College of Nursing

UNIVERSITY OF CENTRAL FLORIDACOLLEGE OF NURSING

Fall 2012

Course Number: NGR 6941

Course Title: Advanced Practice Practicum

Credit Hours: 3 (180 clinical hours)

Prerequisites or Co-requisites: Graduate Standing and Admission to the Graduate MSN or DNP AGNP or FNP Program

Mode of Delivery: WWW, Clinical Experience and Live Meeting Sessions

Faculty Christopher W. Blackwell, Ph.D., ARNP, ANP-BC, CNEAssociate Professor and Coordinator of Nurse Practitioner ProgramsOffice: UT: 453 (hours by appt.)Call (407) 823-2744 to schedule an appt.Office Phone: (407) 823-2517Personal Cellular Phone: (407) 375-4334christopher.blackwell@ucf.edu

Catalog Description: Supervised advanced clinical practice in the role of the nursepractitioner in an individualized preceptorship.

Purpose: To finalize the clinical mastery of entry-level NP practice, begin preparation for Board-certification in the NP role, and demonstrate competency in the ability to manage patient care at the advanced nursing practice level in a safe and appropriate manner.

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Course Objectives: Upon completion of this course the student will:

1. Demonstrate competence in the role of the nurse practitioner in collaborative interdisciplinary relationships;2. Analyze professional, theoretical, cultural, legal, and ethical issues in the provision of nurse practitioner services;3. Deliver comprehensive nurse practitioner services appropriate to the health care needs of clients in selected primary health care settings;4. Develop a public presentation of community project.

Teaching/Learning Strategies:

Clinical practice with a preceptor in primary care practice, written documentation, review of client cases with faculty and peers, focused reading based on clinical problems encountered in practice, and preparation for Board-certification using practice examinations and diagnostic examination evaluation. Clinical practice should occur over at least 2/3 of the semester.

Required Diagnostic Readiness Testing Purchases: Students are required to purchase the DRT testing program from Barkley & Associates or from Advanced Practice Education Associates. The program selected will depend on availability. The cost of the Barkley & Associated program is $39.95. The APEA program is $31.95 for each exam ($63.90). Students will need to purchase the selected program on the day of the live class (see course schedule) via credit card.

Distribution of Clinical Hours:

The following may be listed as clinical hours by NP students:

Community Project: (15) ONLY if students have not or will not take NGR 6242L and ONLY if students have not listed 15 hours for the community project in a prior NGR6941 course.

On-line post conferences (5 hours per semester) Live Meeting Sessions (5 hours total)

BSN-DNP: 3 credits = 180 clinical hours

Documentation of Clinical Hours: All clinical experiences, hours, clinical summaries, etc. must be documented through the Typhon system.

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Clinical Preparation and Attendance When you go to the clinical site be sure you have:

A good stethoscope Reflex hammer Ruler Black Ink pen and notebook Other tools appropriate to the site (e.g.Pregancy wheel if in women's health) Resources covering: health promotion of adults across the lifespan, a drug

prescribing guide, health assessment guide, and text or protocol book for specific clinical setting (probably an electronic-based program on an iPhone or Android device)

All students are expected to prepare for each clinical experience by reading on the types of clients you expect to see. Reading after each clinical experience to review new information and expand learning is encouraged. Students are expected to be present at the clinical site on the dates and on the times scheduled with the preceptor and reported to clinical faculty.

Course Schedule

Date Content AssignmentAug 20, 2012 UCF Classes BeginAug 23, 2012 Last to Drop/Swap Classes for

Full Refund (11:59 PM)Aug 20, 2012 Students may officially

begin clinical rotations.Make sure Dr. Blackwell and Clinical Instructor have a copy of your clinical schedule for the semester by the start of clinicals.

Aug 27, 2012 Clinical Rotations None Specific.Sep 3, 2012 Clinical Rotations None Specific.Sep 10, 2012 First Live Post-

Conference Session on Sep 14, 2012.

UT: 434:1300-1500:FNP or ANP Board Certification Pre-Test1500-1600: Exam de-briefing1600-1630: Clinical discussion

Sep 17, 2012 Clinical Rotations SOAP #1 Post and Response Due by 2355 on 9/23/12.

Sep 24, 2012 Clinical Rotations None Specific.Oct 1, 2012 Clinical Rotations None Specific.Oct 8, 2012 Clinical Rotations None Specific.Oct 15, 2012 Clinical Rotations None Specific.

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Oct 22, 2012 Clinical Rotations SOAP #2 Post and Response Due by 2355 on 10/28/12.

Oct 29, 2012 Clinical Rotations None Specific.Nov 5, 2012 Clinical Rotations None Specific.Nov 12, 2012 Clinical Rotations None Specific.Nov 19, 2012 Clinical Rotations SOAP #3 Post and Response

Due by 2355 on 11/25/12.Nov 26, 2012 Clinical Rotations None Specfic.Dec 3, 2012 Second Live Post-

Conference Session

*All Clinical Rotations must be completed by 12/2/12.

* All documents (see below) must be submitted by 2355 on 12/2/12.

All documents (see below) must be submitted no later than 2355 on August 3, 2012.UT: 434:1300-1500:FNP or ANP Board Certification Post-Test1500-1600: Exam de-briefing1600-1630: Clinical discussion

Evaluation Methods

1. 3 SOAP Posts/Responses S/U2. Completion of Clinical Hours S/U3. Preceptor Evaluation of Performance S/U4. Faculty Evaluation of Performance S/U5. Completion of Site Evaluation S/U6. Attendance at ALL live sessions S/U7. Completion of Pre- and Post- Board Certification Examinations S/U8. Complete documentation of clinical data in Typhon Reporting System S/U

S/U*/**

Grading System: Student must earn a satisfactory grade on all items 1-8 above to receive an overall Satisfactory grade in the course.

*/** Unacceptable, non-passing grades:

** - Not acceptable for progression in the Master of Science in Nursing or DNP Program.

*** All assignments are due on their noted DUE DATE. Late assignments will be significantly penalized. It is recognized that a student may have an emergency -

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students may request an extension for an assignment.  Extensions are negotiated individually. Vacations are not acceptable reasons for late assignments - students will need to make provisions for web access. Web Courses assignments are due at Midnight of Due Date.**

Summary of Assignments

Live Sessions Attendance: Students must plan to attend BOTH live sessions of the practicum course. The purpose of these live sessions is to administer the Barkley DRT NP Board Certification Examination Preparation Program in addition to discussing topics related to practice transition and current practicum clinical experiences. See the course schedule for the dates and times of the live sessions. Absence from either session will result in failure in the course.

SOAP Notes: Students must complete the required number of SOAP notes for the course and these notes must be submitted by the due date and time. Failure to submit any SOAP notes or unacceptable documentation of the SOAP notes will result in failure in the course.

Instructions for SOAP Notes:

Do not put any identifying data on the client in the SOAP. In general, this means no client, preceptor, or practice names and the use of initials different from the client's initials.

Be sure the Subjective contains only subjective data, the objective only objective data, the assessments (diagnoses or symptoms) are all supported by the subjective and objective data, and the plan is clearly related to the assessments and the specific client situation. This includes clear indication of all laboratory and diagnostic tests being done either at or after the visit, health promotion and disease prevention activities, referrals, consultations, and patient education.

The SOAP should provide all data needed for another provider to follow you, know what has been done, and continue the plan of care. These will be longer than those you would write in the practice because they are being used for teaching and learning not simply documentation of care.

Each SOAP should be independently written. Do not use a template or cut and paste from another source (e.g. an EMR or a sample SOAP in class notes or a text.) SOAP notes based on a template or similar document will not be counted. Each SOAP should be independently written. Do not use a template or cut and paste from another source (e.g. an EMR or a sample SOAP in class notes or a text.) SOAP notes based on a template or similar document will not be counted.

Each SOAP posting must be from a clinical experience this semester and can not be one posted for a concurrent or prior course.

S (CC, HPI (OLD CART), PMH, FH, SH, ROS)O – PE and any labs at visit, results of any assessment tools

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A (must be supported by S and O above; should include health promotion and chronic disease management if relevant to this client)P  (must be related to each A item). Should include patient education and other items listed above

Each SOAP should be independently written. Do not use a template or cut and paste from another source (e.g. an EMR or a sample SOAP in class notes or a text.) SOAP notes based on a template or similar document will not be counted. To ensure you address all problems, put the plan for each diagnosis or health promotion/ maintenance item next to the diagnosis or health /promotion item. Since some interventions (e.g. doing a CMP) may be related to two diagnoses (e.g. HTN and Type 2 DM) you may need to list them twice.

Students in pediatric clinical sites should also include development assessment, anticipatory guidance and other SOAP components unique to the care of children.

Medication orders must include the drug name (generic or brand), route, dose, number of pills or volume or amount per dose (as applicable), specific amount of medication to be dispensed (e.g. number of pills), and number of refills.

After the SOAP the student should briefly address topics such as ethical concerns, the impact of culture on this client’s care, facilitators and barriers to care, genomics, epidemiology, and/ or financial , health promotion, and/or access to care  issues as applicable to the case

The student should then pose at least two questions related to the case e.g. "We decided on giving Ampicillin but were thinking that Cipro may have been a better choice, what do you think?" or "We were really concerned she could not get the MRI because of fear. How would you have handled it?"

Both the initial postings and all responses should reflect use of evidence-based clinical resources to allow fuller exploration of the issues or problems being raised. Give sources using as much APA style as possible in a webcourses post. Be sure to indicate the type of citation according to the code below. It is expected most resources will be levels 1 – 5.

Students must reply to questions from instructors and group members regarding their postings and be an active participant in the resultant discussion as long as there are posts related to each of their SOAPs.

All postings should be thoughtful so that participants can learn as a result of the discussion. Self-reflection on performance as a future NP (e.g. what you see that you could have done different/better OR how you might better prepare in the future) is encouraged

All subsequent postings related to a particular SOAP should be in response to an existing thread for that SOAP. (This will keep all the discussions on each case together.) Do not respond using the create a new message tab.

Postings with little substance (“great job”) may be deleted. SOAP notes are due by the dates listed above.

No SOAPS or responses can be a simple cut and paste information of material obtained elsewhere (e.g. on the web, in a course text, from a journal

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article). Paraphrase unless the material MUST be quoted (e.g. to show a tool.) If the original source has a lot in it that other students would want to read, the readers can go to the URL of the on-line source that should be in the reference, (Be sure the URL works!!)

Required Documentation:

Each item MUST be verified by clinical instructor prior to a student receiving a Satisfactory grade:

Required Clinical Item Date of Completion

Grade Assigned: Satisfactory/ Unsatisfactory and Any Additional Comments

Completion of Clinical HoursEvaluation of Clinical Performance (Faculty)Mid-Term Evaluation of Clinical Performance (Preceptor)Evaluation of Clinical Performance (Preceptor)Evaluation of Clinical Site by StudentSOAP #1SOAP #2SOAP #3

Required Typhon Entry and Completion: All clinical data that are required for completion of the system must be submitted through the Typhon Data Management System. Students who fail to document all required clinical information through the Typhon System will receive an Unsatisfactory grade in the course.

Barkley& Associates or APEA Diagnostic Readiness Testing: This course will utilize the Barkley Diagnostic Readiness Testing Program or the Advanced Practice Education Associated Testing Program. This program is designed to assess students’ readiness to successfully pass the Board-Certification examinations for Family Nurse Practitioners and Adult-Geriatric Nurse Practitioners. The program consists of a pre-test and post-test, both of which provide diagnostic information related to the students’ performance on the exam. The diagnostic information details which content area(s) students need to focus on to successfully pass the exam and an overall examination score to help determine if the student would pass or fail their Board Certification examination. In addition, a comparison analysis between the pre-test and post-test is provided through Barkley & Associates. Students also have the ability to review the test items, correct answers, and rationales for incorrect answers. The cost of the program is $39.95 (Barkley &

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Associates) or $31.95 ($63.90) and directions will be provided at the start of the semester on how to register for the program and make the proper payment.

Access to the WebCourses Site

Required On-line Resources:

1) WebCourses Course Site: WebCourses will be used for communication of class announcements and correspondence between faculty and students and among class members. In addition, the WebCourses will be used for lecture enhancements, discussions, etc. To send a note to the faculty member, choose class mail and choose my name or instructor. This note will go only to the faculty member the reply will go only to the student who wrote the initial question. To send a note to the whole class (e.g. to ask for clarification on a class topic, a question about the paper etc) use the bulletin board/forum section so the note and answer will go to everyone.

WHAT IS MY NID?The NID is the “Network ID” used to identify UCF students to several central

computing systems for LAN access (public computer labs), email and web pages (Pegasus) and WebCourses for web classes. The NID will be the same for each system but the passwords for each system are maintained by each separate system.

The format of the NID is:ffnnnnnn

where ‘ff’ is the first two letter of the student’s first name (lowercase), and ‘nnnnnn’ is a six-digit number that is randomly generated. If only one character for the first name is available, that character will be duplicated for the two letters.

The format of the default (initial) password of the NID is:

PYYMMDD

where ‘P’ is the letter ‘P’ (uppercase) and the remaining information is your birthdate in ‘YY’ (year) ‘MM’ (month) and ‘DD’ (day) format. You will be able to obtain the NID from the main PeopleSoft logon screen in the near future.

For example, if a student’s first name is Jim, his birthday is April 19, 1980, and his random number is 500241 then his NID information would be:

NID: ji500241

Password: P800419Note: You will need to register for this course:

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Student Self-Registrationfor

Nursing – Preparation for Professional Practice (NGR 6941: Practicum)

Warning: Your NID password is scrambled at the end of each term. You may reset your password from the https://webcourses.ucf.edu URL. Click on the “changing your NID password” link immediately below the Log In box. You will NEED your UCF ID card to reset your password.

Here are the instructions for students to register in the Nursing - Clinical Placement Planning webcourses course.

This has replaced ngrclinic site on WebCT

1. Go to: https://webcourses.ucf.edu2. DO NOT LOG IN: instead look at the bottom of the left column for Course List.

Click on the blue underlined “Course List.”3. For the Nursing – Preparation for Professional Practice website, click on the

following series of links to find the course: DO NOT CLICK ON College of Nursing at this point, instead click on:

4. Special Programs, then5. Student Support ; then6. Student Support (that is correct, two different screens)7. Next, click on the green arrow before the word Nursing to see the list of courses

available to nursing students. You get a menu list;8. Look for the “Nursing - Preparation for Professional Practice” course and

click on the self-registration image: Here is a picture of that image:

9. A window will open to register for the course. Enter your NID and password. Then, click “Register” button.

a. Warning: Your NID password is scrambled at the end of each term. You may reset your password from the https://webcourses.ucf.edu URL. Click on the “changing your NID password” link immediately below the Log In box. You will NEED your UCF ID card to reset your password.

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Communication Protocols

Communication with faculty will occur in three ways.

Course mail should be used for private questions. The Clinical Planning discussion forum should be used to notify the instructor of

the dates and times you will be at your clinical site.semester")

If a date is listed, you must go to clinical that date unless you notify your preceptor and have contacted your faculty member before the start of the day. While a need to cancel due to illness, family emergency, and changes in the preceptor's schedule is recognized, repeated cancelations or changes in schedule could be a reason for a failure in the clinical course.

If the clinical faculty has confirmed a site visit you must be present that date unless you have confirmed a new date with your clinical instructor. Failure to do this may mandate an additional clinical date for the site visit. Please notify your preceptor and the office manager (or other person the preceptor suggests) of the date(s) the faculty member will be at the site in advance of their visit.

The SOAP Note discussion forum will be used for on-Line post conference discussions of SOAP notes:

o All students in each clinical group will participate with their clinical instructor and other members of this and possibly other clinical courses in an ongoing on-line clinical conference throughout the semester through a discussion of cases as presented in SOAP notes.

o Start a new thread for each new SOAP with the following subject line: Your LastNameSOAPNumberTopic (e.g. WinkSOAP2BreastPain). All updates and responses about that SOAP would go in that thread.

o SOAPs should be on commonly occurring problems, not zebras. If the situation or problem sends most of the staff to their resources and has them saying things like " I have to look this up" and "I never saw this before" it is probably a zebra. Put in the zebra section (see below) and use another patient encounter for your SOAP.

o SOAPs should be on a variety of topics. Students are expected to review those already posted and choose a different topic unless the client situation is a unique one. (For example, if there is already a SOAP on BV (bacterial vaginosis) do not post a note on that topic. But, if the original note was on a 22 year old with BV for the first time and your client was 30 with recurrent BV unresponsive to standard treatment that would be OK.)

o Student SOAP notes must be on different topics. (For example, do not write three SOAP notes on routine well pregnancy visits or two on well women visits or all on women with breast pain.)

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o Each student will post at least three (for 3 and 4 credit courses) OR five (for 7 caredit courses) detailed SOAP notes in the post conference discussion group for their clinical section on the Clinical Planning webcourses site. These should be posted in the body of the message and as an attachment.The SOAPs and SOAP discussions must occur throughout the semester. Failure to post on time and/or failure to engage in ongoing discussion will result in an incomplete in the course. See course schedule for a list of dates/times for the due dates for the SOAP Notes.

o The clinical faculty member will critique of the note either using the version of the SOAP attached to the discussion posting or to the whole post conference group.

o If the SOAP notes are not at the standard expected, additional SOAP note submissions may be required by the clinical faculty

o All students are to read all posted SOAPs: Students are expected to be actively engaged in the critique and

discussion of clinical cases presented via the SOAP notes. This must occur over the course of the semester with discussion in each of the SOAP note posting periods listed above. These posts should include providing answers to questions posed by the poster of the SOAP. Active engaged discussion is NOT a single post or sets of posts occurring on only a single dates a few times during the semester.

The clinical faculty member may ask questions or comment on individual SOAP notes in the open discussion.

Each student is expected to be involved in all discussions of their SOAP note. This includes providing answers to faculty questions if these if not answered by a group member.

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Guidelines for Preceptors

Practicum focuses on the full scope of practice of the family nurse practitioner. Students have already completed courses in Advanced Health Assessment, Nursing Theory, Pathophysiology, Health Promotion, Pharmacology and dialectic and most or all clinical courses in their specialty NP tract. This practicum will complete their clinical hours in the nurse practitioner program. The number of hours the student will be working with you should be confirmed with the student since this varies based on the number of credits the student is taking and the number of sites in which they are working.

As a preceptor, you play a significant role in the education of these future nurse practitioners. The following is provided as a guide for those of you new to the role or seeking a review.

1. Provide access to patients at your practice site. a. The student may accompany you if you make rounds in an acute care (hospital

setting). However the student may not provide care or count these hours towards this course.

b. Students should see about 6-10 patients per day although slight more is appropriate in some settings

2. Provide direct clinical supervision by seeing patients with the student as needed and validate their findings.

3. Listen to student’s case presentation, after their initial patient interaction, and provide critique, guidance, and clinical knowledge gained from practice.

4. Ask lots of questions to help the NP student refine their ability to assess clients appropriately, carry out clinical decision making, and implement care What did you hear, see, assess? What does this mean to you? How do non physical factors impact this patient? What other data do you need? What will you do next? Why are you doing that diagnostic test, selecting that medication, implementing that

teaching, doing that referral? What more do you need to study to better care for this patient or others like them?

Where will you find such information?5. Collaborate with the student in planning care for the patient explaining rationale for

treatment choices if needed. 6. Encourage the study of written resources and other clinical guides relevant to the patients

they see.7. Allow the students to document as much as possible in your practice. This includes review

of their notes, suggesting revisions or making additions, and cosigning the student’s documentation.

8. Allow the student to observe patient interactions which you feel would be of educational value.

9. Supervise procedures student performs. These should be consistent with the student’s learning objectives.

10. Spend a few minutes with the student at the end of the clinical day to review the student’s progress. Encourage them to identify their learning needs and develop a plan to address those needs. This could include reading, study and identification of patients with problems which will help meet those needs.

Statements, Policies, and Regulations Regarding Academic Honesty/ ADA

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Office of Student Rights and ResponsibilitiesUniversity of Central Florida

YOUR ENROLLMENT STATUS MAY BE AT RISK!Academic Dishonesty in any form will not be tolerated!!!

The University of Central Florida has recently started an account with turnitin.com., an automated system which instructors can use to quickly and easily compare each student's report to billions of web sites, as well as an enormous database of student papers that grows with each submission. After submission of the paper, instructors receive a report that states if and how another author's work was used.

Violations of student academic behavior standards are outlined in The Golden Rule, the University of Central Florida's Student Handbook. See http://www.ucf.edu/goldenrule/ for further details.

1. Cheating whereby non-permissible written, visual or oral assistance including that obtained from another student is utilized on examinations, course assignments or projects. The unauthorized possession or use of examination or course related material shall also constitute cheating.

2. Plagiarism whereby another's work is deliberately used or appropriated without any indication of the source. Thereby attempting to convey the impression that such work is the student's own. Any student failing to properly credit ideas or materials taken from another has plagiarized.

3. A student who has assisted another in any of the aforementioned breach of standards shall be considered equally culpable.

ACADEMIC ACTION* Taken by Instructor, Chair, or Dean of College*1. Counseling2. Loss of credit for specific assignment, examination or project.3. Removal from course with a grade of "F" and/orCONDUCT REVIEW ACTION*Taken by the Office of Student Conduct*1. Warning2. Probation3. Suspension4. Expulsion5. Permanent conduct record with UCF accessible by other institutions by request.For more information, please contact the Office of Student Conduct at 823-2851.

NUR3825f01.doc DW/dw 8/8/98 rev 5/5/23

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American Nurses AssociationThe Code of Ethics for Nurses 2001

Just as our behaviors are held to a University of Central Florida and College of Nursing ethical standards, we are also held to our standards as professional nurses. The ANA Code of Ethics does apply to all efforts undertaken as a part of this course. To review those standards please use the following web link:

http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses.aspx

If you cannot access the document directly, please copy and paste the link into your web browser.

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Persons With Disabilities: The University of Central Florida is committed to providing reasonable accommodations for all persons with disabilities.  Students who need accommodations must be registered with Student Disability Services (SDS), Student Resource Center Room 132, phone (407) 823-2371, TTY/TDD only phone (407) 823-2116, before requesting accommodations from the professor.  Students who are registered with SDS and need accommodations in this course must contact the professor at the beginning of the semester to discuss needed accommodations.  No accommodations will be provided until the student has met with the professor to request accommodations.  This syllabus is available in alternate formats upon request.

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