Download Critical Care Nursing 4333.D10

Course Title: Critical Care Nursing
Course Number: NUR 4333
Prerequisite:
 Generic BSN students: Nursing 3320 Adult Health Nursing I Practicum
 Post-Licensure students: none
Faculty: Melissa R. McDowell, MSN, RN, CCRN (Virtual Office Hours Thursdays 0800-1000 and
2000- 2200. Available on Campus by Appointment)
Vincent Nursing-Physical Science Building, Room 134
E-mail: [email protected]
Phone: (325) 212-6694
Course Description: Explores the interrelationship of human bio psychosocial dimensions of
critical care nursing and examines the theoretical basis and nursing process for alterations in
human functioning as consequences of critical illness and care. Grading will be pass or fail.
Course Objectives/Student Learning Outcomes Linked to Program Objectives: By the end of
the course, students will be able to:
1.
2.
3.
4.
5.
Course Objective/Student Learning Outcome
Prioritize, plan, and evaluate outcomes of care for the critically ill patient
with multiple complex, and/or life threatening stressors using health
data, evidence, clinical judgment, and patient preferences.
Integrate principles of safety and quality into research-based
interventions for adult patients and families with complex health needs
and unpredictable outcomes.
Deliver and coordinate compassionate, culturally, ethnically and patientcentered care based on evidence, guidelines, standards, and legal
statutes/regulations.
Analyze acute and critical illness or injury for the interrelationship of the
following factors: epidemiology, demographics, pathophysiology,
physical assessment, diagnostic tests, pharmacological interventions, EKG
interpretation, basic hemodynamic monitoring, nutritional measures,
and genomic competencies for clinical decision making.
Formulate patient and family centered goals that assist toward health
promotion, maintenance, and/or restoration.
BSN Outcomes
1,2,3,4,6,9
1,2,3,4,6,9
1,2,3,4,6,7,8,9
1,2,3,4,6,7,9
1,2,3,4,6,7,9
6. Demonstrate collaboration and communication skills in advocacy actions
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including improvements in quality, safety and error prevention.
7. Interact with peers, colleagues and interdisciplinary health team
members to facilitate positive patient outcomes and a professional
clinical environment.
8. Demonstrate standards of moral, ethical, professional and legal conduct
in the critical care setting.
1,2,3,4,6,8
1,2,3,4,6,7,8,9
1,6,8
Clinical Requirements:
1. Maintain student liability insurance and current American Heart Association Health Care
Professional CPR certification.
2. Provide safe nursing care to adult clients within level of knowledge and nursing
skills.
3. Refer to the Angelo State University Undergraduate Nursing Handbook for the following:
 Clinical Attire - regulations; general appearance
 Behavior in Clinical Agency
 Professional Conduct
 Standards of Nursing Practice
 Patient Client Confidentiality
 Student absences
o In the event of extenuating circumstances preventing a student from attending a
clinical experience, the student will:
 Notify the agency before scheduled time to report on duty
 Notify the clinical instructor a minimum of one hour before scheduled
time to report on duty
 Failure to call in will result in an unsatisfactory for that clinical day
o Students will be prepared for all clinical activities. The faculty has an obligation
to remove a student from the clinical setting if the student is not prepared.
Repeated behavior reflects failure to meet clinical objectives
o Students missing more than one day of clinical will result in reevaluation of a
student’s ability to meet course objectives and may result in an unsatisfactory
clinical grade.
 Dosage Calculation Testing Policy
 Policy on Exam Make-Up
 Policy on Universal Precautions
 Guidelines for Written Work
 BON Declaratory Statement
 All Guidelines for Referencing Materials
Policies Related To This Course: All students are required to follow the policies and procedures
presented in the Angelo State University Undergraduate Nursing Handbook.
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Required Textbooks/Materials:
 Text - Urden, L. D., Stacy, K. M., & Lough, M. E. (2013). Thelan’s critical care nursing:
Diagnosis and management (7th ed.). St. Louis: Mosby ISBN-10: 0323057489 | ISBN- 13:
978-0323057486
 Materials – Name tag, bandage scissors, watch, stethoscope, penlight, ASU uniform,
appropriate reference books, and appropriate clinical forms.
 We recommend the use of a PDA.
 Download and installation of Second Life Viewer software
Optional Textbooks/Materials:
 Text- White, K. (2013) Fast facts for critical care. Kathy White Learning Systems ISBN978-0-9835750-5-4
Teaching Strategies:
 Web-based and asynchronous didactic modules
 Case studies/clinical reasoning activities
 Clinical practicum
 Second Life interactive exercises/gaming
 Written assignments
 Web sites/references
Method of Assessing Learning Outcomes:
Assessment Activity
Case Study Assignment
Clinical Competency Performance
Clinical Assessment Tool
American Heart Association NIH Stroke Scale Test
Interdependent QSEN Competency Assignment
Discussion Board
Quizzes
Course Objective
1,2,3,4,5,6
1,2,3,4,5,6,7,8
1,2,6,7,8
1,2,4,5,7
2,3,6,7,8
1,2,3,4,5,6,7,8
1,2,4,5
The grading system used in this course, NUR 4333 is:
A, B, C, D, F, NC (No Credit)*, W (Withdrawn)*
Grading System:
90 – 100 = A
80 – 89 = B
70 – 79 = C
60 – 69 = D
59 or below = F
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Case Study Assignment
15%
Clinical Competency Performance/Clinical Assessment Tool
15%
American Heart Association NIH Stroke Scale Test
20%
Interdependent QSEN Competency Assignment
20%
Discussion Board
20%
Quizzes
10%
Practicum Hours: Students will spend 20 hours in clinical settings.
Attendance: In the event of extenuating circumstances preventing a student from attending a
clinical experience, the student will:
 Notify the agency before scheduled time to report on duty.
 Notify the clinical instructor a minimum of one hour before scheduled time to report on
duty.
Failure to call in will result in an UNSATISFACTORY for that clinical day.
Students missing one day of clinical will result in reevaluation of a student’s ability to meet
course objectives and may result in an unsatisfactory clinical grade. The instructor may assign
the student work to supplement the experience.
UNSATISFACTORY Clinical Performance: A student will be considered "Unsatisfactory" if
clinical experiences reflect negative performances, lack of preparation or absence.
Unsatisfactory incidents indicate that students may not be able to meet course requirements.
A student whose clinical practice is UNSATISFACTORY will be given (a) counseling, opportunities
for improvement, and/or remediation, and (b) a verbal and written warning. Faculty may
remove a student from the clinical setting for lack of preparation or other unsatisfactory
performance.
A pattern of three (3) clinical "unsatisfactories" may result in the student failing the clinical
portion of the course, and as a result, receive a failing grade for the course.
UNSAFE clinical performance: When direct patient care is part of the learning experience, patient
safety and well-being is of paramount concern. If a faculty member evaluates that a student is
unable to provide safe nursing care in accordance with Standards of Professional Nursing Practice
(BON, Nursing Practice Act, 2001), and if this deficit is such that it cannot be remedied, the
student will be removed from the clinical setting and will receive a grade of “F” in the course.
Policy on Late Work, Revisions, or Missed Assignments: Due dates and times for assignments are
posted. Failure to submit an assignment by the deadline will result in a fifteen point deduction per
day past the posted deadline. Assignments submitted more than one week past the deadline will
result in a documented counseling, unsatisfactory, and a revised deadline. If revisions to the late
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assignment are deemed necessary, a new submission deadline will be assigned and an automatic
15 point deduction will be taken (i.e. all revised assignments will start at an 85% as the maximum
grade). Failure to submit the revised assignment by the deadline will result in another
documented counseling and unsatisfactory. Further revisions are at the discretion of the
instructor.
Student Conferences with Instructors are Required:
1. At mid-term and during the week before final exams for performance evaluation.
2. Excessive absences.
3. Repeated UNSATISFACTORY PERFORMANCE in clinical setting.
4. Any situation that is considered UNSAFE, which can result in immediate dismissal
from the nursing program.
Academic Honesty: Students must maintain complete honesty and integrity in classroom,
online and clinical learning experiences. Any student found guilty of any form of dishonesty in
academic work is subject to disciplinary action. See the following site on the ASU web page for
the ASU Academic Honor Code: http://www.angelo.edu/forms/pdf/honorcode5.pdf
Disability Statement: Students with disabilities must contact the Student Life and Student
Services Office to request any necessary academic accommodations. This student request
should be made early in the semester to allow time for appropriate arrangements.
Syllabus Changes: The instructor reserves the option to make changes as necessary to this
syllabus. If changes become necessary during this course, the instructor will notify students of
such changes, by email communication, class announcement, and/or via a course
announcement on Blackboard.
Student Evaluation of Course: Students are provided the opportunity, and are strongly
encouraged to participate in a course evaluation at the end of the semester.
Clinical Skills:
1. Endotracheal Tube Care
2. Tracheostomy Care
3. Ventilator Care
4. Nutritional Measures
5. Basic Hemodynamic Monitoring
6. SVO2 Monitoring
7. ECG Monitoring/12 Lead ECG Interpretation
8. Care of Patient with Intra-Aortic Pump
9. Care of Patient with Temporary Pacemaker
10. Care of Central Lines
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CLINICAL EXPERIENCES OBJECTIVES
A.
GOAL: To provide opportunities for the student to gain knowledge and participate in
patient care.
B.
DEFINITION: The Nurse must possess good assessment skills and sound clinical knowledge
and be able to apply this knowledge.
C.
OBJECTIVES: The student will:
1.
2.
3.
4.
5.
6.
7.
D.
Become aware of the various aspects of nursing care as an interdisciplinary
component of patient care.
Identify the operation of the department, i.e.
a. Duties and functions of the various personnel
b. Equipment
c. Role-play with the interdisciplinary team using SBAR Communication
d. Use information and patient care technology to communicate effectively with
members of the healthcare team
Observe and/or assist with the use of treatments and therapeutic measures related
to the department.
a. Administer and document administration of medications in the critical
care environment
b. For assigned patients, compare observed practices with published
standards
Identify the needs for skills in assessment based on all body systems.
a. Perform patient assessment and evaluation of patient’s response to
pharmacological agents
Identify the skills needed in patient and family teaching.
a. Conduct basic genetic health screening
b. Address end-of-life decision making
Provide emotional support for the client, family members as needed.
a. Provide evidence-based, patient-centered end-of-life care to a dying
patient and their significant others.
Infection control
a. Reporting communicable diseases required
b. Universal Precautions
EVALUATION:
1.
2.
3.
Onsite or Virtual Clinical Competency Evaluation/Clinical Assessment Tool
Case Study Assignment
Interdependent QSEN Competency Assignment
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ROLE OF RN DURING CARDIAC EMERGENCIES &
CARDIAC OR RESPIRATORY ARREST
SUBJECT:
Nursing Resuscitation and Cardiac Arrest Management
PURPOSE:
To provide the student with theoretical knowledge in performance of the
nursing interventions essential during a cardiac arrest in the practice of
professional nursing.
SUGGESTED
READING:
LEARNING
ACTIVITIES:
Skills Manual
Skills Performance
CPR for Health Care Professionals
VIEW:
Videos: Cardiac Emergencies and Cardiac Arrest
OBJECTIVES:
The student will be able to demonstrate basic understanding related to
the following assessment and psychomotor skills.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Assessment of need for and initiation of cardiopulmonary
resuscitation.
Utilization of the institutions mechanism of reporting a cardiac
arrest that summons appropriate help.
Know the location of and routine checking of “Crash Cart” with
emergency equipment and medications on your unit.
Recognize the role of the arrest team and leader and helping
facilitate the life sustaining interventions.
Identify the progression of resuscitative interventions until client is
stabilized and/or heroic measures are terminated.
Provide psychosocial comfort and understanding emotional support
to family members of arrest victim.
Identify the elements of Cardiac output.
Describe assessment of client with complaints of chest pain.
Recognize the role of the nurse in assessing the client with chest
pains.
Analyze signs and symptoms of myocardial infarction.
EVALUATION: Required current American Heart Association “Health Care Professional.”
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Clinical Assessment Tool
Patient
Patient name outside of room
Wrist band: Name verified with patient and DOB
Correct names/dates on whiteboard inside patient room
Tubes and Lines – follow each line from patient to device, look at connections,
amount of room to move, secured in place, and labels
Oxygen
Nares – any skin breakdown
Source – flow rate
, ordered flow rate
Feeding tubes (DH)
Nares – any skin breakdown
Source– label on bag
, dated
Irrigation set-up – clean/dated
Abdominal tubes
Type: G-tube (input) Biliary tube (output)
Site – described in pathway
, labeled
, bag attached
Chest tube
Site – described in pathway
, dressing intact
Tubing – no kinks
, tight connections_
Pleurovac – check fluid levels and movement of fluid in
Suction chamber
H2O chamber
Drainage chamber
Drainage
Amount noted on chamber
Tracheostomy
Description of trach and size written on pathway
Suction catheters available in room
Extra trach tube available in room
Obturator in sight
Sterile water at bedside for trach care? Dated if opened
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Foley
Date of original insertion noted on pathway
Tubing – dependent and without loops
Drainage bag – below level of bladder
IV’s
Site – inspect for redness, swelling, warmth, tenderness, drainage
Follow tubing to solution – check connections
, label
Solution – Correct drug
, time
, dose
, route
Compare all of above to MAR/admin RX
Pump: Green light
Plugged in to wall socket
Environment
Side rails – necessary?
Bed in low position
Call light working and within reach
No obstacles/clutter at bedside or in route to bathroom
No obstacles in route to sink
No obstacles at bedside
Patient assistive devices within reach – i.e. glasses, hearing aids
Correct date/nurse name on white board in patient room
Water pitcher or glass available and clean
Urinal at bedside
Bathroom or Bedside commode emptied
Trash receptacle available and within easy reach
Questions for patient and/or significant other (5 minute sit-down)
What would you like to see happen today?
How would you describe your hospitalization – Is there anything that could be done to make it
better?
What should nursing students know about what it’s like being a patient in the intensive care unit?
Assessment Tool completed by
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Student Comments
Student
Score:
Date of Evaluation
NUR 4333 Clinical Competency Evaluation
Preceptor
Score:
Preceptor/ Faculty Comments
Chest Tubes
Name three reasons for chest tube insertion.
Monitor the security of the connection between chest tube and drainage system.
Apply appropriate suction and monitor for kinking and large loops of tubing which impede drainage and air evacuation.
Identify appropriate type of dressing.
Recognize the significance of subcutaneous emphysema noted after chest tube insertion.
Recognize the significance of no fluctuations in the water-seal chamber immediately after insertion.
Identify common signs of tension pneumothorax.
Correctly state when it would be appropriate to clamp a chest tube.
Cite three possible reasons for noting absent drainage and fluctuation and/or continuous bubbling in the water-seal
chamber with continued respiratory distress.
Correctly state when the physician should be notified for excessive bloody drainage.
Ventilator Management
Ensure that the ventilator alarms are on.
Instruct patient and family about rationale and expected sensations associated with use of mechanical ventilators.
Routinely monitor ventilator settings, including temperature and humidification of inspired air.
Check all ventilator connections regularly.
Monitor for decrease in exhaled volume and increase in inspiratory pressure.
Monitor for effectiveness of mechanical ventilation on patient’s physiologic and psychological status.
Monitor for symptoms that indicate increased work of breathing (increased heart or respiratory rate, increased blood
pressure, diaphoresis, changes in mental status).
Provide care to alleviate patient distress (positioning, tracheobronchial toileting, bronchodilator therapy, sedation
and/or analgesia, frequent equipment checks).
Use aseptic technique in all suctioning procedures and as appropriate.
Identify key assessment factors that indicate the need for suctioning.
Demonstrate proper method for suctioning and cite two undesired outcomes of suctioning.
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Monitor pulmonary secretions for amount, color, and consistency and regularly document findings.
Monitor ventilator pressure readings, patient-ventilator synchronicity and patient breath sounds.
Analyze ABGs and assess need for repeated ABGs.
Monitor patient’s progress on current ventilator settings and make appropriate recommendations.
Monitor for adverse effects of mechanical ventilation.
Use commercial tube holders, rather than tape or strings, to fix artificial airways to prevent unplanned extubations.
Monitor cuff pressure and evaluate ETT positioning via CXR.
Provide routine oral care per facility policy and evidence-based data.
Promote adequate fluid and nutritional intake.
Promote routine assessments for weaning criteria.
Monitor effects of ventilation changes on on oxygenation: ABG, SaO2, SvO2, end-tidal CO2, A-aDO2, patient’s
subjective response.
Document all changes to ventilator settings with rationale for changes.
Document all patient responses to ventilator and ventilator changes.
Monitor for postextubation complications.
Ensure emergency equipment at bedside at all times (manual resuscitation bag, masks, suction equipment, and
preparation for power failures).
Basic and 12 Lead EKG Interpretation
Arrhythmia
Recognition
Ventricular Fibrillation
Ventricular Tachycardia
Asystole
Junctional.
nd
2 degree AV block: Type I
nd
2 degree AV block: Type ii
rd
3 degree AV block
Supraventricular Tachycardia
Atrial Fibrillation
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Atrial Flutter
Identify reasons for dysrhythmia re: hypoxia, K, Mg, and ischemia
Intervals/Durations
PR Interval
QRS Duration
QT Interval
12 Lead
Correct identification of abnormalities in the cardiac cycle that may signify cardiac disease.
Correct identification of leads that reflect infarct location.
Correct identification of the coronary artery responsible for both inferior and anterior MI’s.
Correlation of infarct location with possible conduction defects.
Distinguish between right and left bundle branch block.
Correct identification of inferior wall MI.
Correct identification of anterior MI.
Management of Temporary Pacemaker
Identify clinical indications for temporary cardiac pacemaker support.
Define the following: asynchronous pacing, demand pacing, sensitivity, MA, and capture.
Identify the routes used for insertion of temporary internal pacemakers.
Differentiate between atrial and ventricular wires.
Identify the positive pole (ground) and negative pole (heart).
st
nd
Utilize codes for identification of pacer function re: 1 letter stands for chamber paced; 2 letter stands for the
rd
chamber sensed; and 3 letter stands for the mode of response to the sensed event.
Comply with electrical safety precautions re: wear rubber gloves when handling the electrodes and identify patient as
electrically sensitive per facility policy.
Monitor dressing changes per facility policy with tips of leads covered and secured when not connected to pulse
generator. Assess for signs of infection. Date of dressing change and an A on the atrial wires dressing and V on the
ventricular wires dressing.
Documentation of pacing mode, MA, sensitivity, intervals, rate, the patients underlying rhythm, appearance of the
insertion site, and EKG strip.
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Hemodynamic Monitoring
Demonstration of correct method for establishing zero-reference line.
State correct frequency of rezeroing.
State correct frequency for changing fluid and lines.
Identification of waveform pattern.
Identify normal ranges for: CVP, PAS, PAD, PAM, PAOP, CO, CI, and SVR. and PVR uses pocket reference.
Identify pertinent data to document in the EMR.
Demonstrate correct method for obtaining blood from A-line: Vamp system.
Correctly state how much air is injected in balloon to accomplish wedge position.
Cognizant of significance of sensation of meeting no resistance when inflating balloon, or blood backing up.
Read the PA pressures at correct phase of respiratory cycle.
State correct definition of PAOP.
Identify indications for using PAD instead of PAOP.
Cite three clinical indicators for PA line insertion.
Identify actions necessary when PA catheter becomes wedged.
Identify four complications of PA catheters.
Correlate hemodynamic pressures to potential clinical situations re: Hypovolemia, LV failure, RV failure, Pulmonary
emboli, and Cardiac tamponade using pocket reference.
Identify correct procedure for PA catheter removal.
Management of IABP
Identify three reasons for IABP insertion.
Name two major contraindications to balloon pump therapy.
Cite two major goals of IABP therapy.
Identify catheter insertion site and where it should be located in the aorta.
Correctly identify triggering mechanisms.
Correlates inflation and deflation with the cardiac cycle.
Describe the effect of balloon inflation on the diastolic pressure.
Describe the effect of early inflation on the waveform and afterload.
Describe the effect of late inflation on augmentation.
Correctly identify the arterial pressure wave landmark that is used to time inflation.
Knowledgeable of the significance of the dicrotic notch.
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Correctly state the expected mmHg drop when the timing of deflation is optimal.
Correctly state the frequency of testing the safety chamber.
Correctly identify the longest length of time that the balloon should be allowed to remain inactive.
State the correct interventions to minimize the incidence of thrombus formation.
Knowledgeable of the procedure for defibrillation during pumping.
Names 3 side effects and complications of IABP therapy.
State correct actions to be taken if blood is noted in the balloon catheter.
NIH Stroke Scale
Practicum
Identify and assess neurological deficits in stroke patients.
Understand the measurement scale for quantifying neurological deficits in stroke patients.
Consistently apply appropriate scores for neurological deficits in stroke patients
Use the scale to assess changes in neurological deficits in stroke patients over time.
Certification
Demonstrate NIH SS competency through NIH SS Certification (Voucher for course issued).
Nursing Considerations of ICP Monitoring
Able to identify three clinical conditions that may require ICP monitoring.
Identify normal ICP.
Correctly define CPP and Normal CPP.
State formula for CPP calculation.
Correctly identify two methods for decreasing ICP.
Define Cushing’s triad and understand the significance.
Knowledgeable of when it is appropriate to withdraw fluid from the ventriculostomy.
Correctly state when to flush an ICP line.
Knowledgeable of when to change the pressure tubing fluid; what type of fluid is utilized.
Name 2 contraindications for the use of ventriculostomy.
Correctly identify the landmark used to level the transducer.
Cite three signs and symptoms of increased ICP.
Recommendations/Comments:
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Preceptor/Faculty Signature:
Student Action Plan or Remediation Required-
Students Signature:
Yes
Date:
No
Scoring Scale
4 – Accomplished SAFE/ACCURATE Proficient, coordinated, confident. Expedient use of time. Focus on patient. Proficient
Skills. Independent, Without direction
3 – Competent SAFE/ACCURATE Efficient coordinated, confident. Reasonable use of time. Competently skilled. Supervised,
with occasional physical or verbal direction
2 –Developing SAFE BUT NOT ALWAYS ACCURATE Partial demonstration of skills. Inefficient or uncoordinated. Delayed
time expenditure. Assisted, Frequent verbal and/or physical direction
1 - Beginning/Novice QUESTIONABLE SAFE and/or QUESTIONABLE ACCURACY Unskilled and inefficient. Considerable
and prolonged time expenditure. Marginal, Requires continuous verbal and/or physical direction
0 –Dependent/ Deficient UNSAFE/INACCURATE Unable to demonstrate procedures. Lacks confidence, coordination, and/or
efficiency. Potential harm to self or patient. Dependent, continuous verbal and/or physical direction
Grading System:
Average Scoring Scale of 4.0-3.5 (90 – 100 = A)
Average Scoring Scale of 3.0-3.4 (80 – 89 = B)
Average Scoring Scale of 2-2.9 (70 – 79 = C
Average Scoring Scale of < 2 > 1 (60 – 69 = D)
Average Scoring Scale of < 1 (59 or below = F)
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Case Study Assignment
Purpose: The purpose of this assignment is for evaluation of meeting course objectives.
Focus: The focus for this assignment is patient care, data collection, and evaluation of care
provided compared to evidence-based research.
Due Date: August 7, 2015.
Course Objective(s): 1, 2, 3, 4, 5, 6
Instructions –During the clinical rotations, students will select an assignment which fits with
their interest in completing course objectives. The clinical objectives are to perform patient
care, gather data for the concept map and the evaluation of care delivery.
The case study consists of six sections with very specific criteria that the student must include
to receive full credit. Required elements are included in each section description. Be thorough
in gathering information and document the reason for any missing elements.
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Angelo State University - Department of Nursing
NUR 4333: Critical Care Nursing
Case Study Guidelines and Rubric
Criteria
I.
II.
III.
Introduction: Section consists of introducing/presenting
the patient. Required elements: Patient initials, date of
birth, age, race and gender, current ht & wt, BMI, and
date of admission.
Chief complaint: (why the pt came into the hospital) and
primary admitting diagnosis.
HPI: history of present illness (length of illness and signs
and symptoms on admission). Provide a detailed course
of illness and his or her present health state (are they
better, worse or the same).
Overview of patient: History, bio-psycho-social
assessments, diagnostic tests, pharmacological
interventions, EKG interpretation, hemodynamics,
nutritional measures, and genomic considerations.
Pathophysiology: Review pathophysiology of the
condition including etiologies, clinical manifestations,
expected outcomes, current research, demographics,
and relating this information to the assigned patient.
Possible
Points
Points Received
10
20
30
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IV.
Plan of Care:
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Part 1: Generate and discuss nursing diagnosis in
planning care for the patient.
Part 2: Priorities of care, plan, and evaluation of
outcomes
V.
VI.
Research-based Interventions: Evaluate the care this
patient received related to your research of the
condition.
References: Cite all references used in the paper. The
references must include at least one peer-reviewed
journal article. The article must be less than 5 years old,
and must be longer than 2 printed pages to count. Your
other references can be textbooks and internet sites. The
reference section must follow APA 6th edition format
Total
10
10
100
Limit your response to no more than 10 double-spaced pages with 1” margins all around. Use
12-point Times New Roman font. All of your work, except for the appendices, must be in type
written form for this assignment. Follow APA 6th edition for this paper. Please do not plagiarize,
as this is grounds for failure. As much as possible one should paraphrase (put into your own
words) when referencing sources. One may use quotes as appropriate. All papers are subject to
submission to http://safeassign.com/ to assess for plagiarism. Spelling, punctuation, and
grammar needs to be correct.
Point totals of 70 to 100 points equal “Satisfactory performance” on this assignment. Point
totals of 0 to 69.99 points will result in an “Unsatisfactory performance.” Unsatisfactory
assignments will be returned to the student for corrections. These assignments will be rescored
using the same scoring guidelines. The student may have the assignment rescored once.
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Interdependent QSEN Competency Assignment
Purpose: The purpose of this assignment is to prepare students to actively participate as
collaborative partners in a transforming healthcare system.
Focus: The focus for this assignment is to apply real life healthcare problems in the critical care
setting to the Interdependent QSEN Competency Model. Students identify how an issue with
one competency is affected by other competencies for the creation of a quality improvement
plan.
Due Date: July 20, 2015.
Course Objective(s): 2, 3, 6, 7, 8
Instructions – Prior to the Critical Care/ER rotations, students will do a library database
assignment looking at research recommendations and standards for the assigned competency
in those areas. Five or more peer-reviewed sources required for an APA formatted reference
list. Three must be journal articles.
Prior to the clinical rotations, students will collaborate with peers to identify issues/situations
illustrating use or lack of use of assigned competency in the critical care setting. Students will
collaboratively create a 10 slide PowerPoint presentation summarizing the issues/situations and
recommendations with an APA formatted reference list. The PowerPoint presentation will be
turned in to the instructor one week prior to the students’ clinical rotation. Post instructor
approval, students will share the presentation with their peers in Blackboard (Bb) and Second
Life (SL). Since access is not restricted on the virtual campus, no patient or facility identifiers to
be presented. **Maintain confidentiality, including HIPAA policy at all times.
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Angelo State University - Department of Nursing
NUR 4321: Critical Care Nursing
Interdependent QSEN Competency Assignment Rubric
Criteria
1. Use library databases to review the
literature exploring one of the six QSEN
competencies. Include an APA
formatted reference list of 5 or more
peer-reviewed sources (Three must be
journal articles).
2. Collaborate with peers to identify
issues/situations illustrating use or lack
of use of assigned competency in the
critical care setting.
3. Identify how the issue with the
competency is affected by other
competencies.
4. Identify how the issue may compromise
Safety and Quality Improvement; as well
as how competencies could be part of
the solution. Collaboratively formulate a
quality improvement plan.
5. Create a 10 slide PowerPoint
Presentation summarizing the
issues/situations and recommendations
with APA formatted reference list to
share with your peers in Bb.
Total
Points
Possible
Evaluation
10
20
20
25
25
100
Please do not plagiarize, as this is grounds for failure. As much as possible one should
paraphrase (put into your own words) when referencing sources. One may use quotes as
appropriate. All papers are subject to submission to http://safeassign.com/ to assess for
plagiarism. Spelling, punctuation, and grammar needs to be correct.
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Angelo State University NUR
4333 Critical Care Nursing
Discussion Board Assignment
Description: Online protocols include: -Postings should be evenly distributed during the
discussion period (not concentrated all on one day or at the beginning and/or end of the
period). -Postings should be a minimum of one short paragraph and a maximum of two
paragraphs. -Avoid postings that are limited to 'I agree' or 'great idea', etc. If you agree (or
disagree) with a posting then say why you agree by supporting your statement with concepts
from the readings or by bringing in a related example or experience. -Address the questions as
much as possible (don't let the discussion stray). -Try to use quotes from the article that
support your postings. Include page numbers when you do that. -Build on other responses to
create threads. -Bring in related prior knowledge (work experience, prior coursework, readings,
etc.) -Use proper etiquette (proper language, typing, etc.)
Course Objective(s): 1, 2,3,4,5,6,7,8
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Discussion Board Rubric
Exit
Excellent
Timely Discussion
Contributions
Discussion and
Demonstration of
Knowledge and
Understanding Gained
from Assigned Reading
Adherence to On-Line
Protocols
Good
Average
Poor
Points Range: 9 (30%) - 10 Points Range: 8 (26.67%) - Points Range: 6 (20%) - 7
(33.33%)
8 (26.67%)
(23.33%)
Points Range: 0 (0%) - 5
(16.67%)
5-6 postings well
distributed throughout
the week
Feedback:
2-6 not distributed
throughout the week
Feedback:
4-6 postings distributed
throughout the week
Feedback:
3-6 postings somewhat
distributed
Feedback:
Points Range: 9 (30%) - 10 Points Range: 8 (26.67%) Points Range: 6 (20%) - 7
(33.33%)
8 (26.67%)
(23.33%)
Very clear that readings
were understood and
incorporated well into
responses
Feedback:
Readings were
understood and
incorporated into
responses
Feedback:
Points Range: 0 (0%) - 5
(16.67%)
Not evident that readings
Postings have
were understood and/or
questionable relationship
not incorporated into
to reading material
discussion
Feedback:
Feedback:
Points Range: 9 (30%) - 10 Points Range: 8 (26.67%) - Points Range: 6 (20%) - 7
(33.33%)
8 (26.67%)
(23.33%)
Points Range: 0 (0%) - 5
(16.67%)
All on-line protocols
followed
Feedback:
4 or more online protocols
not adhered to
Feedback:
1 online protocol not
adhered to
Feedback:
2-3 online protocols not
adhered to
Feedback:
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