, Name of medication, Dose, Route, presents of adverse effect, child response, and Signature Total Marks: /22 Signature of the faculty member Date : Done Done complete incomplete (2) (1) Not done ( 0) 64 Intramuscular Injection Checklist Date: __________________________Student's Name:__________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Perform hand hygiene before patient contact. Verify the correct child using two identifiers. Review the child’s history for drug allergies. Assess the child for specific contraindications to receiving the medication and advised the practitioner accordingly. Assess the child’s muscle mass and skin condition. Perform hand hygiene. Check the accuracy and completeness of the MAR with the practitioner’s original order. Ensure the six rights of medication safety: right medication, right dose, right time, right route, right child, and right documentation. Used a bar code system or compared the MAR to the child’s armband. Provide privacy. Select an appropriate injection site based on the child’s age and muscle mass, the medication volume, and the viscosity of the medication. Apply a local anesthetic as appropriate per the manufacturer’s instructions if prescribed. Mix and drew up the exact amount of medication. Used a filter needle if drawing the medication from a glass ampule. Attach an appropriate-size needle to the syringe. Label all medications and medication containers. Position the child and performed distraction measures. For infants unable to breastfeed or for infants who do not breastfeed, administered 24% oral sucrose via pacifier (non-nutritive sucking). Wear gloves. Clean the area with alcohol or an antiseptic swab and allowed the skin to dry. Administer the injection. Remove the needle and syringe quickly and smoothly. Apply pressure at the injection site. Assess the injection site for complications and applied Not done ( 0) Done incomplete (1) Done complete (2) 65 an adhesive bandage 23 Praise the child for positive behavior and allowed the child to express his or her feelings after the procedure. 24 Assess, treated, and reassessed pain. 25 Discard supplies, removed gloves, and performed hand hygiene. 26 Document the procedure in the child’s record. Total Marks: /52 Signature of the faculty member Date : 66 Intravenous Therapy Dose and Flow Rate Calculation Checklist Date: __________________________Student's Name:____ ____________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1 2 3 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Perform hand hygiene before patient contact. Verify the correct child using two identifiers. Assess for allergies, history of kidney or liver disorders, and fluid and electrolyte status. Assess for potential drug incompatibilities if the prescribed medication was to infuse concurrently with other medications or fluids. Determine the child’s age, height, weight, and BSA (if indicated). Collect all necessary supplies and equipment. Perform hand hygiene and donned gloves. Check accuracy and completeness of the MAR with the practitioner’s original order. Review information about the drug to be administered. Determine whether the drug was within the recommended dose amount based on body weight or BSA. Calculat the desired dose or volume, using the ratio-proportion method to solve for the unknown variable. Calculated the flow rate for a continuous IV infusion. Ensured that a second nurse or clinical pharmacist independently performed the calculation, and then compared results. Ensured the six rights of medication safety: right medication, right dose, right time, right route, right patient, and right documentation. Used a bar code system or compared the MAR to the child’s armband. Labeled all medications, medication containers, and other solutions, including those that were on a sterile field. Assessed the IV line for patency by slowly infusing 1mL of normal saline. If required, reconstituted and/or diluted the medication. Cleansed the needleless injection cap of the intermittent lock with an antiseptic solution and allowed the solution to dry. Injected the correct volume of medication slowly over the time specified. Not Done Done done incomplete complete ( 0) (1) (2) 67 21 Flushed with 3-5ml of normal saline. 22 Filled the container using compatible IV fluid bag, with amount of fluid required for dilution. 23 Cleansed the diaphragm used for medication administration located on the top of the chamber with antiseptic solution and allowed the solution to dry. 24 Injected the correct volume of medication into the chamber. 25 Set the infusion rate to infuse medication volume and flush over the desired time 26 Connected the tubing to the IV access port or stopcock. 27 Monitored the child’s response to the medication. 28 Discarded supplies, removed gloves, and performed hand hygiene. 29 Documented the procedure in the child’s record. Total Marks: /58 Signature of the faculty member Date : 68 Intra-dermal Injection Checklist Date: __________________________Student's Name:________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Wash hands 2. Check medication order. 3. Prepare the prescribed medication 4. Give honest explanation to the child and his parent. 5. Wear gloves 6. Position the child, the forearm is well exposed. 8. Cleanse skin thoroughly with antiseptic sponge and let dry 9. Support patient's forearm and stretch the skin between the thumb and forefinger 10. Insert needle at a 5-15 angle 11. Stabilize needle, and then inject medication slowly over 3 to 5 seconds 12. Withdraw needle. Don't massage site or cover it with bandage. 13. Don’t recap the needle, discard it in a disposable needle box 14. Remove gloves and Wash hands 15.Record : Date, Time, Name of medication, Dose, Route, presents of adverse effect, child response, and Signature Total Marks: /30 Signature of the faculty member Date : Done Done Not done complete incomplete ( 0) (2) (1) 69 Subcutaneous Injection Checklist Date: __________________________Student's Name:________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Wash hands 2. Check medication order. 3. Prepare the prescribed medication 4. Give honest explanation to the child and his parent. 5. Wear gloves 6. Put the child in comfortable position with area of injection is well exposed 7. Cleanse skin thoroughly with antiseptic sponge and let dry 8. Gently accumulate a well defined roll of skin and subcutaneous tissue without pinching 9. Insert the needle at 45° angle to the long axis of the extremity 10. Rapidly inject the medication 11. Withdraw the needle quickly. 12. Apply pressure over the site with a dry cotton ball 13. Place adhesive bandage over site 14. Dispose of needle, syringe, and waste in appropriate receptacle 15. Remove gloves and Wash hands 16.Record : Date, Time, Name of medication, Dose, Route, presents of adverse effect, child response, and Signature Total Marks: /32 Signature of the faculty member Date : Done complete (2) Done incomplete (1) Not done ( 0) 70 Infant’s Sponge Bath Checklist Date: __________________________Student's Name:________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Gather the necessary equipment 2. Explain procedure to the mother 3. . Close windows and doors . 2. Keep opposite side rails or crib raised 3. Turn on the warmer lamp and keep it above the infant's body by 0.5 cm 4. Fill the bath basin one-half full of warm water 5. Test temperature of water by your wrist or elbow 6. Place a dry bath blanket or water proof bad on the bed surface of the crib 5. Perform hand hygiene &don gloves 6. . Undress the infant ,and wrap him in bath towel 6. Clean the eye and face with water only 7. Clean the eye and face with water only 8. Cleanse nose with corner of cloth or moist cotton ball ,using a twisted motion 10. . Wash infant’s ears and neck giving particular attention to skin fold of the neck , behind the ears and the external part of the ears .. 11. Using a mild liquid cleansing agent, work from the shoulders to the feet in a symmetric manner to wash one section of the body a time. Pay special attention to the folds of the neck ,thighs &underarms Done completel y. (2) Done In-comp. (1) Not done (0) 71 12.Rinse &t dry area after washing with a towel. Don't rub the skin 13. Clean the umbilical area with cleansing agent and water, leave site open to air; 14. Place the infant on his abdomen .wash, rinse &dry the infant's back .cover hem by a dry towel. 15. Clean the genital area 16. Raise the infant's lower body by the ankles to expose the buttocks, wash ,rinse &dry from front to back 17. Apply protective ointment to the genitalia &buttocks 18. Apply a clean diaper ,if umbilical still in place keep it below the stump 19 .Wrap the infant in a warm blanket &hold the infant in a football hold position ,keep head over the basin &lather the infant 's scalp by baby shampoo to wash hair . 20. . Rinse ,dry the scalp &comb the hair 21. Remove the unclean blanket ,dress the infant ,wrap him in a dry blanket ,cover the head by cap &keep bed side rails up 22.Return ,dispose &disinfect the equipment 23. Remove gloves &perform hand hygiene 24. Document the following (infant's response ,abnormal finding &type of bath Total Marks: /48 Signature of the faculty member Date : 72 Infant’s Tub Bath Checklist Date: __________________________Student's Name:________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Gather the necessary supplies 2. Keep opposite side rails or crib raised 3. Turn on the warmer lamp and keep it above the infant's body by 0.5 cm 4.Fill basin or tub with enough water with temperature 37.0 to 37.5 ◦C that reach the infant's hips when in setting position . 5. Perform hand hygiene &don gloves 1. Undress the infant 2. Gradually slip the infant into the tub while supporting the neck &head 3. Wash the infant with the soapy cloth beginning by shoulders, arms ,to lower extremities with cleansing of the skin folds . 4. Undress the infant 5. Gradually slip the infant into the tub while supporting the neck &head 6. Wash the infant with the soapy cloth beginning by shoulders, arms ,to lower extremities with cleansing of the skin folds . 7. Rinse the infant thoroughly with a clean ,damp washcloth 8. Follow steps 22 to 24 in sponge bath with keeping infant head &neck supported by caregiver hand and be backward. 9. Remove the unclean blanket , dry &dress the infant ,wrap him in a dry blanket ,cover the head by cap &keep bed side rails up &door closed 10. Disinfect &rinse the basin or tub .Return all equipments to their place ,dispose of waste 11.- Remove gloves &perform hand hygiene 12- Document the following (infant's response ,abnormal finding &type of bath ) Total Marks: /24 Signature of the faculty member Date : Done completel y. (2) Done In-comp. (1) Not done (0) 73 Oxygen Therapy and Oxygen Delivery – Checklist Date: _________________________ Student's Name:___________ _______________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Wash hands. Verify the correct child using two identifiers. Assess the child’s developmental level and ability to interact. Assess the child for signs and symptoms of inadequate oxygenation and ventilation. Assess oxygen saturation levels. Assess the child’s and family’s understandings regarding the requirement for supplemental oxygen and the risks and benefits of therapy. Wash hands and wear gloves. Review the order. Select the appropriate oxygen delivery device Adjust the flowmeter to deliver the desired amount of oxygen. Ensure that the liter flow was appropriate for the device. Apply and secure the noninvasive oxygen delivery device, ensuring that it was the correct size. Assess, treat, and reassess pain. Discard supplies, remove PPE, and wash hands Document the procedure in the child’s record. Total Marks: /28 Signature of the faculty member: Date : Done completel y. (2) Done Incomp. (1) Not Done (0) 74 Nebulized Medication Administration Checklist Date: ________________________Student's Name:_________ ______________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Wash hands. Verify the correct child . Assess baseline - Vital signs, lung sounds, respiratory effort, pulse oximetry reading, and, peak flowmeter reading. Determine the appropriate delivery device - a mouthpiece between the lips, - a face mask. Assess the child for specific contraindications to receiving the nebulized medication . Wash Hands and were gloves. Check accuracy and completeness of the MAR with the practitioner’s original order. Ensure the six rights of medication. Use a bar code system or compared the MAR to the child’s armband. Label all medications, medication containers, and other solutions Assemble the nebulizer equipment according to the manufacturer’s recommendations. Assist the child into a comfortable sitting or semi-Fowler position Add the prescribed medication and diluent if needed to the medication chamber of the nebulizer. Checked the required fill volume for the device used. Turn on the small-volume nebulizer via the flowmeter. - If a mouthpiece was used, instruct the child to hold it with the lips, using gentle pressure to form a seal around the tip. - If the infant or child unable to hold the mouthpiece, use a face mask. Make sure the face mask fit tightly and instruct the child to breathe through an open mouth. Instruct the child to take a deep breath slowly and exhale passively. - Monitor the child’s heart rate periodically during treatment. - - Discontinued treatment if his or her heart rate is Done completel y. (2) Done Incomp. (1) Not Done (0) 75 raising 18 Tap the sides of the chamber to drop medication to the bottom of the chamber. When the medication dose has been delivered 19 Turn off the flowmeter and check heart rate, respiratory rate, lung sounds, oxygen saturation values, and, if ordered, peak flow readings. When treatment is completed 20 Disassemble all parts of the nebulizer, - shake the nebulizer cup, - remove all the remaining solution, - rinse each part in sterile or distilled water, - shake off excess water, and - allow to air dry completely. - Store the nebulizer cup and tubing assembly in a clean bag until its next use. 21 Praise the child for positive behavior. 22 Help the child back to a comfortable position. 23 Assess the child for adverse reactions 25 Discard supplies, and remove PPE, and performed hand hygiene. 26 Wash hands 27 Document the procedure in the child’s record. Total Marks: /54 Signature of the faculty member: Date : 76 Nasopharyngeal (NP) suctioning- Checklist Date: ________________Student's Name:___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1 2 3 4 5 6 Wash hands. Verify the correct child using two identifiers. Assess the child’s developmental level and ability to interact. Monitor the child’s vital signs before, during, and after suctioning . Assess the child’s last intake of any food or liquids. Ensure that a handheld, appropriate-size resuscitation bag with mask is available . 7 Wash hands and wear gloves. 8 Assess for the presence of airway secretions. 9 Determine the appropriate-size suction catheter. 10 Place the child in the semi-Fowler position. 11 Turn the suction device on and set the suction regulator pressure. a. b. c. d. Neonate: 60 to 80 mm Hg Infant: 80 to 100 mm Hg Child 1 to 8 years of age: 100 to 120 mm Hg Adult: 100 to 150 mm Hg 12 Determine the appropriate insertion length of catheter by measuring from the tip of the nose to the tragus of the ear. 13 Apply water-soluble lubricant to the suction catheter. 14 Pour a small amount of sterile water or normal saline in a sterile basin. 15 Wash hands wear gloves, mask, and eye protection. 16 Pick up the suction catheter with the dominant hand. 17 Pick up connecting tube with the non-dominant hand and secure it to the suction catheter. 18 Place the non-dominant thumb over the control vent of the suction catheter and suction a small amount of fluid from the sterile solution in the basin. 19 Dip the end of the catheter in the water-soluble lubricant. 20 Instruct the child to cough before the procedure, if developmentally appropriate. Consider administering oxygen before, during, and after the procedure. 21 Insert the catheter into the nose next to the septum without applying suction and advanced it caudally to the predetermined catheter length. Done completely . (2) Done Incomp. (1) Not Done (0) 77 22 Roll the catheter between the fingers to assist with advancing through the turbinates until the child began to cough. 23 Place the non-dominant thumb over the control vent of the suction catheter and apply continuous suction while withdrawing the catheter from the narse. 24 Rotate the catheter between the thumb and forefinger during withdrawal, limiting suctioning to less than 5 seconds. 25 Flush the catheter with sterile solution from the basin and rinse off any secretions on the exterior of the catheter. 26 Assess the child’s response to suctioning. - If coughing or gagging with evidence of pallor was present, ceased the procedure until the coughing or gagging subsided. - Instruct the child to take several deep breaths during this rest period before the next suctioning pass, if developmentally appropriate. 27 Repeat the procedure, alternating nares unless contraindicated, until the airway was clear. 28 Wrap the catheter around the dominant hand and pull the glove off inside out. 29 Flush the connecting tubing with sterile water or normal saline solution. 30 Discard the collection basin contents and clean or replace the sterile saline basin per the organization’s practice. 31 Assess breath sounds for any pertinent changes after suctioning. 32 Monitor the child’s vital signs and assess for changes in oxygenation and ventilation indices. 33 Document the procedure in the child’s record. Total Marks: /66 Signature of the faculty member: Date : 78 Cardiopulmonary Resuscitation Checklist Date: ______________________Student's Name:___________ __________________ ID#:_________________ Group# ___________ Rotation#:_________ Steps of the Procedure 1. Wash hands 2. Prepare equipment needed and check for efficiency. 3. Assess child's ability to respond 4. If the child is unresponsive, start CPR immediately, continue for 2 minutes, and then call for help. 5. If child is in respiratory distress, put child in a position that is of most comfort. 6. For the child that will require chest compressions, place the child in supine position on a firm, flat surface 7. If trauma is suspected, support the head and back when you transport the newborn. 8. Initiate ABC sequence when you resuscitate a newborn baby and CAB sequence for infants and children Managing Circulation Check the pulse for no longer than 10 seconds If the pulse is present and the respirations are absent, give a breath at a rate of approximately 40 to 60 breaths/minute for newborns and at a rate of 12 to 20 breaths/minute for the infant and child (>1 year of age) FOR NEWBORN: Begin chest compressions if the pulse is less than 60b/m or absent. a. Use the two-thumb or two fingers technique with rate of 90 compressions/minute. b. Give 30 breath /minute c. Check the pulse after 90 compressions & 30 breaths(one minute) d. Call for help if your alone FOR INFANT: Perform infant chest compressions as the first step of the CPR sequencing (CAB). a. Compress with two fingers just below the intermammary line(lower half of the sternum) down with about 1.5 inches or 4 cm depth. Done comp. (2) Incomp. (1) Not done (0) 79 b. Deliver 30 compressions c. Open the airway and give 2 rescue breaths (8-10 breaths/minute). d. Do Compression with rate of 100/minute. e. Recheck the pulse. f. Call for help after 2 minutes of CPR. FOR CHILD: Perform child (>1 year old) chest compressions as the first step of the CPR sequencing (CAB) Place the heel of one hand over the lower half of the sternum between the nipples. b. Press straight down to a depth of 2 inches or 5 cm. c. Complete steps 5c through 5:1. Managing the Airway a. a. Perform the head-tilt/chin-lift method to open the airway. Perform the jaw-thrust method on infants and children (>1 year of age) who may have a neck or cervical spine injury. b. Remove a foreign body or vomitus if it is visible. c. Use suction if available. d. Proceed to Procedure: Implementing Rescue Breathing. Implementing Rescue Breathing a. Use a barrier device or bag-mask and oxygen if available, delivering two effective ventilations for a breathless child. b. Adjust the volume of your breath to the size of the child. c. Watch for a normal chest rise with each breath.. Each breath should take about 1 second. d. Do mouth-to-nose breathing in newborns/infants, make a seal by covering both the nose and mouth with your mouth. e. Use mouth-to-mouth breathing in children (>1 year old). f. Use bag-mask ventilation when 2-person CPR is performed Manage Obstructed Airway a. use a combination of five back slaps and five chest thrusts to dislodge the foreign body in newborn babies. b. Ask the conscious child (>1 year old) to cough forcefully. c. Use Heimlich maneuver. d. Continue doing series of five thrusts until a foreign object is expelled For an obstructed airway for an unconscious child (>1 year old) a. Position the child on his or her back on a firm, flat surface. b. Grasp the child's lower jaw and lift away from the back of the 80 throat. Depress the tongue with your thumb. If an object is visible, remove it. Do not do a blind finger sweep. c. Open the airway with a head-tilt/chin-lift and give rescue breaths. d. Kneel down and straddle the child's legs. e. Place one hand directly over the other and place the heel of your hand in the middle of the abdomen a little above the navel. f. Press quickly inward and upward into the abdomen toward the head five times in rapid succession. g. Checks for foreign body before delivering another breath. h. Repeat sequence until object is expelled or rescue breaths are effective. i. Proceed with CPR sequence. j. Place in the recovery position if the child demonstrates adequate breathing and circulation. Stabilization of the Child a. Use length based resuscitation tape and emergency medication and drip calculation sheets. b. Perform frequent assessment and reassessment of cardiac and respiratory function. c. Transfer the child to an area with a staff that is skilled in techniques that are required to continue advanced life support d. Put The child on a cardiac/apnea monitor and an oximeter. e. Continue to maintain normal ventilation. f. Stabilization of the airway may require intubation and mechanical ventilation g. Insert a peripheral IV to Provide circulatory support h. Maintain a neutral thermal state. i. Assess glucose level. j. Perform brief neurologic examination and pupillary response. DOCUMENTATION Documentation should be completed on an arrest record to include: • Time event • Vital signs • Medications administered & Treatments • Responses to all resuscitation measures • Personnel present • Cardiac rhythm strips • Document parental presence during procedure, noting supportive personnel to assist parents and parental response to resuscitation efforts. Wash hands and dispose equipments Total Marks: /66 Signature of the faculty member: 81 82 PEDIATRIC NURSING (NURS 1610- 431) 1st Semester- 4th Year/ 7th Level Academic Year 2015/2016-G (1436/1437-H) Skill Lab and Clinical Simulation Experience Rotation Skills lab rotation will support students’ psychomotor skills in real situation in the hospital clinical settings and increase student's self-confidence. The Simulated Clinical Experience rotation is designed to allow the student to gain practical experience in aspects of assessment & management of pediatric patient. High fidelity simulation is used as a strategy of teaching in this rotation & clinical scenario of child with bronchial asthma is used to teach the students. Learning Objectives: 1- Professionalism: By the end of this rotation, the student will be able to demonstrate the following professional behavior: Show punctuality in attendance and in submission of requirements, e.g. assignment, portfolio, etc. Show interest and initiative to work. prepare for scenario and skill lab before coming to the clinical rotation. Maintain proper grooming and uniform. Follow nursing ethical principles during work. Treat patients, family, staff, instructor and classmates and other personnel with respect. Seek feedback and immediately self-corrects. Demonstrate open and responsive attitude to feedback from instructors, patients, families, and peers. Coordinate a teamwork strategy. Accept responsibility and accountability. 2- safety: By the end of this rotation, the student will be able to demonstrate the following safety behavior: Follow lab conduct behavior and use equipment in the lab as specified Handle Sharps and sharps containers appropriately 83 3- Skill lab: By the end of the skill lab rotation the student will be able to: 1. Feed infant and children by Nasogastric tube and bottle feeding. 2. Administer IM medication. 3. Administer IV medication. 4. Administer Nebulizer medication. 5. Administer oxygen through mask, nasal cannula, and oxygen hood. 6. Perform suction. 7. Perform CPR. 3- Clinical simulation experience: By the end of rotation, the following objectives are emphasized: 1- Critical thinking and interpersonal skills: Promote patient safety and quality health care. Utilize critical thinking in the application of the nursing process. Enhance clinical competence to promote quality patient care. Enhance the student’s self-confidence in skill performance. Utilize of therapeutic communication skills. Communicate verbally and nonverbally in effective way with the health care providers, patient and significant others. Use terms appropriate to child’s level of development & education. Demonstrate effective participation in healthcare team. Enhance peer evaluation skills. 2- Clinical Practice: By the end of Management of Childhood Bronchial Asthma scenario, the student will be able to: Perform focused physical assessment for thorax & lungs Recognize signs and symptoms of bronchial asthma exacerbation. Demonstrate appropriate management of a child with exacerbation of bronchial asthma. Interpret appropriate diagnostic tests associated with asthma management. Discuss the actions and side effects of different medications in the treatment of bronchial asthma (albuterol, atrovent, prednisolone, prednisone, solumedrol). Perform procedures for oxygen administration, measuring oxygen saturation by pulse oximeter, drug calculation, administration of Nebulizer and IV Medication. By the end of Dehydration and Shock scenario, the student will be able to: Differentiate between the mild, moderate and severe dehydration. Recognize the manifestations of dehydration and shock. 84 Describe common etiologies of hypovolemic shock. Discuss important diagnostic tests of hypovolemic shock. Demonstrate appropriate management for pediatric patients with dehydration. Demonstrate appropriate fluid management for pediatric patients with hypovolemic shock. Provide patient teaching plan about Oral Rehydration Solution. Perform the needed procedures in oxygen administration, measuring oxygen saturation by pulse oximeter, drug calculation, and administration of IV medication and IVF boluses. 85 PEDIATRIC NURSING (NURS 1610- 431) 1st Semester- 4th Year/ 7th Level Academic Year 2015/2016-G (1436/1437-H) Simulation and skills lab rotation plan Time Experience o 08001200 Skills lab o o o o o 12000100 01000300 Details Day 1 Nebulizer medication administration. NG and bottled feeding. O2 administration and suction. IM medication administration IV Medication administration. CPR. Location Instructor Pediatric lab/ Newborn Lab Mrs. Ghada AL-Ghamdi Break Simulation Bronchial Asthma and Shock overview /Demonstration Newborn Lab Mrs. Ghada AL-Ghamdi Day 2 08001100 11001200 12000100 01000300 Simulation Simulation Bronchial Asthma Simulation and Debriefing CC1 Shock Simulation Newborn Lab Mrs. Ghada AL-Ghamdi Break Simulation Cont. Shock Simulation and Debriefing Newborn Lab Mrs. Ghada AL-Ghamdi Day 3 08001000 10001200 Skill lab Skill lab evaluation Skill Lab Simulation Evaluation 12000100 01000300 Pediatric Lab/ Newborn Lab Pediatric Lab/ Newborn Lab Mrs. Ghada AL-Ghamdi Mrs. Ghada AL-Ghamdi Break Simulation Simulation Evaluation Pediatric Lab/ Newborn Lab Mrs. Ghada AL-Ghamdi 86 College of Nursing Pediatric Nursing Course (NURS 1610-431) 1st Semester 4th year/7th level Academic year 2015-2016 G(1436 – 1437) Evaluation of simulation and skill lab rotation Date: _____________Student's Name: _________________________________________ ID#:______________________ Group# ______________ Rotation#:_____________ Criteria Part I Responsibility and Professionalism Expected skills Show punctuality in attendance and in submission of requirements, e.g. assignments. Allotted Points 1 Show interest and initiative to work. 1 Prepare for scenario and skill lab before coming to the clinical rotation. 1 Maintain proper grooming and uniform. 1 Follow nursing ethical principles during work. Treat patients, family, staff, instructor and classmates and other personnel with respect. 1 Seek feedback and immediately self-corrects. 1 Demonstrate open and responsive attitude to feedback from instructors, patients, families, and peers. 1 Coordinate a teamwork strategy. 1 Accept responsibility and accountability. 1 Keeps Clinical experiences file (Portfolio). 5 1 15 Total Part II Safety Follow lab conduct behavior and use Equipment in the lab as specified. Handle sharps and sharps containers appropriately 2.5 2.5 5 Total Part III Simulation Part IV Skill Lab Performed according to the attached check list. 60 Performed according to the attached check list. 20 Total Instructor Name: __________________________________ Student's Name: _______________________________ Signature: _______________________________________ Signature: ___________________________________ 100 Actual Points 87 PEDIATRIC NURSING (NURS 1610- 431) 1st Semester- 4th Year/ 7th Level Academic Year 2015/2016-G (1436/1437-H) Evaluation of simulated clinical experience (Bronchial Asthma) Date: __________________________ Student's Name: ___________________________________ ID#:_________________ Group# ___________ Rotation#:_________ Items Expected skills/findings/ interventions Allotte d Points Safety measures Hand Hygiene: Performs hand hygiene as needed Introduces Self: States name and role to patient, family member and/or health care provider. Verifies Patient Identification: using two verification. Hand wash Verifies Allergy: Asks the patient about allergies Communication: Explains to patient/and or family member what they are doing and/or why. Ask about allergies 1 Introduce Self Identify Role 1 1 Verify Patient Full Name 0.5 Verify MR# 0.5 Explain Assessment Explain Interventions 1 1 1 7 Total Assessments and Critical Thinking History taking Vital Signs /O2 Sat/Pain: Assess VS, Identifies pt’s normal and/or abnormal as a scenario evolves. Focus Assessment Assess general appearance and systems appropriately based on patient presentation, signs and symptoms. Ask about triggering factors of asthma. 1 Ask about asthma symptoms. Ask about home medication and compliance. BP (1 mark), HR (0.5 mark), RR (0.5 mark). O2 sat. Pain. Identifies changes Level of consciousness. Use of accessory muscles. Wheeze. Skin color, cyanosis. Breathlessness, PEF. 1 1 2 1 1 1 2 2 2 2 2 18 Total Problem Identification and Critical Thinking Identify Problem/s Identify actual and/or possible medical and/or nursing problems (Can identify while thinking out loud or by actions) Severity of Bronchial Asthma. 2 Medication compliance 1 3 Total Interventions, Evaluation and Critical Thinking Priority Interventions Perform the nursing interventions according to priority. Perform procedures according to the checklist. Calculate medication correctly. Position the patient. Apply O2 as needed Reassure & support Calculate and Administer nebulizer medications (checklist is attached) Calculate and administer other medication. Reassess and re-evaluate. 2 4 2 6 Carry out the rest of orders 1 Discharge home with appropriate health teaching and instructions. 3 5 2 Actual Points 88 25 Total Communication Skills Communication Communicate verbally and nonverbally in effective way with the health care providers, patient and significant others. Use terms appropriate to child’s level of development & education. Demonstrate effective participation in healthcare team. 1 1 1 3 Total Other Critical Thinking and Processing Components Discuss out loud during/after scenario possible problems and Thinking Process Reflection: During Debriefing pathophysiology. Discuss rationale for assessment and interventions. Identify strengths. Identify areas for improvement. 1 1 1 1 4 Total 60 Comments Grading Scale Actual Points (out o50) 45-50 (equivalent to 90-100) SCET* Behavior Rating 5 40-44.5 (equivalent to 80-89) 4 35-39.5 (equivalent to 70-79) 3 30-34.5 (equivalent to 60-69) 1 25-29.5 (equivalent to 50-59) 0 Rating description Outstanding performance: The clinical objectives have been met at a level exceeding expectation. Good performance: The clinical objectives have been met by the student. Minimal performance: Clinical objectives have been minimally met by the student. Unsatisfactory performance:* Inconsistent in meeting clinical objectives. Inconsistent in meeting standards for safe practice. Unsafe performance:* The clinical objective has not been met by the student. Fail in meeting standards for safe practice. * SCET= Simulated Clinical Evaluation Tool. *(If unsatisfactory or unsafe performance rating, the student needs to repeat the scenario) Instructor Name: __________________________________ _______________________________ Student's Name: Signature: _______________________________________ ____________________________________ Signature: 89 PEDIATRIC NURSING (NURS: 1610-431) Academic Year 2014/2015 (1436/1437) 1st Semester – 4th Year / 7th Level Evaluation of simulated clinical experience (Dehydration/ Shock) Date: _________________Student's Name: ___________________ ID#:_________________ Group# ___________ Rotation#:_________ Items Expected skills/findings/ interventions Allotted Points Safety measures Hand Hygiene: Performs hand hygiene as needed Introduces Self: States name and role to patient, family member and/or health care provider. Verifies Patient Identification: using two verifications. Verifies Allergy: Asks the patient about allergies Communication: Explains to patient/and or family member what they are doing and/or why. Hand wash Introduce Self Identify Role Verify Patient Full Name Verify MR# Ask about allergies Explain Assessment Explain Interventions 1 1 1 0.5 0.5 1 1 1 7 Total Assessments and Critical Thinking History taking Vital Signs /O2 Sat/Pain: Assesses VS, Identifies pt’s normal and/or abnormal as a scenario evolves. Focus Assessment Assess general appearance and systems appropriately based on patient presentation, signs and symptoms. Ask about causes for dehydration/ previous signs and symptoms Ask about oral intake. Ask about the significance of the problem BP (1 mark), HR (0.5 mark), RR (0.5 mark). 1 O2 sat. Pain (0-10 scale). Identifies changes Behavior Thirst & sunken eyes or fontanel. Mucous membrane and tears. Skin: Cap refill & turgor. Urine 1 1 1 2 2 2 2 2 18 1 1 2 Total Problem Identification and Critical Thinking Identify Problem/s Identify actual and/or possible medical and/or nursing problems (Can identify while thinking out loud or by actions) Severity of dehydration (mild, moderate or severe dehydration). Other 2 1 3 Total Interventions, Evaluation & Critical Thinking Priority Interventions Start O2 as needed. 3 Perform the nursing interventions according to priority. Perform procedures according to the checklist Start IV line. Calculate and administer medication (checklist is attached). Calculate and administer ORS. Reassure & support 3 6 Reassess and re-evaluate. Carry out the rest of orders. Discharge home with appropriate health teaching and instructions. 2 1 3 5 2 Actual Points 90 25 Total Communication Skills Communication Communicate verbally and nonverbally in effective with the health care providers, patient and significant others. Use terms appropriate to child’s level of development & education. Demonstrate effective participation in healthcare team 1 1 1 3 Total Other Critical Thinking and Processing Components Thinking Process Reflection: During Debriefing Discuss out loud during/after scenario possible problems and pathophysiology. Discuss rationale for assessment and interventions. Identify strengths. Identify areas for improvement. Total Comments: 1 1 1 1 4 60 Grading Scale Actual Points (out o50) 45-50 (equivalent to 90-100) SCET* Behavior Rating 5 40-44.5 (equivalent to 80-89) 4 35-39.5 (equivalent to 70-79) 3 30-34.5 (equivalent to 60-69) 1 25-29.5 (equivalent to 50-59) 0 Rating description Outstanding performance: The clinical objectives have been met at a level exceeding expectation. Good performance: The clinical objectives have been met by the student. Minimal performance: Clinical objectives have been minimally met by the student. Unsatisfactory performance:* Inconsistent in meeting clinical objectives. Inconsistent in meeting standards for safe practice. Unsafe performance:* The clinical objective has not been met by the student. Fail in meeting standards for safe practice. * SCET= Simulated Clinical Evaluation Tool. *(If unsatisfactory or unsafe performance rating, the student needs to repeat the scenario) Instructor Name: ______________________ Signature: ____________________________ Student's Name: ___________________ Signature: ___________________ 91 Dehydration Simulated Clinical Experience (SCE™) Overview Name: Sami Ahmed Age: 3 months Gender: Male Weight: 6.7kg Location Emergency Department and Pediatric In-patient Unit. Scenario The patient is a 3-month-old male infant brought to ED by his parents for fever, diarrhea and vomiting and poor oral intake. The parents state that he has had 24 hours of watery diarrhea and vomiting. This afternoon, he developed a tactile fever and refused oral intake. He is tachycardic, mottled and restless. Past Medical History: Healthy up to 24 hours ago. Immunizations up to date. Allergies: No known drug allergies Medications: None Learning Objectives/Questions Differentiate between the mild, moderate and severe dehydration. Recognize the manifestations of dehydration and shock. Describe common etiologies for hypovolemic shock. Discuss important diagnostic tests for hypovolemic shock. Demonstrate appropriate management for pediatric patients with dehydration. Demonstrate appropriate fluid management for pediatric patients with hypovolemic shock. Provide patient teaching plan about Oral Rehydration Solution. Perform procedures: oxygen administration, measuring oxygen saturation by pulse oximeter, drug calculation, IV medication administration and IVF boluses 1. 2. 3. 4. 5. 6. Questions to Prepare for the Simulated Clinical Experience How to calculate oral rehydration solution? Differentiate between the 3 levels of dehydration and their clinical manifestation. What etiology may cause hypovolemic shock in pediatric patient? What are the clinical manifestations of a child experiencing hypovolemic shock? Explain the 3 stages or phases of shock. Discuss the pathophysiology of shock. 92 93 PEDIATRIC NURSING (NURS 1610- 431) 1st Semester-4th Year/7th Level Academic Year 2015-2016/G (1436-1437-H) Rubric: Evaluation of Child Case Study Student's Name: …………………………… ID#............................. Group # ………………… People soft #:…………. Clinical Rotation: …………………………. Date: ……………… Title: ………………………………………………................... Criteria Exceeds Standard 4 The majority or none of health history is not mentioned. Physical exam is appropriate for the chief complaint but some pertinent systems or special tests are missing. Physical examination is incomplete. The information obtained would not be sufficient to identify child's problems. Most of pertinent information related to physical assessment are missed The majority (80%) of the appropriate tests have been recorded. The main data are analyzed Some (50%) of the appropriate tests are missed. The majority of the appropriate tests are missed. The analysis of some important data are not carried out The majority of data are not analyzed ALL of the pertinent problems for the child are mentioned The main problems for the child are identified but one or more problems are missed. Some of the child’s main problems are missed. The majority of the main problems and chief complaint are missed. There is a complete discussion of the actual and potential problems with appropriate There is a discussion of the actual and potential problems with appropriate intervention There is incomplete discussion of the actual and potential problems with appropriate intervention The most of actual and potential problems with appropriate intervention Physical examination has been completed as instructed, is age/gender appropriate, relates to the chief complaint, and pertinent findings. tests are recorded. Nursing Management Below Standard 1 History is scant. Some of vital information is missing. c. Labs & All appropriate diagnostic test labs and diagnostic d. Analysis of the data (in relation clinical textbook) e. Identification of problems Approaching Standard 2 History is age/gender appropriate and contains pertinent information. However, it is missing some points. 1. Child health History is complete and Assessment: age/gender a. Past history appropriate. It is written in logical manner b. Physical assessment At the standard 3 All pertinent data are critically analyzed in the light of scientific references. Points 94 Organization of the written paper intervention including rationale for each aspect of care with respect of priorities of nursing actions. The paper is wellwritten in a logical, organized manner. including rationale for each aspect of care without consideration of priorities of nursing actions. The paper relays information but is slightly disorganized. including rationale for each aspect of care. are not discussed. The paper does not relay adequate information on the subject, is disorganized and difficult to follow. The paper is containing irrelevant information to the selected case. Total Marks = 28 Grade out of: ( 5) Evaluated By: ----------Updated & Modified by: Dr. Laila Younis Abu-Salem Student's Signature: ----------------- 95 PEDIATRIC NURSING (NURS 1610- 431) 1st Semester-4th Year/7th Level Academic Year 2015-2016/G (1436-1437-H) Rubric: Evaluation of Child Study Student's Name: …………………………… ID#............................. Group # ………………… People soft #:…………. Clinical Rotation: …………………………. Date: ……………… Title: … Criteria Exceeds At the Approaching Below Standard standard Standard Standard 4 3 2 1 1. Description of The nursery school function nursery school and its daily program are fully described. 2. Child Assessment: f. Temperament, behaviors, attitudes. g. Reaction or response to daily program. h. Relationships with other children – individually and groups. i. Relationships with adult, teachers, parents. j. Play interests and activities. k. Skills and coordination development 3. Comparison of the level of growth and development (G&D) of the child to the normally expected level in relation to: a. Physical growth & general health b. Motor development. c. Emotional All points are fully described and supported with related examples. All aspect of growth and development are fully described and compared with the normally expected. Poi nts The nursery school function and its daily program are reasonably described. Some basic nursery school functions are omitted and daily program is missed some basic items The nursery school function and daily program are not mentioned Description of the points with giving examples but one or two points are missed/ or all points are described without related examples. Three or four points are not illustrated More than four points are missed. X 3= The aspect of growth and development are described and compared with the normally expected, but one or two points are missed. Three are four aspects of G&D neither described nor compared. More than four aspects of G&D are missed. X 3= 96 development. d. Cognitive development e. Psychosocial development. f. Language development. 4. Identification of child's needs All child needs are identified. The majority (80%) of the child's needs are identified. Some (up to 50%) of the child's needs are missed. The majority of the child's needs are missed. 5. Organization of the written paper The paper is wellwritten in a logical, organized manner. The paper relays information but is slightly disorganized. The paper does not relay adequate information on the subject, is disorganized and difficult to follow. 6. References Used variety of related scientific references (5 or more) Used scientific references (4-3) Used only scientific references The paper is containing irrelevant information to the selected child. Used one scientific reference. two Total Marks = 40 Grade out of: ( 5) The score of item 2&3 will be multiplied by 3 for the sake of balance Evaluated By: ------------- Student's Signature: ---------------------------- Developed by: Dr. Laila Younis Abu-Salem 97 PEDIATRIC NURSING (NURS 1610- 431) 1st Semester-4th Year/7th Level Academic Year 2015-2016/G (1436-1437-H) Rubric for Pediatric Nursing Clinical Assessment Date: _____________Student's Name: ______________ ID#:_________ Group# ___________ Rotation#:_________ Criteria Part I. Communication Skills Expected skills Communicates effectively with the teacher, colleagues and health care providers. Communicates effectively with child (with respect to the developmental level) and family members. Obtain accurate and complete data about the 5 Marks Comm ents Points /20 child through history taking and reading records and lab reports. Communicate orally and writes documentation clearly, concisely & accurately Part II. Identify the signs & symptoms of the disease Knowledge and its complication that apparent on the child. Identify child’s and family needs /10 (developmental, physical, psychological & social) Part III Cognitive Interprets collected data that obtained from (Critical thinking) Formulate nursing care plan with respect to history, physical assessment and lab results. priorities of action Provides specific rational for interventions /25 Create teaching plan based on child’s needs and problems Evaluates interventions and outcomes. Part IV Perform developmentally appropriate physical Psychomotor examination (head to toes skills Perform growth measurements accurately /35 98 Provide a developmentally safe and sensitive care environment Prepare child and family for procedure Perform nursing procedures safely and competently Follow infection control precautions Conduct health education session for child and/or family (injury prevention, safety, normal growth and development, behavioral expectations, disease processes and outcomes of procedures, health screening and immunization schedule). Part V Exhibits interest and initiative to work. Responsibility Maintains punctuality in attendance and and submission of activities Professionalism Follow nursing ethical principles during work. Maintains proper grooming and uniform. /30 Follows nursing ethical principles while provide care for child and family. Completes her portfolio neatly, orderly and on time. /120 Total 5 Points=All aspects of the expected skill was met with no prompting or input from the faculty 4 Points= The majority (75% or greater) of the expected skill was met with no prompting or input from the faculty. 3 Points=Over 50% of the expected skill was met with no prompting or the skill was met with minimal (1 or less) prompting from the faculty. 2 Points=Less than 50% of the expected skill was met with no prompting or the skill was met with multiple (2-3) prompts from the faculty. 1 Point=The expected skill was only met with multiple (2 or more) prompts from the faculty 0 Point=The expected skill was not met with multiple (2 or more) prompts from the faculty Instructor Name: ________ Student's Name: ___________ Signature: _________________ Signature: ______________ Updated & Modified by: Dr. Laila Abu-Salem & Mrs. Ghada Al-Ghamdi 2015- 99 Pediatric Nursing Course (NURS: 1610- 431) First Semester Academic year 2015-2016G 1436/1437H Evaluation Sheet of Nursery School experience Student's name: ……………………………. ID……………… Rotation: ……………… Date……… Group ……… Items Marks I. Assessment: 20 Marks -Observation of child’s behavior. 10 -Interpretation of behavior. 10 II. Practicing skills in managing the child: 40 Marks - Engagement the student in the child's activities. 10 -Encouragement the child to follow the healthy habits & 10 independency -Applying play materials that are suitable to the child age. 10 - Providing health education according to the child age. 10 III. Knowledge. IV. Documentation of findings. V. Professional behavior: 10 Marks 5 15 Marks -Maintain proper grooming. 2 - Show punctuality in attendance. 4 - Communicates effectively with others. 2 - Respects roles, regulations, and constructive criticism. 2 - Student’s portfolio. 5 Total 90 The total out of one hundred 100 Instructor ‘Signature: Student’s Signature: Student's mark 100 PEDIATRIC NURSING (NURS 1610- 431) 1st Semester-4th Year/7th Level Academic Year 2015-2016/G (1436-1437-H) Rubric: Evaluation for Topic Presentation Student's Name: …………………… ID#................... Group # …………People soft #:…………. Clinical Rotation: …………………………. Date: ……………… Title: …………. Character 1. 1. Information Quality & Organization 2. 2. Understandi ng of the topic 3. 3. Presentation Skills 5 – Excellent 4 – Very Good 3– Adequate 2– Inadequate 1 – Poor Main points of the topic are fully explained. Presented information is relevant to the topic. Information is clear & organized Used variety of related scientific references (5 or more) Main points of the topic are explained. Information is linked to presentatio n topic. Well organized. Used scientific references ( 4-3) Main points are not fully included Most information is linked to the topic. Information is somewhat organized. Used only two scientific references Main points are not clear and lack significant detail. Some information is linked to the presentation topic. Information is less organized. Used one scientific reference. Presentation lacks main points and related details. Information is not relevant to the topic. Information is not organized. References that used are not scientific Shows excellent understanding of the topic. Information was expressed sufficiently in scientific & easy way. Reflects good understandi ng of the topic. Information was expressed in scientific way. Mostly maintains good eye contact. Explain with confidence & clear voice., Mostly initiate discussion. Reflects fair understandi ng of the topic. Information was fairly explained. Some understanding of topic with some errors. Information is explained with minimum details No understandin g of the topic. Information is presented with no details. Sometimes faces the students. Explain with confidence & clear voice. Sometimes initiate discussion. Keep little eye contact. Voice is frequently weak or too strong. Rarely initiate discussion. No eye contact. Voice is consistently too weak or too strong. Didn’t initiate discussion. Always maintains good eye contact. Explain with confidant with steady & clear voice. Consistently initiate discussion. Mark 101 4. 4. Audio- Visual aids 5. 5. Summary & Conclusion Visual aids are very creative, clear, and easy to read. Visual aids are usually creative, clear, and easy to read Visual aids are reasonably creative, clear, and easy to read Visual aids have limited creativity or clarity or are sometimes difficult to read. Visual aids demonstrate no creativity or clarity and are often difficult to read. The summary & conclusion were clear and effective, with key points emphasized. Reasonable summary &conclusio n is given The presentatio n was inadequatel y summed up. An attempt was made to conclude the presentation. Weak or no conclusion provided Total Evaluated By: -------------------------Grade Out of 5: Updated & Modified by: Dr. Laila Abu-Salem /25 Student's Signature: --------------------- 102 103 Inventory – May, 2015 Equipment Quantity Remarks Cabinet 1 LINENS 1. Bath Towel – Cream 15 2. Bath Towel - White 2 3. Face Towels (Small) 12 4. Bed Sheet- White 8 5. White Baby Blanket 5 2 sent to male college 6. Bed Sheet- Blue 4 1- In bed 7. Bed Sheet with Design 2 8. Laerdal Blanket 2 9. Pillow Case – White 2 10. Pillow Case – Blue 16 11. Blanket – Blue 4 12. Blanket - White 4 13. Draw sheet 2 14. White sheet for caring 8 15. Hamper bag 1 16. Small towel (green) 3 17. Patient gowns (pink) 6 18. Patient gowns (blue) 5 19. Patient gowns with design 5 20. Eye sheet 1 21. Patient clothes (3pcs) 1 Cabinet 2 1. 2. 3. 4. 5. 6. 7. 8. 9. Percussion Hammer Penlight Tourniquet Tuning Fork Cloth Bag Pocket Mask Vital Signs Monitor Cuff Laerdal Silicone Resuscitator Otoscope 2 2 2 2 2 2 4 1 2 1 pink – 11 white 1-Adult; 2- Pedia; 1- Infant 104 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. Cabinet 3 1. Cabinet 4 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Cabinet 5 1. 2. 3. Others 1. 2. 3. 4. 5. 6. 7. 8. Plastic Tape Measure Simulaids Lung Sound Trainer Miniature Sphygmomanometer Stethoscope-Specturm-Adam Rouilly Stethoscope-Littmann Laryngoscope with 3 Curved Blades Phillips Respironics-Aerofamily Infant Virtual IV Pediatric Skill Lab Manual Sim Baby Accessories Infusion Pump Syringe Pump-Med Fusion Model 2HCO7 OR 2HC11 Suction Machine (Zeiner Rescue) 6 3 4 1 3 1 1 1 1 Little Junior/CPR Sim 8 Mike Michelle/1 year old/HSL Infant Model for Nursing Practice ECG Manikin Mike/Michelle 5 year old/CPR Mike/Michelle 1 year old/ CPR Mike/Michelle Injection Arm Mike/Michelle Infusion Arm Baby Weighing Scale Oxygen hood Nasco IV arm 1 1 1 1 1 1 1 2 2 1 Mike/Michelle 3 year old Resusci Junior Little Junior/CPR Sim 1 2 4 Laerdal Baby Sim Helping Lives Manikin Electronic Bed Child Bed Examiner Bed Stretcher Pillow Link Box 1 1 1 1 1 1 2 1 2new (2015) 1Nebulizer January 2012 2 1-Alaris; 1-Terumo 1 2010-P/N 0-612011-C-O 1 January,2012 Old (2004) Old (2004) Discarded Discarded 2015 On bed On bed Transferred out to MSL Transferred out to NBL Came from MSL Came from OB/Gyne 105 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 22. 23. 24. Furniture 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Dell Laptop –for Simulator Dell CPU Optiplex- for Simulator Dell Monitor – for Simulator Dell Keyboard - for Simulator Dell Mouse - for Simulator Data Show Remote Control for Data Show Speaker Vital Signs Monitor (Mindary) IV Stand Dell CPU Optiplex- for Instructor Dell Monitor – for Instructor Dell Keyboard – for Instructor Dell Mouse for Instructor Trolley - Silver Crash Cart Laundary Cart Medicine Cart Adult Digital Weighing Scale` Sony TV with remote control Laerdal Suction Machine Computer Table Laboratory Table Swivel Chairs Steel Cabinet with Glass Door Colored Cupboard Bedside Table Patient’s Screen – White Piped-in Oxygen & Suction Automatic Voltage Regulator Bulletin Board - White Inventory done by Lab Managers: Mrs. Sarah Al-Abdali Pediatric Nursing Lab Coordinator: Dr. Ahlam Hussein Skill and Simulation lab coordinator: Dr. Radwa Baker 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 2 4 20 5 1 1 1 1 2 1 759-GBIW, 7BE-ODJM ODJ301, G1401JLO Not working 3-Silver; 2- Cream