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THE OHIO STATE UNIVERSITY

COLLEGE OF NURSINGNursing 6410

Health AssessmentSummer Semester 2014

3 Credit hours

Course Faculty:

Coursehead: Margaret Clark Graham, PhD, CRNP, FAANP, FAAN344 Newton [email protected] Class lecture Monday 8:30 AM

12:15 PM (June 16th class will start at 9:15am due to Lighting the Lamp ceremony)

Clinical faculty: Kristina Skinner, MS, RN, BC, CMSRN Thursday and Friday Lab111 Newton [email protected]

Melody Thomas, MS, RN, PCCN Wednesday and Thursday Lab377 Netwon [email protected]

Sinead Yarberry, MS, RN, AOCNS Tuesday and Wednesday Lab377 Newton [email protected]

Prerequisite: Enrollment in the graduate entry program

Course Description Introduction to the foundational health assessment concepts of nursing and the assessment skills required in the provision of nursing care.

The AACN Essentials of Baccalaureate Education for Professional Nursing Practice

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(1998, 2008) were used to guide course development.

Course Objectives: At the completion of this course, the student will be able to:1. Utilize interview skills in obtaining a health history across the lifespan.2. Demonstrate health assessment skills across the lifespan.3. Differentiate between normal and abnormal data regarding the health status of selected individuals. 4. Use written and verbal communication techniques to report history and physical findings.5. Apply beginning clinical judgment to the assessment of individuals.

Conduct of the course: This course is taught through lecture and lab. Lecture is held once a week on Monday 8:30 AM – 12:15 PM. Lab is once a week and is a 4 hour session in 082 Newton Hall.

Required Texts:Ball, J. (2014). Seidel’s Guide to Physical Examination (8th ed.). St. Louis: Mosby. ISBN-13: 978-0323112406Jarvis, C. (2012). Jarvis Student Laboratory Manual, Physical Examination & Heatlh Assessment, 6 th Edition. ISBN-13: 000-1437701515Ball, J. (2014). Seidel’s Physical Exam Handbook (8th ed.) St. Louis: Mosby. ISBN-13: 978-0323169530 Required Equipment:Littman Classic II stethoscopeBlood pressure cuffPenlight with AAA batteriesClear centimeter rulerReflex hammerClipboard (optional)

Evaluation:A student will earn one grade for the course based on performance in classroom, discussion, and in laboratory experiences. All components of the course must be completed to successfully pass the course. Student performance will be evaluated by:Quizzes……………………………20% Lab Write-ups …………………25%Midterm Exam…………….....25%Final Exam……………………...30%

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The lab evaluation is a recorded complete physicial exam. You must pass the complete physical exam with a score of 80 percent to pass the course. You must have an average of 80 percent or greater on the quizzes, two written exams and lab write ups to pass the course. Unsatisfactory laboratory or classroom performance will result in an E in the course.

Grade Equivalents:

A 93-100% B 83-86% C 73-76% D 60-66%A- 90-93% B- 80-82% C- 70-72% E 59% and B+ 87-89% C+ 77-79% D+ 67-69% below

ASSESSMENT REPORTS or WRITE UPS 25%: At the end of each lab (or subject to the lab instructor’s discretion), you will be assigned a SOAP note. The SOAP note will be submitted to your lab instructor via the Carmen drop box. The write up should be organized, pertinent and similar to what would appear in a patient's chart. Use only acceptable abbreviations posted on the Carmen Content page. Use correct spelling and medically appropriate terminology. Your lab faculty will advise you on the criteria for the SOAP note.

Midterm Exam 25% July 7A midterm exam will be given on July 7 during class time starting at 8:30 AM. The exam will be an objective short answer exam consisting of multiple choice and matching questions. Exam questions will be based on lecture material, assigned reading, lab experiences and class discussions. You will be allowed 60 minutes to complete the exam 80% of your exam grade will come from your individual effort. During the second hour of class, you will be randomly assigned to a group of approximately five students and you will be given 60 minutes to work in groups to retake the exam. Your grade on the retake will count 20% of the midterm.If you miss the exam due to illness or other excused reason, you will be given a make-up exam but there will be no opportunity to retake the exam with a group, 100% of your score will be based on your individual effort. Please review the Test Policy included in the syllabus. The Test Policies will be strictly followed.

Quizzes 20%During weeks 2, 3, 6, and 7 you will have a quiz the beginning of the class time. The quizzes will be will be objective short answer questions consisting of multiple choice, matching and true false questions. The quizzes will be given during the first fifteen minutes of class and will cover information from the

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previous week’s lecture, labs and readings. If you have an excused absence and miss a quiz, your quiz grade will be averaged among the 3 remaining quizzes. If you have an unexcused absence, your quiz grade for that date will be a zero.

Final Written Exam 30%A final comprehensive exam will be given on Aug 4, 8:00 AM – 9:45 AM. The exam will be an objective short answer exam consisting of multiple choice, matching and true false questions. Exam questions will be based on lecture material, assigned reading, lab experiences and class discussions. You will be allowed 75 minutes to complete the exam 90% of your exam grade will come from your individual effort. During the remaining 60 minutes of class, you will be randomly assigned to a group of approximately five students and you will be given 45 minutes to work in groups to retake the exam. Your grade on the retake will count 10% of the final exam grade.If you miss the exam due to illness or other excused reason, you will be given a make-up exam but there will be no opportunity to retake the exam with a group, 100% of your score will be based on your individual effort. Please review the Test Policy included in the syllabus. The Test Policies will be strictly followed

Clinical Lab Expectations

Clinical lab, is held in the TLC Room 082 Newton Hall every week. The clinical laboratory component is a supervised experience. You will meet in 082 clinical laboratory at your assigned lab time. Lab is 4 hours in length. You are required to attend all laboratory sessions and come to laboratory sessions prepared for class.You will practice assessment techniques on fellow classmates. You are expected to meet the professional behaviors outlined on Carmen.

You are expected to wear your red scrubs and medical center ID to lab. Please follow the Student Handbook for the specific requirments for dresscode for clinical lab.

Therapeutic Communication Checkoff Pass/Fail

Normal Physical Exam P/FYou are required to do a physical exam the seventh week of the semester. The elements of the physical required and grading criteria are included on Carmen. You will examine a classmate assigned by your lab faculty. You (the examiner) should give the person being examined instructions, e.g., follow my finger, look straight ahead, turn your head and swallow, etc. The majority of the time you will be stating what they are assessing, the procedure being used, and your findings. You will not be graded on your therapeutic communication in this assignment, you are being graded on your ability to perform the skills included in a normal physical exam. The examination must take no longer than 30 minutes and must

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include all of the elements in the checklist included in this syllabus. Students will be given an additional 10 minutes to demonstrate on videotape any exam technique that was not included or that was performed incorrectly in the original 30-minute videotape. The total video with corrections may not exceed 40 minutes. Points will be deducted if you perform physical assessment over the patient’s clothes.

You will be required to perform your PE in 082 lab. A schedule will be posted on Carmen with the time for your assessment.

A grade of 80% is required to pass the normal physical exam assignment. Failure to achieve 80% pass rate will result in an E for the course grade.

Computer Based Learning (CBL) and IHIS Modules Pass/FPlease see the document on Carmen regarding the mandatory CBL and IHIS modules that must be completed before entering a hospital clinical setting. Transcript due to the Carmen drop box July 21 st 2359

Carmen Online Technical Information:

Web-based components of this course will use The Ohio State University’s course management system, Carmen. Access to this course will require a username and password. Access N6410 at: https://carmen.osu.edu (the same password used to enroll for classes at the Registrar’s website). Carmen requires the use of your UNIVERSITY login and password. Information concerning your University email and login account can be found at https://acctmgt.service.ohio-state.edu/.

As part of Carmen, your homepage after you log in will reflect all courses that you are taking across the University. 24 hour technical support can be reached at: Carmen/TELR - Phone: 614-688-4357 (688-HELP) or through the Carmen Help Web page at: https://telr.osu.edu/carmen/help/index.htm

Course content will be available via Carmen. Grades will be posted via Carmen.

TEST POLICYTesting policies to be followed by all students and faculty for quizzes and tests. Student responsibilities: (Exceptions may be made by faculty discretion.) 1. No late entry into quizzes or exams.2. For the exams, books, backpacks, purses should be placed in the front of the room until you are ready to take Part B of the Exam. For quizzes, books and other belongings may be at your seat but must be stowed underneath your seat until your quiz is turned in.

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3. No cell phones or other communication devices may be used during the exams or quizzes.3. Hats may not be worn or be in student’s possession during the exam or quizzes unless it is a pre approved religious headcovering.4. You may not leave the room when the exam or quiz is in progress. If you leave the classroom the exam must be turned in to the proctor.5. If you are caught cheating during an exam or quiz, you will receive a grade of 0 on the exam/quiz and may receive a failure for the course. Academic misconduct charges for cheating will be filed against you.

Video ServerInstructional videos can be viewed from any Windows computer on campus. The instructions to access the server follow:

College of Nursing Streaming Media Instructions Go to http://nucleus.con.ohio-state.edu in your web browserSelect “Adult Health” After you make this selection, you will be prompted for your OSUCON login.Logon using your College of Nursing username and password:Please Note: Username will need to be entered in one of these two ways: Students: OSUCON\lastname_# (example: OSUCON\jordan_23) Faculty: OSUCON\firstinitiallastname (example: OSUCON\alincoln) Passwords are entered normally.

The Bates Assessment videos and the OSU videos will be found under the Adult Health. Additional videos will be assigned throughout the summer term.

Need Help? There are some links on the right side of the page to help you locate Media Player updates or to install Windows Media support for Mac users. There is also a link to the e-mail address: [email protected] where all support questions should be directed.

Students with Disabilities:Students requesting accommodation for disability for classroom needs are responsible for notifying Dr. Graham by the end of the first week of the semester to discuss specific needs. Self-identification is the only way to assure that the faculty member can make the appropriate accommodation. Students should provide a letter from the Office for Disability Services (150 Pomerene Hall, 1760 Neil Avenue; (614) 292-3307; TDD: (614) 292-0901) to verify the disability.

Students needing accommodation for temporary physical disabilities or health related reasons should contact Dr. Graham in order to discuss placement options. Students must be able to perform all job functions as required by the clinical placement site. Students may be asked to provide the Dr. Graham with a letter from their physician indicating physical restrictions or limitations.

Academic and Professional Misconduct:

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Students are subject to the provisions in the “Code of Student Conduct” (copies located in: Student Affairs, Room 240 Newton Hall, Office of Student Life, Room 464 Ohio Union or online at http://studentaffairs.osu.edu/resource_csc.asp.) and also the Professional Standards (The OSU CON Student Handbook). Any action taken by a student that gives that student an unfair advantage over members of the class will be handled as academic and/or professional misconduct. Failure to comply with these policies will be handled as outlined in the respective documents.

Cell Phone E-transmission and Privacy Policy:The use of cell phones is prohibited during class/seminar/clinical with the exception of break times. Students who need to have a cell phone on for emergency purposes should discuss the issue with the designated faculty course head. Students found in violation of this policy should be aware faculty has the option of lowering the course grade and/or reporting the violation to the academic/professional misconduct committee chair. Taking pictures of the College of Nursing/College of Nursing property, clinical sites, and patients using ANY device are prohibited without the written consent of the institution and all parties involved.Please be aware that electronic transmission of data related to patient specific identifiers and student to student health information obtained in physical assessment labs with student identifiers is a violation of HIPAA.

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Course Content and Reading Assignments:

WEEK: TOPIC: READINGS: Text and Lab Manual

Week 1June 16 - 20

I. Critical Thinking in Health AssessmentII. Assessment TechniquesIII. General Survey:

A. Subjective dataB. Objective data

1. Lifespan considerations2. Cultural considerations

C. DocumentationD. Critical thinking

Seidel:▪ Chapter 3, Examination Techniques and Equipment,▪ Chapter 5, Mental Status,

I. Interpretation of Abnormal Vital Signs: Growth and Measurement

A. Objective data1. Lifespan considerations2. Cultural considerations

B. DocumentationC. Critical thinking

Seidel:▪ Chapter 4 Vital Signs and Pain Assessment

Seidel Handbook:▪ Chapter 2 Vital Signs and Pain Assessment

Jarvis Lab Manual (optional):▪Chapter 9 General Survey, Measurement, Vital Signs▪ Chapter 10 Pain Assessment: The Fifth Vital Sign

I. Health History and DocumentationA. Interviewing techniquesB. Interviewing people with special

needsC. The complete health historyD. Documentation

Seidel:▪ Chapter 1, The History and Interviewing Process▪ Chapter 26, Recording Information

Seidel Handbook:▪ Chapter 1 The History

Jarvis Lab Manual (optional):▪Chapters 1-7

LAB ● General survey, vital sign competency check-off, obtaining a health history

Jarvis: Will complete pages 27-34; 41-42; 63-64 in lab

Week 2June 23 - 27

I. Assessment of the Skin, Hair and NailsA. Subjective data

Seidel:▪ Chapter 8, Skin, Hair and Nails

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Quiz 1 B. Objective data1. Lifespan considerations2. Cultural considerations

C. Common problems of the integumentary system

D. DocumentationE. Critical thinking

Seidel Handbook:▪ Chapter 5 Skin, Hair, Nails

Jarvis Lab Manual (optional):▪Chapter 12 Skin, Hair, Nails

I. Assessment of the Heart and Great Vessels



C. Common problems of the cardiac system


Seidel:▪ Chapter 14, Heart, pp. 294-313▪ Chapter 15, Blood Vessels pp 332-345

Bates Physical Assessment Videos:▪ Cardiovascular Neck and Heart 01-08▪ Cardiovascular Peripheral Vascular System 01-05

Seidel Handbook:▪ Chapter 11 Heart▪ Chapter 12 Blood Vessels

Jarvis Lab Manual (optional):▪Chapter 19 Heart and Neck Vessels

I. Assessment of the Peripheral Vascular System:



C. Common problems of the peripheral vascular system


Seidel:▪ Chapter 9, Lymphatic System, pp.166-177▪ Chapter 15, Blood Vessels, pp. 332-345

Bates Physical Assessment Videos:▪ Cardiovascular Peripheral Vascular System 01-05

Seidel Handbook:▪ Chapter 6 Lymphatic System▪ Chapter 12 Blood Vessels

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Jarvis Lab Manual (optional):▪ Chapter 13 Head, Face, Neck including Regional Lymphatics▪ Chapter 20 Peripheral Vascular System and Lymphatic System

LAB ● Assessment of the skin, hair, and nails, and documentation

● Assessment of the heart and great vessels, peripheral vascular systems and documentation

Jarvis: Will complete pages 89-90; 171-172; 181-182 in lab

Week 3June 30 –July 3Quiz 2

No Lab on July4. Students in Friday lab will have lab on Tuesday July 1. If you are in AM lab, you will attend lab in the AM on July 1 and if you are in PM lab on Friday, you will attend the PM lab on July 1.

I. Assessment of the Gastrointestinal and Genitourinary System



C. Common problems of the gastrointestinal and genitourinary system


I. Assessment of the thorax and lungsA. Subjective dataB. Objective data


C. Common problems of the thorax and lungs


Seidel:▪ Chapter 17 Abdomen pp 370-398

Bates Physical Assessment Videos:● Abdomen 01-09

Seidel Handbook:▪ Chapter 14 Abdomen

Jarvis Lab Manual (optional):▪ Chapter 21 Abdomen

Seidel:▪ Chapter 13 Chest and Lungs, pp. 260-282

Bates Physical Assessment Videos:▪ Thorax and Lungs 01-11

Seidel Handbook:▪ Chapter 10 Chest and Lungs

Jarvis Lab Manual (optional):▪ Chapter 18 Thorax and Lungs

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LAB ● Assessment of abdomen and documentation● Assessment of the thorax and lungs and

documentation

Jarvis: Will complete pages 157-158; 195-196 in lab

Week 4July 7 - 11Midterm Exam

I. Midterm Exam Content from week 1 through end of week 3

Lab Therapeutic Communication Check off Lab check offsWeek 5July 14 - 17

I. Assessment of the neurological systemA. Subjective dataB. Objective data


C. Common problems of the neurological system


Seidel:▪ Chapter 22, Neurological System

Bates Physical Assessment Videos:▪ Neurological Cranieal Nerves and Sensory System 01-11▪ Neurological Motor System and Reflexes 01-09

Seidel Handbook:▪ Chapter 19 Neurological System

Jarvis Lab Manual (optional):▪ Chapter 23 Neurological system

I. Assessment of the head, ears, and eyesA. Subjective dataB. Objective data


C. Common problems of the head, ears, and eyesD. DocumentationE. Critical thinking

▪ Chapter 11, Eyes, pp.204-222.▪ Chapter 12, Ears, Nose and Throat, pp. 231-253

Bates Physical Assessment Videos:▪ Head Eyes and Ears 01-09

Seidel Handbook:▪ Chapter 8 Eyes▪ Chapter 9 Ears, Nose and Throat

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Jarvis Lab Manual (optional):▪ Chapter 14 Eyes▪ Chapter 15 Ears▪ Chapter 16 Nose, Mouth and Throat

I. Assessment of the mouth, throat, and neck



C. Common problems of the mouth, throat, and neckD. DocumentationE. Critical thinking

▪ Chapter 9, Lymphatic System, review lymph nodes of the neck▪ Chapter 10, Head and Neck, pp. 184-197.

Bates Physical Assessment Videos:▪ Nose Mouth and Neck 01-05

Seidel Handbook:▪ Chapter 6 Lymphatic System▪ Chapter 7 Head and Neck

Jarvis Lab Manual (optional):▪ Chapter 13 Head, Face, Neck, Including Regional Lymphatics▪ Chapter 19 Heart and Neck Vessels▪ Chapter 20 Peripheral Vascular System and Lymphatic System

LAB ● Assessment of the neurological system and documentation

● Assessment of the Ear, Eye, Nose, Mouth, Throat, and Neck and documentation

Jarvis: Will complete pages 113-114; 123-124; 133-134; 221-222; in lab

Week 6July 21 - 24Quiz 3

I. Assessment of the musculoskeletal system



C. Common problems of the musculoskeletal system


Seidel:▪ Chapter 21, Musculoskeletal pp.501-534▪ Chapter 23, Sports Participation Evaluation

Bates Physical Assessment Videos:▪ Musculoskeletal System 01-10

Seidel Handbook:

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▪ Chapter 18 Musculoskeletal System▪ Chapter 24 Sports Participation Evaluation

Jarvis Lab Manual (optional):▪ Chapter 22 Musculoskeletal System

LAB ● Assessment of musculoskeletal system● Practice/Review for head to toe exam● Practice Accucheck● Practice Isolation Procedures

Submit Completed CBL transcript to Carmen drop box by Monday July 21st 2359

Jarvis: Will complete pages 205-207 in lab

Mosby’s Nursing Video Skills:Basic Infection Control- Using Personal Protective Equipment

Week 7July 28 - 31Quiz 4

I. Assessment of the reproductive system, breast and testicular exam



C. Common problems of the reproductive system, breast and testicular exam


Seidel:▪ Chapter 16, Breasts and Axillae, pp.350-364▪ Chapter 18, Female Genitalia, pp. 416-449.▪ Chapter 19, Male Genitalia, pp.466-475▪ Chapter 20, Anus, Rectum and Prostate pp. 485-493

Bates Physical Assessment Videos:▪ Female Genitalia Anus and Rectum 01-07▪ Male Genitalia Recum and Hernias 01-07

Seidel Handbook:▪ Chapter 13 Breast and Axillae▪ Chapter 15 Female Genitalia▪ Chapter 16 Male Genitalia

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▪ Chapter 17 Anus, Rectum and Prostate

Jarvis Lab Manual (optional):▪ Chapter 17 Breasts and Regional Lymphatics▪ Chapter 26 Female Genitourinary System▪ Chapter 24 Male Genitourinary System▪ Chapter 25 Anus, Rectum, and Prostate

Lab Record Assessment Competency Video Seidel:▪ Chapter 24, Putting It All Together

Week 8Aug 4 8:00 – 9:45 AM

Theory: FINAL EXAM Cumulative

Panopto

Panopto is the College of Nursing’s lecture capture solution. It is utilized to record the in-class lectures in many nursing courses for students to refer to as a study aid and also provides supplemental or asynchronous materials to students. If your class will be utilizing Panopto, the appropriate links and instructions will be placed in the Carmen Content Page for your course. Panopto is used in a majority of courses, so it is important that you test and verify functionality of playback with your system before classes begin. Some instructors permit students to download Video or Audio podcasts of their lectures to the mobile devices, also accessible through a course’s Panopto link. For technical information and sample recording to test playback performance, see the IT Support section below.

Unbound Medicine

Unbound Medicine is software provided through the College of Nursing Technology Fee to students. It includes several reference resources and interactive tools that you will be required to utilize in clinical. Unbound Medicine uCentral software, which includes 5-Minute Clinical Consult, Davis's Drug Guide, Bright Futures, Drug Interaction Facts, Evidence-Based Medicine Guidelines, Pocket Guide to Diagnostic Tests, Red Book and Taber's. For more information see http://nursing.osu.edu/mobile

iSWAT

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The Interactive Simulation Watching and Training system is utilized to record simulations, physical exams and faculty created demonstration. The iSWAT system is installed in room 082, the advanced physical assessment laboratory. iSWAT will provide students and faculty with recordings of activities that occur in room 082 and allow them to be watched securely over the web for teaching, grading and self-evaluation purposes. For technical information and sample recording to test playback performance, see the IT Support section below.

College of Nursing IT Support

For technical support and system requirements for these and other systems you will use while enrolled at the College of Nursing, please visit the College of Nursing Technology Guide at http://go.osu.edu/techguide or e-mail [email protected]

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