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General Information

Course ID (CB01A and CB01B)
NURS D095L
Course Title (CB02)
Complex Health Challenges 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 to the management of nursing care of critically ill clients experiencing complex health challenges and rapid 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 and evidence-based care. The learning experience will be enhanced with clinical simulation and observation activities. Both NURS 95L and NURS 95 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 the 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 to 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 advanced medical-surgical 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 D085L.)

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
4.5
Maximum Credit Units
4.5

Weekly Student Hours

TypeIn ClassOut of Class
Lecture Hours0.00.0
Laboratory Hours14.00.0

Course Student Hours

Course Duration (Weeks)
12.0
Hours per unit divisor
36.0
Course In-Class (Contact) Hours
Lecture
0.0
Laboratory
168.0
Total
168.0
Course Out-of-Class Hours
Lecture
0.0
Laboratory
0.0
NA
0.0
Total
0.0

Prerequisite(s)

NURS D094., NURS D094A, NURS D94AL, and NURS D094L

Corequisite(s)

NURS D095.

Advisory(ies)

Limitation(s) on Enrollment

Entrance Skill(s)

General Course Statement(s)

Methods of Instruction

Demonstration and evaluation of clinical skills in direct patient care

Modeling of clinical nursing behaviors

Discussion of patient condition and nursing interventions

Review of nursing care plan, patient assessment forms and nurses notes

Assignments

  1. Providing care for medical-surgical clients in an acute care setting.
    1. Clients experiencing health deviations discussed in theory
    2. Student to client ratio increasing from one to two unstable clients by the end of the rotation.
  2. Daily care plans.
  3. Patient assessment forms with nurses notes.

Methods of Evaluation

  1. Final clinical evaluation tool with satisfactory performance in all critical element areas to evaluate performance of clinical skills, communicating therapeutically with patient, families and members of the healthcare team and functioning as a member of the team on an advanced medical/surgical unit.
  2. Nursing care plans and patient assessment forms are evaluated per the Standards of Nursing Practice to evaluate student ability to utilize a comprehensive approach to patient assessment, critical analysis of data and planning of safe and appropriate care. Nurses notes are evaluated per the legal standard for documentation.
  3. Successful completion of Nursing 95 within the same quarter is required to pass Nursing 95L.

Essential Student Materials/Essential College Facilities

Essential Student Materials: 
  • Uniform and equipment for medical surgical nursing care
  • Current CPR certification
  • Current health and immunization information
  • Transportation to clinical sites
  • Current background check and drug testing
Essential College Facilities:
  • A current Foothill-°®¶¹´«Ã½ Community College District contract with the affiliated clinical facility on file with the district office
  • Availability for student placement
  • Nursing skills laboratory equipped with supplies/equipment for practice and demonstration

Examples of Primary Texts and References

AuthorTitlePublisherDate/EditionISBN
*Ignatavicius, Workman & Rebar. "Medical Surgical Nursing: Concepts for Interprofessional Collaborative Care", 9th ed. 2018. Elsevier.
Purnell. "Guide to Culturally Competent Health Care". 3rd. edition. 2014. F. A. Davis.
Doenges, Moorhouse & Geissler-Murr. "Nursing Diagnosis Manual", 6th ed. 2019. F.A. Davis.
Van Leeuwen & Bladh. "Davis's Comprehensive handbook of Laboratory and Diagnostic Tests with Nursing Implications", 8th ed. 2019. F.A. Davis.

Examples of Supporting Texts and References

AuthorTitlePublisher
Hospital policy and procedure manuals
Nursing journals with current articles specific to clinical practice and health deviations
Internet (www.medscape.com)
Nursing 95L Course Syllabus-on Canvas site
°®¶¹´«Ã½ College, Department of Nursing Student Handbook, on-line
Drug book with nursing implications
Tomlinson & Ennis. " Pocket IV Drugs", 2012. F.A. Davis.

Learning Outcomes and Objectives

Course Objectives

  • Evaluate complex patient problems or needs and analyze data trends to accurately identify, frame and manage problems within the context of care for critically ill adult patients.
  • Interact effectively with critically ill adult patients, families 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 the critically ill adult patient.
  • Influence the behavior of individuals and groups of individuals, including critically ill 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 critically ill adult.
  • Identify, evaluate, and integrate the best current evidence with clinical expertise and consideration of patient preferences, experience and values to make practice decisions for a critically ill adult patient.
  • Use data to monitor the outcomes of care and examine approaches to improve the quality and safety of health care systems and individual performance, thus minimizing the risk of harm to critically ill patients and providers.
  • Demonstrate accountability for the delivery of standard-based nursing care of a critically ill patient 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 in providing compassionate and coordinated care based on respect for the critically ill patient's preferences, needs and cultural values.

CSLOs

  • Manage the care of adult patients experiencing rapid changes in health status utilizing the nursing process.

  • Provide safe and comprehensive care for two adult patients experiencing complex health challenges.

Outline

  1. Evaluate complex patient problems or needs and analyze data trends to accurately identify, frame and manage problems within the context of care for critically ill adult patients.
    1. Use nursing process to manage care of adult patients experiencing critical health challenges.
    2. Conduct a comprehensive assessment of critically ill adult patients and organize the assessment data to facilitate clinical decision-making.
    3. Utilize the assessment to identify real and potential problems and formulate priorities of care.
    4. Develop and implement the plan of care based on the assessment and identified real and potential problems.
    5. Use data to critically evaluate outcomes of care and modify the plan of care.
  2. Interact effectively with critically ill adult patients, families and staff, fostering mutual respect and shared decision making to enhance patient satisfaction and health outcomes.
    1. Communicate therapeutically with critically ill patients with respect to physical and psychological needs and limitations associated with rapid changes in health status.
    2. Develop and discuss plan of care with patients, families, nurses, assistive personnel and instructor.
    3. Communicate and document pertinent information to nurses, instructor and other healthcare team members in a timely manner and at each transition of care, including handoffs.
    4. Demonstrate accountability and maintain professional integrity in all aspects of the learning process and nursing care.
  3. Use information and technology to communicate, manage knowledge, mitigate error and support decision-making while providing care to the critically ill adult patient.
    1. Use available information technologies to collect assessment data and other relevant information to support clinical decision-making.
    2. Document patient care in a clear and appropriate manner, and in accordance with instructor and clinical agency guidelines.
    3. Use the available technology and information management systems to detect changes in patient status, communicate with other team members and respond to changing care needs and directions.
    4. Utilize scholarly sources and resources provided by clinical agencies to facilitate clinical decision-making.
  4. Influence the behavior of individuals and groups of individuals, including critically ill 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 within own scope of practice.
    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. 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 critically ill adult.
    1. Participate in interdisciplinary care within own scope of practice.
    2. Assess and value role of team members, and critically reflect on own role as a member of the healthcare team.
    3. Provide salient information to interdisciplinary team.
    4. Collaborate with instructor and nurses to identify and suggest referrals.
    5. Evaluate patient outcomes and make recommendations to the interdisciplinary team.
  6. Identify, evaluate, and integrate the best current evidence with clinical expertise and consideration of patient preferences, experience and values to make practice decisions for a critically ill adult patient.
    1. Utilize scholarly and practice resources to identify evidence-based practices.
    2. Involve patient, family and other members of care team when formulating goals of care.
    3. Use established guidelines to prevent and treat infection and other complications.
  7. Use data to monitor the outcomes of care and examine approaches to improve the quality and safety of health care systems and individual performance, thus minimizing the risk of harm to critically ill patients and providers.
    1. Protect the client from safety hazards, using QSEN principles.
    2. Articulate and implement measures to prevent infections and other iatrogenic problems and complications.
    3. Complete care in a timely manner.
    4. Demonstrate knowledge of Joint Commission National Patient Safety Goals and quality improvement indicators.
  8. Demonstrate accountability for the delivery of standard-based nursing care of a critically ill patient that is consistent with moral, altruistic, legal, ethical, regulatory, and humanistic principles.
    1. Advocate for the patient and family members within own scope of practice.
    2. Identify and critically reflect on legal and ethical issues affecting professional nursing practice in the context of care for critically ill adult patients.
    3. Proactively seek and respond professionally to feedback from the instructor and care team members.
    4. Demonstrate retention and proficiency of previously and concurrently learned knowledge and skills.
  9. Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for the critically ill patient's preferences, needs and cultural values.
    1. Treat the patient, patient designee and family members as partners in care.
    2. Integrate patient preferences, experiences and values when planning and implementing care.
    3. Provide compassionate, age-appropriate and culturally-congruent care.
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