NU-235 Health and Illness in Nursing III

Course Description:

This course builds upon NU 225, introducing application of the core competences to complex chronic health alterations across the lifespan and palliative care in the Pacific Islands. Focuses on prioritization of care, client and family teaching,
care coordination, and ethical decision-making. Includes concepts on primary care and public health nursing in the Pacific Islands, such as non-communicable chronic diseases. Clinical learning experiences in a variety of health settings and simulation lab emphasize evidence-based practice that includes culturally, developmentally, and age-appropriate aspects in the nursing process, delegation and supervision, and collaboration with the interprofessional health team.

This course also meets PLO #(s) ___ of _PN/RN_____________ program.

Prerequisite Courses: NU 235; Corequisites: 245

PROGRAM LEARNING OUTCOMES (PLOs):

The student will be able to:

Model personal and professional actions based on self-reflection, core nursing values, and lifelong growth integrating new knowledge, ethical principles, and legal standards for safe, quality nursing practice.
Incorporate nursing knowledge to assess, plan, deliver, and evaluate care within the context of the interprofessional health team.
Make evidence-based nursing judgments in the delivery of safe, holistic nursing care.
Demonstrate a spirit of inquiry to manage and improve the quality of care and outcomes for individuals, families, and communities.
Practice relationship-centered communication and incorporate health technology as a member of the interprofessional team.
Advocate for a caring, culturally safe, and flourishing environment that reflects the values and needs of Micronesian families and communities.
Practice and contribute to the primary care and public health care systems in Micronesia to promote family and community wellness.

B. STUDENT LEARNING OUTCOMES (SLOs) GENERAL:

The student will be able to:

Demonstrate personal and professional accountability in caring for groups of individuals & families with complex chronic health alterations and palliative care needs.
Demonstrate clinical judgment and collaboration skills to deliver care for groups of individuals and families with complex health alterations and palliative care needs across the lifespan.
Use evidenced based rationales to plan and evaluate care for groups of individuals and families with complex chronic health alterations and palliative care needs across the lifespan.
Integrate evidence, tradition, and preferences of groups of individuals and families with chronic health alterations and palliative care needs to manage care for improvement of quality of care and health outcomes.
Implement relationship-centered communication and health technology skills for groups of individuals, families with complex chronic health alterations across the lifespan.
Adapt nursing care to support the cultural values, developmental needs, and health practices and needs of Micronesian individuals, families, and communities.
Design plans of care for groups of individuals, families with complex chronic health alterations and palliative care needs in the context of primary care and public health settings.

SLO	PLO 1	PLO 2	PLO 3	PLO 4	PLO 5	PLO 6	PLO 7
SLO 1	I,D
SLO 2		I,D
SLO 3			I,D
SLO 4				I,D
SLO 5					I,D
SLO 6						I,D
SLO 7							I,D

C. STUDENT LEARNING OUTCOMES (SLOs)-SPECIFIC:

General SLO 1. Demonstrate personal and professional accountability in caring for groups of individuals & families with complex chronic health alterations and palliative care needs.
The student will be able to:

Student Learning Outcomes	Assessment Strategies
Identify the standards of nursing practice for the care of individuals, families, and groups with complex chronic health alterations and palliative care needs across the lifespan. 1.1.1 Roles of the nurse in complex chronic care and palliative care. 1.1.2 Nursing core competencies for chronic illness (WHO).	Quizzes, exams Case scenarios & nursing care plan (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
Determine decision-making strategies to address legal-ethical dilemmas in the care of individuals, families, and groups with complex chronic and palliative care needs. 1.2.1 The infant, child, or adolescent with complex physical, emotional, and developmental health alterations. 1.2.2 The child with complex cancer, musculoskeletal, cardiac, respiratory, renal, psychosocial health alterations. 1.2.3 The adult or elder with complex cancer, chronic cardio-vascular, neurological, respiratory, endocrine, or psychosocial health alterations. 1.2.4 The child or adult with a complex acute mental health alteration. 1.2.5 The client with a complex chronic health alteration or palliative care need that impacts public health.	Quizzes, exams Case scenarios & nursing care plan (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
1.3 Demonstrate acceptance of personal responsibility and accountability for the care of groups of clients and families with complex chronic illness and palliative care needs. 1.3.1 Provision of complex chronic and palliative care. 1.3.2 Delegation of care provided to groups of clients and families with complex chronic health alterations.	Quizzes, exams Case scenarios & nursing care plan (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
1.4 Anticipate and implement strategies to meet own learning needs for competence in care of groups of clients and families with complex chronic health alterations and palliative care needs.	Quizzes, exams Case scenarios & nursing care plan (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)

General SLO 2. Demonstrate clinical judgment and collaboration skills to deliver care of groups of individuals and families with complex health alterations and palliative care needs across the lifespan.
The student will be able to:

Student Learning Outcomes	Assessment Strategies
2.1. Utilize critical thinking, clinical judgment, and clinical reasoning in care of groups of individuals & families with complex chronic health alterations and palliative care needs, and groups across the lifespan. 2.1.1 Conduct comprehensive holistic health assessments of individuals with complex chronic health alterations and palliative care needs. 2.1.2 Analyze nursing assessment data, and laboratory and diagnostic results for the client with complex chronic health alterations or palliative care needs. 2.1.2 Differentiate signs and symptoms of life-threatening situations in the chronic care client. 2.1.3 Identify premonitory signs and symptoms of death in the client with lingering illness. 2.1.4 Design and prioritize interventions for an individualized plan of care for clients with complex chronic health alterations or palliative care needs, supporting each recommendation with evidence-based rationales. 2.1.5 Design health education plans for groups of clients and families with complex chronic health alterations, including prevention, harm reduction, and disease management. 2.1.6 Implement use of common formulas and algorithms in selected complex chronic health alterations and palliative care needs. 2.1.7 Evaluate client responses to interventions and progress toward health goals and document accurately.	Quizzes, exams Case scenarios & nursing care plan (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
2.2. Collaborate with the interprofessional health team members to coordinate and refer complex patient care in the hospital and community settings. 2.2.1 Identify situations for potential breaks in communication and collaboration between the individual, family, and interprofessional health team collaboration. 2.2.2 Problem-solve strategies to prevent and/or resolve health literacy issues in the care of individuals with complex chronic health alterations. 2.2.3 Identify FSM in-patient and community resources to support the care of complex chronic clients and those with palliative care needs. 2.2.4 Determine the processes and issues related to referrals and payor systems in FSM and off-island for clients with complex chronic health alterations. 2.2.5 Discuss the feasibility of home care, hospice care, and long term care services in the FSM. 2.2.6 Discuss common ethical and advocacy dilemmas encountered in promoting continuity of care.	Quizzes, exams Case scenarios & nursing care plan (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
2.3. Assign and delegate care to health team members to provide patient care in the hospital and community settings for complex chronic care and palliative care. 2.3.1 Apply national standards and principles of delegation in the practice lab simulations and the clinical setting during care of the complex chronic client. 2.3.2 Use the principles of delegation to problem-solve common delegation dilemmas during care of the complex chronic client.	Quizzes, exams Case scenarios & nursing care plan (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)

General SLO 3. Use evidenced based rationales to plan and evaluate care for groups of individuals and families with complex chronic health alterations and palliative care needs across the lifespan.
The student will be able to:

Student Learning Outcomes	Assessment Strategies
3.1 Utilize organizing frameworks to guide nursing practice 3.1.1 Health behavior models 3.1.2 Chronic illness model 3.1.3 Palliative care model 3.1.4 Home health and hospice models 3.1.5 Chronic mental health care 3.1.6 Rehabilitation and recovery models 3.1.7 Goals & Standards: Ambulatory Care, Primary Care, Public Health Care, Disability Standards, National Safety Goals, Healthy People 2020, WHO Millennium Goals, Institute of Medicine Reports related to chronic disease and eldercare, International Council of Nurses (ICN) 3.1.8 Health outcomes, quality assurance, and quality improvement for chronic and palliative care	Quizzes, exams Case scenarios, group projects, or presentation (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
3.2 Seek current evidence-based information to deliver safe, holistic care to individuals, families, and groups across the lifespan with complex chronic care and palliative care needs: 3.1.1 Child and adult developmental delays, congenital and other disabilities 3.1.2 Complex chronic mental health issues 3.1.3 Complex chronic neurological health alterations 3.1.4 Complex chronic non-communicable diseases (cardiac, respiratory, diabetes, cancer, end-stage renal disease) 3.1.6 Pain management for complex chronic health alterations and palliative care 3.1.9 Complex chronic musculoskeletal health alterations 3.1.10 Dialysis and transplants 3.1.11 Rehabilitation and recovery with complex chronic health alterations: medical-surgical and psychosocial 3.1.12 Complementary & alternative therapies	Databases, Search Engines Case scenarios, nursing care plan, or professional paper , or project(scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
3.2 Use safety guidelines and evidence-based best practices when demonstrating advanced nursing skills and therapies in caring for clients with complex chronic health alterations and palliative care needs. (See Level II Nursing Skills List). 3.2.1 Identify evidence-based skill adaptations for clients with complex chronic health alterations who are fragile, confused, physically, cognitively, emotionally, or developmental delayed. 3.2.2 Identify basic principles and strategies of rehabilitation care. 3.2.3 Differentiate among complementary, alternative, and integrative therapies to incorporate into care of individuals with complex chronic health alterations and palliative care.	Quizzes, exams Case scenarios, nursing care plan, or professional paper , or project(scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)

General SLO 4. Integrate evidence, tradition, and preferences of groups of individuals and families with complex chronic health alterations and palliative care needs to manage care for improvement of quality of care and health outcomes.

The student will be able to:

Student Learning Outcomes	Assessment Strategies
4.1. Develop strategies to allocate and manage patient care resources efficiently during complex chronic care and palliative care in hospital and community based settings. 4.1.1 Prioritize and organize care for a group of clients with complex health alterations and palliative care needs based on health status, safety needs, time management, and effective use of resources. 4.1.2 Identify strategies to reduce client care costs while maintaining positive health outcomes and patient satisfaction.	Quizzes, exams Case scenarios, nursing care plan, or (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
4.2. Adapt patient care activities to incorporate client preferences while facilitating positive health outcomes and improve the quality of care during complex chronic care and palliative care. 4.2.1 Hospital and community based care. 4.2.2 Involvement of family and community. 4.2.3 Conduct an assessment of patient satisfaction, perceived health outcomes, and quality of care.	Quizzes, exams Case scenarios, nursing care plan, or professional paper (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
4.3 Provide palliative care based on national standards of care and individual/family preferences. 4.3.1 Identify national standards for palliative care. 4.3.2 Identify cultural and individual/family goals and preferences for palliative care. 4.2.1 Conduct a health assessment for a client receiving palliative care. 4.2.2 Support the individual and family in setting goals and resolving conflicts. 4.2.3 Using principles of teaching and learning, develop and implement a client education plan surrounding palliative care concerns.	Quizzes, exams Case scenarios, nursing care plan, (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)

General SLO 5. Implement relationship-centered communication and health technology skills for groups of individuals, families with complex chronic health alterations across the lifespan.
The student will be able to:

Student Learning Outcomes	Assessment Strategies
5.1. Implement effective communication protocols, such as SBAR and documentation, to ensure client safety and team collaboration in the care of clients with complex chronic health alterations and palliative care needs.	Quizzes, exams Case scenarios, nursing care plan, or professional paper (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
5.2 Adapt therapeutic communication skills for clients and families with complex chronic health alterations and palliative care needs, refocusing communication toward common stress behaviors, coping strategies, goal-setting, and problem-solving.	Quizzes, exams Case scenarios, nursing care plan, or professional paper (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
5.2. Apply strategies to build interpersonal and/or interprofessional relationships and resolve conflicts during complex chronic care and palliative care. 5.2.1 Establishing partnerships. 5.2.2 Managing and adapting to change. 5.2.2 Negotiation strategies. 5.2.3 Team-building and collaboration strategies.	Quizzes, exams Case scenarios, or professional paper (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
5.3 Analyze own documentation for accuracy, timeliness, and professionalism and collaborate with nursing instructor before entering it into the client record.	Case scenarios, Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
5.4 Resolve cultural/ linguistic barriers to communication and document solutions such as accessing professional interpretive services.	Quizzes, exams Case scenarios, nursing care plan, or professional paper (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)

General SLO 6. Adapt nursing care to support the cultural values, developmental needs, and health practices and needs of Micronesian individuals, families, and communities.
The student will be able to:

Student Learning Outcomes	Assessment Strategies
6.1. Adapt nursing care to support the values and health needs of Micronesian individuals across the lifespan, families, and communities with complex chronic health alterations or palliative care needs. 6.1.1 Identify general concepts of caring and caring interventions that support individuals and families with complex chronic health alterations and palliative care needs across the lifespan. 6.1.2 Identify and differentiate the meaning of complex chronic health alterations and lingering illness to individuals and families of diverse Micronesian and Pacific Island cultural groups. 6.1.3 Caring interventions in the event of a significant change in the client’s health condition. 6.1.4 Caring interventions to support psychosocial needs in individuals and families with complex chronic mental health alterations. 6.1.4 Caring interventions to facilitate major health and lifestyle changes to slow the progress of complex chronic health alterations. 6.1.5 Caring interventions related to public health needs and priorities. 6.1.6 Caring interventions for the caregiver(s), both family and health professional.	Quizzes, exams Case scenarios, nursing care plan, or professional paper (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
6.2 Identify own values, concerns, and dilemmas surrounding care of clients with complex chronic health alterations and palliative care needs.	Case scenarios or professional paper (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (score by rubric)
6.3. Assist health team members to recognize the values and health needs of individuals and families with complex, chronic health alterations or palliative care needs.	Quizzes, exams Case scenarios, nursing care plan, or professional paper (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
6. Apply a model of transcultural care or cultural competence to care of a Micronesian client/family.	Simulations, case scenarios, nursing care plan, presentation, or professional paper (scored by rubric)

General SLO 7. Design plans of care for groups of individuals, families with complex chronic health alterations within the contexts of primary care and public health.

The student will be able to:

Student Learning Outcomes	Assessment Strategies
7.1. Demonstrate personal and wellness practices in to prevent complex chronic illness.	Poster, project or group activity (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)
7.2. Discuss concepts basic to principles of primary care, community health, and public health nursing. 7.2.1 Multideterminants of health and disease in individuals, families, and communities 7.2.3 Definitions of distributive care, social justice, and health equity 7.2.3 Core functions function of community health nursing 7.2.4 Relationships of concepts related to community/public health nursing: focus of health outcomes, nursing care delivery model, focus of client care, environmental settings 7.2.5 Use of data to guide evidenced-based practice, health policies. planning and implementation of health services, and financing of health care 7.2.6 Evaluation of health outcomes at the community level	Quizzes, exams Case scenarios, project or presentation, professional paper (scored by rubric) Simulations, Portfolio (scored with rubric)
7.3 Use epidemiological data to plan nursing care of groups of individuals and families with complex chronic health alterations and palliative care needs.	Quizzes, exams Nursing care/education project or professional paper (scored by rubric)
7.4 Identify basic principles & strategies for prevention, harm reduction, and community protection for complex chronic health alterations and palliative care needs.	Quizzes, exams Case scenarios, nursing care plan, or professional paper, special projects (scored by rubric) Simulations, Reflective journal, Clinical Evaluation Tool & Portfolio (scored with rubric)

D. COURSE CONTENT

Care management
Professional identity
Standards of practice and core competencies for care of groups of clients and families with complex health alterations and palliative care across the lifespan.
Decision-making strategies for ethical dilemmas relating to care of clients and families with complex health alterations and palliative care across the lifespan.
Personal and professional accountability for care of groups of clients and families with complex health alterations and palliative care across the lifespan.
Designing learning plans for personal and professional growth.
Clinical judgment, clinical decision-making, and collaboration
The nursing process and care of clients and families with complex health alterations and palliative care across the lifespan.
Collaboration with the health team

Breakdowns in communication and collaboration
Health literacy
Coordinating chronic and palliative care in the FSM
Ethical issues

Health outcomes and quality of care in complex chronic and palliative care
Delegation in complex chronic and palliative care

Evidence-based practice and standards of care

Managing resources in care of clients and families with complex health alterations and palliative care across the lifespan.
Communication and collaboration

Adapting strategies for communication and collaboration during care of clients and families with complex health alterations and palliative care across the lifespan.
Problem-solving
Establishing partnerships
Managing and adapting to change
Negotiation strategies
Team building and collaboration.

Organizing frameworks for evidenced-base practice in chronic and palliative care

Health behavior models
Chronic illness model
Palliative care model
Home health and hospice models

d. Adapting nursing skills to care of clients with chronic health alterations and palliative care needs
e. Evidence-based nursing care

Chronic mental health care
Complex chronic neurological health alterations
Complex chronic non-communicable diseases (cardiac, respiratory, diabetes, cancer, end-stage renal disease)
Pain management for complex chronic health alterations and palliative care
Complex chronic musculoskeletal health alterations
Dialysis and transplants

Rehabilitation and recovery with complex chronic health alterations: medical-surgical and psychosocial/mental health
Complementary & alternative therapies
Adapting culture and caring concepts to the client and family with complex chronic health alterations and palliative care needs
Primary care, community health, and public health concepts
Multideterminants of health and disease in individuals, families, and communities
Definitions of distributive care, social justice, and health equity
Core functions function of community health nursing
Relationships of concepts related to community/public health nursing: focus of health outcomes, nursing care delivery model, focus of client care, environmental settings
Use of data to guide evidenced-based practice, health policies. planning and implementation of health services, and financing of health care
Evaluation of health outcomes at the community level
Epidemiological data to plan nursing care of groups of individuals and families with complex chronic health alterations and palliative care needs.
Basic principles & strategies for prevention, harm reduction, and community protection for complex chronic health alterations and palliative care needs.

E. METHODS OF INSTRUCTION

Lectures: in class mini-lectures
Group discussions and exercises (problem-solving, role-playing, teaching, debate)
Independent learning activities
Web-based and media activities
Skills lab and simulation lab practice
Direct patient/client care in hospital, clinics, and other community settings

F. REQUIRED TEXT(S) AND COURSE MATERIALS

Carpenito-Moyet, L. (2009). Nursing diagnosis: Application to clinical practice (13th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. (or most recent edition)

Jensen, S. (2011). Nursing health assessment: A best practice approach with DVD. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. (or most recent edition)

Maville, J., & Huerta, C. (2008). Health promotion in nursing. (2nd ed.). NY: Thomson Delmar Learning. (or most recent edition)

Pilliteri, A., and others. (2009). Care of the childbearing and childrearing family (6th ed.), text, study guide, and Lippincott’s clinical simulations: maternity/pediatric nursing course set. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. (or most recent edition)

Stedman, (2010) Stedman’s medical dictionary for the health professions. (6th ed.). Philadelphia: Lippincott, & Wilson, & Williams. (or most recent edition)

Taylor, C., Lillis, C., LeMone, P., and Lynn, P. (2011). Fundamentals of nursing: the art and science of nursing (7th ed.). Philadelphia: Lippincott, & Wilson, & Williams. (or most recent edition)

Taylor, C., and others. (2011). Skills checklists for fundamentals of nursing: the art and science of nursing (7th ed.). Philadelphia: Lippincott, & Wilson, & Williams. (or most recent edition)

Taylor, C., Lillis, C., LeMone, P., and Lynn, P. (2011). Taylor’s video guide to clinical nursing skills. (2th ed.). Philadelphia: Lippincott, & Wilson, & Williams. (or most recent edition)

Videback, S. (2010). Psychiatric mental health nursing. (5th ed.), Philadelphia: Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. (or most recent edition)

G. REFERENCE MATERIALS (previously purchased references)

American Psychological Association. (2009). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author. (or most recent edition)

Bucholz, S. (2012). Henke’s med-math dosage calculation, preparation and Administration (7th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. (or most recent edition)

Karch, A. (2011). Focus on nursing pharmacology (5th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. (or most recent edition)

Karch, A. (2012). 2012 Lippincott’s nursing drug guide. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. (or most recent edition)

Laboratory Diagnosis reference of choice. [optional]

Nutrition book of choice

Stedman's Plus Spellchecker 2011 Standard Edition Upgrade (software) [optional]

H. INSTRUCTIONAL COSTS

Initial: Adult/Pediatric/Infant/Clinic Patient Units, VS equipment, Ambu bags, forceps, wheelchair, scales, DVDs, learning software, manikins, models, nebulizers, computers/printers, Microsoft Office software
Ongoing: Maintenance repair and replacement of equipment; insurance and maintenance agreements for simulators

Disposable supplies:
$175 fee/student (Examples: gloves, underpads, alcohol pads, soap, disinfectant, glucometers, lancets and strips, meal trays, specimen cups, catheter kits/bags, thermometers, sterile supplies, dressings, paper isolation equipment, bio-disposable hazard fees, medication administration equipment: needles, syringes, among others)

EVALUATION

Grading for this course involves two sets of competencies, classroom and lab/clinical. Students must demonstrate mastery of competencies in both the classroom and lab/clinical to pass the course. The benchmark for passing in the classroom component is a 70%. The benchmark for passing the lab/clinical component is an “S” for satisfactory performance. Note: Corequisites ED/PY 201, NU 123 must also be passed with a “C” or better for students to progress to the next nursing courses (NU 133, 134, 135).

L. CREDIT BY EXAMINATION

None.

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NU-235 Health and Illness in Nursing III