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General Information

Course ID (CB01A and CB01B)
NURS D094L
Course Title (CB02)
Gerontology Nursing Clinical
Course Credit Status
Credit - Degree Applicable
Effective Term
Fall 2021
Course Description
The focus of this course is on the application of concepts learned in the theory class for the management of nursing care of older adult patients experiencing complex health challenges and chronic changes in health status. Students will use nursing processes, research, problem-solving and critical thinking skills to facilitate culturally congruent care in acute care settings within the framework of safe patient-centered, evidence-based care. Learning experiences will be enhanced with clinical simulation and observation activities. Both NURS 94L and NURS 94 must be taken and passed concurrently within the same quarter (failure of either component requires both courses to be retaken).
Faculty Requirements
Course Family
Not Applicable

Course Justification

This course is in a CTE program that was developed based on requirements from the California Board of Registered Nursing (BRN), and input from current/potential healthcare employers and current/future health needs of society. This course belongs on the A.S. degree in Nursing. This course is a BRN mandated component of the nursing program and exposes students to the clinical practice of nursing the older adult patient population. Successful completion of this course is required for students to be eligible for the national licensing exam.

Foothill Equivalency

Does the course have a Foothill equivalent?
No
Foothill Course ID

Course Philosophy

Formerly Statement

Formerly Statement
(Formerly NURS D084L.)

Course Development Options

Basic Skill Status (CB08)
Course is not a basic skills course.
Grade Options
  • Pass/No Pass
Repeat Limit
0

Transferability & Gen. Ed. Options

Transferability
Transferable to CSU only

Units and Hours

Summary

Minimum Credit Units
2.0
Maximum Credit Units
2.0

Weekly Student Hours

TypeIn ClassOut of Class
Lecture Hours0.00.0
Laboratory Hours6.50.0

Course Student Hours

Course Duration (Weeks)
12.0
Hours per unit divisor
36.0
Course In-Class (Contact) Hours
Lecture
0.0
Laboratory
78.0
Total
78.0
Course Out-of-Class Hours
Lecture
0.0
Laboratory
0.0
NA
0.0
Total
0.0

Prerequisite(s)

NURS D093., NURS D093A, NURS D93AL, NURS D093L, and NURS D93PL

Corequisite(s)

NURS D094.

Advisory(ies)

Limitation(s) on Enrollment

Entrance Skill(s)

General Course Statement(s)

Methods of Instruction

Review of written assignments

Demonstration and evaluation of clinical skills in direct patient care

Modeling of clinical nursing behaviors

Discussion of patient conditions and nursing interventions

Other: Facilitating simulation experiences

Assignments

  1. Reading assignments from the syllabus, texts, and medication reference
  2. Patient data worksheets
  3. Critical thinking worksheets
  4. Clinical reasoning worksheets
  5. Skills testing
  6. Clinical simulation exercise

Methods of Evaluation

  1. One critical thinking worksheet, and daily clinical reasoning worksheets, using the nursing process, to critically analyze pertinent data, demonstrating the ability to summarize, integrate and apply information. Rubrics and Standards of Nursing Practice used for evaluation.
  2. Final skills testing will incorporate current skill competency as well as retention of previously learned skills to evaluate skill mastery.
  3. Demonstration of safe and effective care as evaluated per the final Clinical Evaluation Tool.
  4. Successful completion of Nursing 94 within the same quarter is required to pass Nursing 94L.

Essential Student Materials/Essential College Facilities

Essential Student Materials: 
  • Student uniforms including nametags
  • Stethoscope, watch with second hand, hemostat, scissors
  • Transportation to and from clinical sites
  • Current CPR certification for health care professional
  • Current physical examination with updated TB test and immunizations
  • Current background check and drug testing
Essential College Facilities:
  • Nursing skill laboratory equipment with supplies and equipment for practice and demonstration;
  • A current Foothill-°®¶¹´«Ã½ Community College District contract with each affiliating clinical facility on file with the district office

Examples of Primary Texts and References

AuthorTitlePublisherDate/EditionISBN
* Touhy & Jett. "Ebersole & Hess' Toward Healthy Aging", 9th ed. 2016. Elsevier.

Examples of Supporting Texts and References

AuthorTitlePublisher
Ignatavicius, Workman & Rebar. "Medical Surgical Nursing: Patient-Centered Collaborative Care", 9th ed. 2018. Elsevier.
Van Leeuwen & Bladh. "Cavis's Comprehensive Handbook of Laboratory and Diagnostic Tests with Nursing Implications", 7th ed. 2018. F.A. Davis.
Potter, Perry, Stockert & Hall. "Fundamentals of Nursing", 9th ed. 2017. Elsevier.
Morris. "Calculate with Confidence", 7th ed. 2018. Elsevier.
Doenges, Moorhouse & Geissler-Murr. "Nursing Diagnosis Manual", 6th ed. 2019. F.A. Davis.
Purnell. "Guide to Culturally Competent Health Care". 3rd edition. 2014. F.A. Davis.
A drug refernece handbook or a packet of drug cards (purchase before medication experience)
A medical or medical/nursing dictionary
Nursing 94L Course Syllabus-most current version
°®¶¹´«Ã½ College, Department of Nursing Student Handbook, on-line

Learning Outcomes and Objectives

Course Objectives

  • Assess patient problems and needs, and analyze trends of data to accurately identify and frame problems, plan, implement and evaluate care within the context of the older adult patient and their environment.
  • Interact effectively with older adult patients, families, students and staff, fostering mutual respect and shared decision making, to enhance patient satisfaction and health outcomes.
  • Use information and technology to communicate, manage knowledge, mitigate error, and support decision-making while providing care to an older adult patient.
  • Influence the behavior of individuals or groups of individuals, including older adults, within their environment in a way that will facilitate the establishment and acquisition of shared goals.
  • Function effectively within nursing and interdisciplinary teams, fostering open communication, mutual respect, shared decision making, team learning, and development to enhance patient and peer satisfaction and health outcomes of the older adult patient.
  • Identify, evaluate, and integrate the best current evidence coupled with clinical expertise and consideration of patient preferences, experience and values to make practice decisions for an older adult patient.
  • Use data to monitor the outcomes of care processes, and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems and individual performance, thereby minimizing the risk of harm to older adult patients and providers.
  • Demonstrate accountability for the delivery of standard-based nursing care that is consistent with moral, altruistic, legal, ethical, regulatory, and humanistic principles.
  • Recognize the patient or designee as the source of control and full partner when providing compassionate and coordinated care based on respect for the older adult patient's preferences, needs, and cultural values.

CSLOs

  • Formulate a plan of care for an older adult incorporating age-related changes and developmental tasks.

  • Analyze and apply salient trends of comprehensive assessment data during the clinical reasoning process for an adult patient experiencing an acute or chronic problem.

Outline

  1. Assess patient problems and needs, and analyze trends of data to accurately identify and frame problems, plan, implement and evaluate care within the context of the older adult patient and their environment.
    1. Collect and analyze trends in patient information, including normal physiologic changes of aging.
    2. Perform comprehensive assessment, including functional and socioeconomic status, emotional state, religion, culture and gender as reference points.
    3. Utilize assessment data to indentify problems and outcomes.
    4. Create, implement, and evaluate a comprehensive plan of care based on assessment data, problems and outcomes.
    5. Include in the plan of care interventions and measures that promote continuity of care across healthcare settings.
  2. Interact effectively with older adult patients, families, students and staff, fostering mutual respect and shared decision making, to enhance patient satisfaction and health outcomes.
    1. Communicate therapeutically with patients, taking special care with older adults and patients experiencing visual, auditory, cognitive and/or perceptual problems.
    2. Create and discuss a plan of care with patients, families, instructor, RN and UAP, remaining open to input and feedback.
    3. Communicate and document pertinent information to RN and/or instructor in a timely manner and at each transition of care, including handoffs.
    4. Educate patient/family about nursing actions, medications, procedures, discharge plans and communication, in clear, concise, patient-friendly terms with consideration of visual and auditory abilities.
    5. Act consistently with integrity and respect for differing views.
  3. Use information and technology to communicate, manage knowledge, mitigate error, and support decision-making while providing care to an older adult patient.
    1. Use available information technologies to collect salient assessment data, medications, analyze trends in patient assessments, laboratory and diagnostic data before providing care and throughout shift to support clinical decision-making.
    2. Check for new orders and patient data throughout shift, communicate with other team members and respond to changing priorities and patient needs.
    3. Document patient care in a clear and appropriate manner, following clinical agency and instructor guidelines.
    4. Utilize scholarly sources and resources provided by clinical agencies to research knowledge gaps in patient data, procedures and medications and facilitate decision-making.
  4. Influence the behavior of individuals or groups of individuals, including older adults, within their environment in a way that will facilitate the establishment and acquisition of shared goals.
    1. Function professionally and effectively in the role of a leader.
    2. Recognize different styles of communication used by patients, families, and other healthcare providers.
    3. Critically reflect on own leadership and communication styles and adapt them to facilitate effective collaboration.
    4. Complete patient care in a timely manner and notify teams of any critical changes in patient condition in a timely manner.
    5. Demonstrate accountability and maintain professional integrity in all aspects of the learning process and nursing care.
  5. Function effectively within nursing and interdisciplinary teams, fostering open communication, mutual respect, shared decision making, team learning, and development to enhance patient and peer satisfaction and health outcomes of the older adult patient.
    1. Assess the need for interdisciplinary team members.
    2. Provide salient information to interdisciplinary team to facilitate referrals and resources.
    3. Interact with and make suggestions to health team members related to patient needs and improvement of care.
    4. Assess and evaluate role of team members, considering scope of practice.
    5. Participate in resolving conflict in the context of patient care.
  6. Identify, evaluate, and integrate the best current evidence coupled with clinical expertise and consideration of patient preferences, experience and values to make practice decisions for an older adult patient.
    1. Use scholarly and practice resources and methods to obtain evidence.
      1. Differentiate between research and evidence guidelines and clinical opinions.
    2. Involve patient/family and RN when establishing goals and outcomes.
    3. Use hand cleansing and other proven guidelines to prevent and treat infections and other complications.
    4. Participate in implementing universal protocol/boarding passes and time outs prior to procedures.
  7. Use data to monitor the outcomes of care processes, and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems and individual performance, thereby minimizing the risk of harm to older adult patients and providers.
    1. Assess and protect the patient from safety hazards, using QSEN principles.
    2. Articulate and implement measure to prevent infections and complications of hospitalization.
    3. Demonstrate knowledge of Joint Commission National Patient Safety Goals.
    4. Demonstrate knowledge of Quality Improvement indicators, processes, and outcomes at the clinical agency.
  8. Demonstrate accountability for the delivery of standard-based nursing care that is consistent with moral, altruistic, legal, ethical, regulatory, and humanistic principles.
    1. Identify opportunities to advocate for an older adult patient/family.
    2. Identify patient care situations that pose legal/ethical dilemmas for the practicing RN in the care of the older adult.
    3. Examine principles of advance care planning.
    4. Demonstrate retention and proficiency of previously and concurrently acquired theoretical concepts and skills.
    5. Seek proactively and respond professionally to feedback from the instructor and care team members.
  9. Recognize the patient or designee as the source of control and full partner when providing compassionate and coordinated care based on respect for the older adult patient's preferences, needs, and cultural values.
    1. Respect the patient or designee as a full partner in care.
      1. Respect patient preferences for degree of active engagement in care process.
      2. Elicit and encourage expression of patient values, preferences and needs.
    2. Provide compassionate, age- and culturally-appropriate, safe and effective care, considering age-related changes and cognitive status in all aspects of care.
    3. Demonstrate understanding of the concepts of quality of life, pain and suffering, advanced illness management, palliative care, end of life and hospice.
      1. Assess levels of physical and emotional comfort.
      2. Implement and evaluate interventions aimed at improving quality of life, relieving pain and/or improving comfort.
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