SAMPLE SYLLABUS 1 Long Term Care Clinical Scholars Program (LTC-CSP) Summer Nursing Internship A collaboration between UW-Madison School of Nursing and Edgewood College School of Nursing Description of the program The Long Term Care Clinical Scholars Program is designed to provide a twelve week summer internship experience for baccalaureate nursing students in a nursing home setting. The program consists of supervised clinical experiences, classroom workshops and independent study for classroom preparation. Faculty: Dr. Barbara Bowers Dr. Colleen Gullickson UW-Madison School of Nursing Edgewood College SoN Phone: 263-5185 Phone: 574-5380 E-mail: [email protected]E-mail: [email protected]Additional Instructors and Staff: Kim Nolet, MS, Program Coordinator, UW-Madison School of Nursing Brenda Ryther MS, RN, Researcher, UW-Madison Ctr for Health Systems Research & Analysis Tonya Roberts MS, RN, UW-Madison Doctoral student Andrea Gillmore MS, RN, UW-Madison Doctoral student Rachel Roiland MS, RN, UW-Madison Doctoral student Program Goals 1. Increase the appeal of long term care for new baccalaureate prepared nurses and baccalaureate nursing students by creating positive experiences showing nursing homes as welcoming, interesting, and innovative places to work where RN nursing skills are used and valued. 2. Increase feelings of preparedness in caring for older adults in nursing homes for nursing students entering the workforce. 3. Increase complex nursing skills in care of older adults for baccalaureate nursing students. 4. Increase the leadership abilities in care of older adults for baccalaureate nursing students.
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SAMPLE SYLLABUS
1
Long Term Care Clinical Scholars Program (LTC-CSP)
Summer Nursing Internship
A collaboration between
UW-Madison School of Nursing
and
Edgewood College School of Nursing
Description of the program
The Long Term Care Clinical Scholars Program is designed to provide a twelve week summer
internship experience for baccalaureate nursing students in a nursing home setting. The
program consists of supervised clinical experiences, classroom workshops and independent
1. If you are not familiar with age-related physiological changes, please visit http://consultgerirn.org/topics/normal_aging_changes/want_to_know_more and familiarize yourself with this information.
Required
Clinical
Activities Pre-
Workshop
Pre-Workshop Activities:
1. Consider the following questions that will be discussed during the
workshop:
a. What should you use as a guide to make decisions about care
prioritization?
b. What is important when considering how you prioritize care?
c. What do you think about when you consider ways to effectively
manage your time?
d. What does time management involve?
e. What is necessary to have effective time management?
f. How can you anticipate the consequences of the decisions that
you make?
Week 2: June 15th Group, 2:30-3:30 p.m. workshop + 30 minutes for interns only
Topic Resident Quality of Life
Instructors Tonya Roberts, MS, RN and Barbara Bowers, PhD, RN
Objectives 1. Discuss the importance of addressing quality of life for ltc residents.
2. Distinguish the relevance of quality of life for different populations.
3. Discuss the intersection of quality of care and quality of life.
Required Readings
1. Cohen-Mansfield, J. & Taylor, J. W. (2004). Hearing aid use in
nursing homes part 1: Prevalence rates of hearing impairment
and hearing aid use. Journal of the American Medical Directors
3. Gladstone, J. & Wexler, E. (2002). Exploring the relationships
between families and staff caring for residents in long-term care
facilities: family members’ perspectives. Canadian Journal on
Aging., 21(2), 39-46.
Suggested
Resources &
Readings
Check intern website for any suggested readings.
Required Clinical
Activities Pre-
Workshop
Before you contact a physician yourself, observe a nurse information
exchange with a physician (your preceptor can help you identify this
learning opportunity). What kinds of questions did the physician have?
Was the nurse prepared to answer those questions? How did the
nurse communicate information from the physician back to staff and/or
family? This activity will prepare you for workshop discussions and to
interact independently with physicians.
Week 4: June 29th Group, 2:30-3:30 p.m. workshop + 30 minutes for interns only
Topic Achieving and Maintaining Resident Function
Instructors Barb King, PhD, RN and Barbara Bowers, PhD, RN
Objectives 1. Understand the factors contributing to unnecessary functional
decline in nursing home residents
2. Identify practices in their environments that contribute to
resident functional decline
3. Analyze how the system they work in could be altered to
prevent functional decline where possible
Required Readings
1. Fitzsimmons, S. (2010). Physical functioning: Maintaining,
improving, and preventing decline. Activities Directors’
Quarterly for Alzheimer’s & Other Dementia Patients, 11(1):15-
21.
2. Bell, A. (August, 2002). Restored function, renewed hope.
Provider. 57-60.
3. Connelly, D (2000). Resisted exercise training of
institutionalized older adults for improved strength and
functional mobility: A review. Geriatric Rehabilitation,15(3): 6-
28.
Suggested
Resources &
Readings
Check intern website for any suggested readings.
Required Clinical
Activities Pre-
Workshop
1. Contact an admission nurse to see if you can work with him/her when a new resident is admitted. What information is provided on the admitting notes regarding ambulatory status? Does the
plan of care reflect a thorough understanding of the resident’s potential? How will the plan of care maximize this potential?
OR
2. Look at the PT or OT plan for a resident. This could be a resident currently receiving PT or OP services or one whose formal PT/OT plan has ended. What is the plan for improving ambulation? How was potential assessed? Is the staff following through on improving ambulation? If not, what are the barriers? If yes, what is being done? Is walking ability important to the resident? How do you know? Is the nursing staff continuing the plan effectively for those whose OT/PT has expired?
Week 5: July 6th Interns Only, 2:30-4:30 p.m.
Topic Diabetes, Swallowing and Nutrition
Instructors Colleen Gullickson, PhD, APNP, RN
Objectives 1. Demonstrate sound decision-making skills in a variety of
patient communication in dementia. Journal of Gerontological
Nursing, April, 43-52.
Suggested
Resources &
Readings
1. Rader, J, Barrick, A., Hoeffer, B., Sloane, P., McKenzie, D.,
Talerico, K., & Glover, J. (2006). The bathing of older adults
with dementia. AJN, 106(4), 40-48.
2. Amella, E. (2007). Eating and feeding issues in older adults
with dementia: Part 1: Assessment & Part II: Interventions.
Try this: Best practices in nursing care to older adults with
dementia, Hartford Institute for Geriatric Nursing, NY.
Required Clinical
Activities Pre-
Workshop
1. Review your facilities policy/protocol for when a resident’s
MMSE decreases below 15.
How is the HCPOA activated?
What is the procedure for obtaining consent for care?
2. Review your facilities psychotropic protocols related to
mandated ‘washout’ periods.
Week 7: July 20th Interns Only, 2:30-4:30 p.m.
Topic Change in Condition: Assessment and Care Planning
Instructors Brenda Ryther, MS, RN & Tonya Roberts, MS, RN
Objectives 1. Discuss change of condition and how it can be recognized by nursing home staff.
2. Understand the importance of communicating and responding to change of condition.
3. 3. Identify care planning strategies to address change of condition.
Required Readings
1. Boockvar, K.S. & Lachs, M.A. (2003). Predictive value of nonspecific symptoms for acute illness in nursing home residents. JAGS, 51: 1111-1115.
2. Taunton, R.L., Swagerty, D.L., Smith, B., Lasseter, J.A., & Lee, R.H. (2004). Care planning for nursing home residents: incorporating the Minimum Data Set requirements into practice.
SAMPLE SYLLABUS
10
Journal of Gerontological Nursing, 30(12): 40-49.
Suggested
Resources &
Readings
1. Boockvar, K., Brodie, H.D. & Lachs, M. (2000). Nursing assistants detect behavior changes in nursing home residents that precede acute illness: development and validation of an illness warning instrument. JAGS, 48(9).
2. Amella, E.J. (2004). Presentation of illness in older adults. AJN, 104(10): 40-51.
Required Clinical
Activities Pre-
Workshop
1. Attend a care conference to observe care team discussion, including resident change of condition. Note which disciplines attended the care conference. Follow-up with the care team to learn how the information and plans discussed are translated and communicated into daily practice.
Week 8: July 27th Group, 2:30-3:30 p.m. workshop + 30 minutes for interns only
Objectives 1. Utilize therapeutic presence and professional communication
skills in providing end of life care.
2. Advocate for resident and family requests in providing end of
life care.
3. Demonstrate an understanding of the nurse’s role in providing
spiritual care.
4. Apply basic pathophysiologic principles related to pain
management and nutrition at end of life.
Required Readings
1. ANA position statement: Pain management and control of distressing symptoms in dying patients.
2. Liao, S., & Ackermann, R., (2008). Interdisciplinary end-of-life-care in nursing homes. Clinical Gerontologist, 31(4). 83-96.
3. Sheehan, D.K., & Schirm, V. (2003) End- of-life care of older adult. AJN, 103(11), 48-59.
4. Kruse, B.G., Ruder, S., & Martin. L. (2007). Spirituality and coping at the end-of-life. Journal of Hospice and Palliative Nursing, 9(6). 296-304.
Suggested
Resources &
Readings
Check intern website for any suggested readings.
Required Activities
Pre-Workshop
1. Review your facility’s protocols end of life pain management, nutrition management, and/or comfort cares.
2. Review your facility’s protocol for the activities that should be
completed after an individual has passed away. What activities
will be expected of you and other staff?
3. Check to see if your facility has any resources that provide information about end-of-life cultural practices. Review them if they are available.
4. On a piece of paper or note card, write two questions you would like answered during class. (Bring them with you.)
SAMPLE SYLLABUS
11
Week 9: August 3rd Interns Only, 2:30-4:30 p.m.
Topic Resident Comfort and Pain Management
Instructors Andrea Gilmore, MS, RN & Tonya Roberts, MS, RN
Objectives 1. Demonstrate an understanding of age-related changes that contribute to increased prevalence of chronic pain in the elderly population, generational considerations, and common acute syndromes that contribute to pain in the elderly population.
2. Demonstrate an understanding of pain and the nurse’s role in its identification, assessment, and treatment.
a) Identify a variety of non-pharmacological, evidence based strategies to promote resident comfort.
b) Utilize the multidisciplinary team to optimize resident comfort.
3. Demonstrate the ability to make clinical judgment about pain management and resident comfort in persons with limited communicative ability and dementias.
Required Readings
1. Gran, et al. (2009). Alone with my pain – it can’t be explained, it
has to be experienced. A Norwegian in-depth interview study of
pain in nursing home residents. International Journal of Older
People Nursing, 5(1), 25-33.
2. Strategies for Success: Pharmacologic management of
persistent pain in the older adult. Clinical Advisor ,October
how it could be improved? Are there general guidelines that are
followed?
Week 10: August 10th Group, 2:30-3:30 p.m. workshop + 30 minutes for interns only
Topic Nursing Leadership and Management
Instructors Barbara Bowers, PhD, RN
Objectives 1. Understand the staff nurse’s role and expectations as a leader
in nursing homes
2. Describe the impact of staff nurse leadership on nursing home
quality
3. List desirable leadership qualities for long term care nurses
4. Develop strategies to improve staff nurse to CNA delegation,
communication and coaching and mentoring
5. Select leadership strategies and skills to practice and improve
upon in the workplace
Required Readings
1. Boockvar, K. S., Gruber-Baldini, A. L., Burton, L., Zimmerman, S., May, C., & Magaziner, J. (2005). Outcomes of infection in nursing home residents with and without early hospital transfer. Journal of American Geriatric Society, 53(4), 590-596.
2. McGillis-Hall, L., McGilton, K. S., Krejci, J., & Pringle, D. (2005). Enhancing the quality of supportive supervisory behavior in long-term care facilities. The Journal of Nursing Administration, 35(4), 181-187.
3. Maxwell, J. C. (1993). The quickest way to gain leadership: Problem solving. In Developing the Leader Within You (pp. 75-95). Nashville: Thomas Nelson.
Suggested
Resources &
Readings
Check intern website for any suggested readings.
Required Clinical
Activities Pre-
Workshop
1. Review the most recent Survey findings for your facility. Select one citation from the survey, or another quality issue your facility has recently tried to improve. Read the Plan of Correction (if a Survey citation) or QI plan (if another quality issue).
2. Briefly interview a charge nurse (that was employed at the home at the time of the last survey) about the issue.
Do they know about the issue from the survey or other
quality initiative you are discussing?
How do they view their role?
Have they tried to change CNA practices around this
issue? How? Have their strategies worked?
Have they encountered any challenges?
3. Bring your notes to the workshop for our 30 minute post-workshop debrief.
Week 11: August 17th Interns Only, 2:30-4:30 p.m.
SAMPLE SYLLABUS
13
Topic RN Decision Making in LTC and Practice Change
Objectives 1. Describe some current innovations in LTC. 2. Discuss how to select and implement practice change.
Required Readings
1. Koren, M. J. (2010). Person-centered care for nursing home residents: the culture-change movement. Health Affairs, 29(2), 312-317.
2. Tobin, S. S. (2003). The historical context of “humanistic” culture change in long-term care. In A. S. Weiner & J. L. Ronch (Eds). Culture Change in Long-Term Care: Haworth Social Work Practice Press, New York.
Suggested
Resources &
Readings
Check intern website for any suggested readings.
Required Clinical
Activities Pre-
Workshop
1. Be prepared to discuss situations you’ve encountered during the internship which could benefit from change