NGR-6242L-Syllabus-Spring-2013-FinalGville

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UNIVERSITY OF FLORIDA
COLLEGE OF NURSING
COURSE SYLLABUS
Spring 2013
COURSE NUMBER

NGR 6242L, Section 0377 Gainesville

COURSE TITLE

Adult Acute Care Nurse Practitioner 1

CREDITS

03

PLACEMENT

DNP Program: Adult Acute Care Nurse Practitioner (ACNP) Track

PREREQUISITES

NGR 6002C: Advanced Health Assessment and Diagnostic
Reasoning
NGR 6636:
Health Promotion and Role Development in
Advanced Nursing Practice
NGR 6140:

Physiology and Pathophysiology for Advanced
Nursing Practice
NGR 6101:
Theory and Research for Nursing

PRE/CO-REQUISITES

NGR 6241:
Common Adult Health Problems
NGR 6052C: Diagnostics & Procedures for Adult Nursing
NGR 6172:
Pharmacotherapeutics for Advanced Practice
Nursing
NGR 6230C: Adult Acute Care Nurse Practitioner: Diagnostics
and Procedures for Acutely Ill Adults

FACULTY

OFFICE

PHONE

OFFICE HOURS

Tonja Hartjes, DNP, ARNP, ACNP-BC
Course Coordinator
Adjunct Clinical Assistant Professor


HPNP 3217

(352) 215-6278 [cell]

By Appointment

Kae Pearson, MSN, ARNP, ACNP-BC
Adjunct Clinical Assistant Professor


HPNP 3217

(352) 273-6355 [O]
(352) 317-6560 [cell]

TBD

Jeannie Schiller, MSN, ARNP, ACNP-BC
Adjunct Clinical Assistant Professor


ORMC

(321) 239-8085 [cell]

TBD

HPNP 3230
Gainesville

(352) 273-6394 [O]

By appointment

DEPARTMENT CHAIR
Joyce Stechmiller PhD, ARNP, ACNP-BC, FAAN


COURSE DESCRIPTION
This course provides the student with foundational clinical
experiences necessary for the management of adult health, including wellness promotion, illness
prevention and treatment in post-pubescent client from diverse backgrounds. Emphasis is on the
utilization of critical thinking and evidence-based practice to formulate differential diagnoses,
clinical impressions, diagnoses, and treatment and evaluation plans for adults. This course
provides clinical opportunities in the acute care setting to provide safe, cost effective, legal, and
ethical care for adults with acute and critical episodes of common acute and chronic health
problems.

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COURSE OBJECTIVES
Upon completion of this course, the student will be able to:
1. Apply knowledge from health, psychological, physiological, and social sciences in the
advanced nursing management of adults with acute and critical episodes of common
health problems in acute care settings.
2. Accurately assess adult clients presenting with acute and critical episodes of common
health problems.

3. Develop diagnosis and differential diagnoses based on a holistic health assessment
including medical and social history presenting symptoms, physical findings, and
diagnostic information.
4. Develop appropriate diagnostic and therapeutic interventions for adults with emphasis on
safety, cost, efficacy, and client’s immediate condition and needs.
5. Implement treatment plans for illness prevention, wellness promotion, and health
problem management based on current research, evidence-based standards of care and
practice guidelines for adults with acute and critical episodes of common health
problems.
6. Evaluate the effectiveness of treatment plans based on client outcomes.
7. Integrate legal and ethical principles into decision-making in the advanced nursing
practice role.
8. Integrate cultural sensitivity into advanced nursing practice care.
9. Demonstrate effective oral and written communication skills.
10. Collaborate with preceptor and interdisciplinary health care team in facilitating the adult’s
progress toward maximum functional health.
CLINICAL SCHEDULE
Variable hours. A total of 144 clinical hours are required.
E-Learning is the course management system that you will use for this course. E-Learning is
accessed by using your Gatorlink account name and password at . There are
several tutorials and student help links on the E-Learning login site. If you have technical
questions call the UF Computer Help Desk at 352-392-HELP or send email to
It is important that you regularly check your Gatorlink account email for College and University
wide information and the course E-Learning site for announcements and notifications.
Course websites are generally made available on the Friday before the first day of classes.
TEACHING METHODS
Supervision of clinical practice with onsite clinical and faculty preceptors and guided seminar
group discussions
LEARNING ACTIVITIES
Supervised onsite clinical practice and seminar presentations with analysis of selected clients

reflecting ongoing and emergent clinical issues; verbal and written reports related to assessment,
diagnosis and management plans.

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EVALUATION
Clinical experience will be evaluated through faculty observation, verbal communication with the
student, written work, and agency staff reports using a College of Nursing Clinical Evaluation
Form. Faculty reserve the right to alter clinical experiences, including removal from clinical
settings, of any student to maintain patient safety and to provide instructional experiences to
support student learning. The College of Nursing supervising faculty member is the person
ultimately responsible to assign a final grade for this course.
Evaluation will be based on achievement of course and program objectives using a College of
Nursing Clinical Evaluation Form. All areas are to be rated. A rating of satisfactory represents
satisfactory performance and a rating of unsatisfactory represents unsatisfactory performance.
The student must achieve a rating of Satisfactory in each area by completion of the semester in
order to achieve a passing grade for the course. A rating of less than satisfactory in any of the
areas at semester end will constitute a course grade of unsatisfactory.
Faculty will hold evaluation conferences with the student and preceptor at site visits and during
conference calls. The faculty will write a summary of each conference. This summary will be on
the Elearning web site as a link to the grade book/clinical site visits. Final evaluation
conferences with the faculty are mandatory and will be held during the last few weeks of each
clinical rotation. A student or the faculty may request additional conferences at any time by
contacting the clinical faculty.
GRADING SCALE:
S

U

Satisfactory
Unsatisfactory

TEXTS
All texts from previous and current required in current graduate program
Gomella, L. G. & Haist, S.A. (2007). Clinician’s Pocket Reference (11th ed.). Stamford, CT:
Lange Clinical Science.
RECOMMENDED CLINICAL RESOURCES ( OPTIONAL):
Aehlert, B. (2006). Pocket reference for ECGs made easy (3rd ed.). St. Louis, MO: Mosby
Elsevier Mosby.
Cooper, D.H., Krainik, A.J., Lubner, S.J., & Reno, H.E.L. (Eds). (2007). The Washington manual
of medical therapeutics (32nd ed.). Philadelphia: Lippincott Williams & Wilkins.
Grauer, K. (2007). 12-Lead ECGs: A pocket brain for easy interpretation (4th ed.). Gainesville, FL:
KG/EKG Press.
Green, S.T. (2009). Tarascon pocket pharmacopoeia. Lompoc, CA: Tarascon. (Print & Mobile
Applications)
Greenwald, J. L. (2003). Writing a history and physical. Philadelphia, PA: Hanely & Belfus.
Maxwell, R. (2006). Maxwell quick medical reference (5th ed.). Tulsa, OK: Maxwell Publishing
(www.MAXWELLBOOK.com).

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Hinshal, J.S., & Lederman, R.J. (2007). Tarascon internal medicine & critical care pocketbook
(4th ed.). Lompoc, CA: Tarascon.

OTHER:
Up To Date (Library Web Site Access): Excellent current clinical information
Smart Phone Application Options: Epocrates (drug emphasis but also general), Merck
Medicus (general medical), Medscape (latest news/research), Med Calc (frequently used
equations), Blackbag (new research and news), Eponyms (medical terms, signs & symptoms,
dictionary), Sanford Guide to Antimicrobial Therapy (antibiotic standards), Harrison’s Internal
Medicine (general medical), American College of Cardiology (cardiac standards)
Personal Pocket Pal: Personal pocket notebook/cards on important information learned from
class/clinical that you want at your fingertips. Also, helpful for writing down questions that need
researched.

Approved:

Academic Affairs Committee:
Faculty:
UF Curriculum:

12/07
01/08
10/08

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Addendum: Adult Acute Care Nurse Practitioner
Common Health Problems Laboratory
CLINICAL SCHEDULE

Variable hours. A total of 144 clinical hours are required (approximately one day per week ). First
day of clinical can not occur before January 7, 2013. In addition all of the UF requirements and
hospital orientation requirements must be completed. Last day of clinical is April 24 th, 2013.
Students are responsible to submit planned clinical dates and times in calendar format to the
course
faculty prior to beginning the clinical rotation. Any changes to the calendar (dates or times) must
be submitted in writing to the course faculty before the change is planned to occur. Clinical hours
accrued without prior knowledge of the faculty will not be counted toward the total number of
clinical hours required for the course.

•

Minimal Requirements for Appearance in Clinical Practice Areas
* Any faculty member has the right to remove any student from a clinical area if, in the
faculty member's judgment, the student presents an unprofessional appearance or in
anyway is a threat to patient safety or comfort.
1. Graduate students are identified with the Health Science Center ID badge in clinical
settings at all times during planning and/or provision of care.
2. Graduate students wear clean, pressed, white lab coats over professional attire in clinical
settings at all times during planning and/or provision of care.
3. Overall appearance conveys a professional image. This includes as a minimum:
• Minimal jewelry (one earring per lobe)
• No perfumes/scented lotions/etc.

•
•
•

4.
5.

6.

Minimal makeup
Hair extending beyond collar length
must be neatly secured away from face
(ponytail)
Closed-toes shoes (sandals are not
allowed)

•
•
•
•

No artificial fingernails or nail polish
Neat, short fingernails (not visible from
the palmar surface of the hand)
No gum chewing.

Length of shirts and/or blouses must
prevent exposure of upper and/or lower
torso (no low-rise pants and/or low cut
blouses/shirts).
Personal hygiene and grooming are of a standard that ensures the safety and comfort of
clients.
Students arrive in clinical areas with all the required equipment (e.g., stethoscope)
necessary for client care.
Activated cell phones and/or pagers are not allowed in either the clinical or classroom
setting.

CLINICAL EVALUATION
Feedback from clinical preceptors, direct observations of students’ performance, written
documentation samples, and participation in mandatory online seminars will be used to complete a
minimum of two progress evaluations: mid-term and final evaluation. More than two progress
evaluations may be performed at faculty discretion, based on students’ performance and
learning needs. The College of Nursing supervising faculty member is the person
ultimately responsible to assign a final grade for this course.

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•

Students must complete ALL of the following criteria to successfully pass the course:
1. Maintain patient safety in the clinical setting.
2. Satisfactory demonstration of advanced practice professional accountability to include:
a. Compliance with attendance and appearance guidelines as described in this
syllabus.
b. Complete and submit written assignments within established guidelines and time
frames per expectations as described in this syllabus.
3. Satisfactory participation in scheduled online seminar activities as per the seminar
guidelines described in this syllabus.
4. Satisfactory performance in the clinical setting as indicated using the NGR 6242L clinical
evaluation tool.
5. A rating of less than satisfactory in any of the above stated criteria at semester end
will constitute a course grade of U.

•

Grading Scale:

S=Satisfactory

U=Unsatisfactory

Clinical Seminar Expectations
Mandatory clinical seminars will be held online. The TurnItIn anti-plagiarism technology will
be used to evaluate this educational activity.
Each student is responsible to:
1) Participate and successfully complete online course orientation BEFORE attending first
clinical experience date
2) Participate in all scheduled on-line seminars. Seminar absences associated with
extenuating circumstances will result in an “I” in the course and will need to be made-up
before the course can be successfully completed.
3) POST one evidence-based Clinical Pearl and RESPOND to two Clinical Pearl peer postings
as assigned (refer to schedule on website). Students posting Clinical Pearl information will
be assigned to respond to peer clinical pearl postings during the assigned seminar period.
Refer to the Online Clinical Pearls: Seminar Presentation Guidelines and Clinical Pearls:
Evaluation Criteria (see attached) for completion of these activities.
Unexcused absences/lack of participation will result in a zero score and unsatisfactory
performance for scheduled seminar activity. A rating of less than satisfactory in any of
the areas at semester end, will constitute a course grade of U.
4) Submit completed copies of the following material at the following scheduled submission
dates (2-4-13, 3-18-13, and 4-22-13) :

Clinical Hours Log signed by the preceptor (including all data from the start of
the semester to the day before submission of the paper).


Patient Summary Log (including all data from the start of the semester or
previous submission date to the day before the form is submitted)

Two (2) HIPAA compliant samples of the student’s clinical documentation (one
complete assessment and one focus assessment) during the time from the start
of the semester or previous submission day. Format for documentation samples
as per the Documentation Samples Guidelines (attached). (Faculty members
may request more than 3 submissions based on individualized needs of
students).

Submit the following by the end of the semester on or before April 22th , 2013:
• Form A, F and Form G

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5) Submit the Clinical Evaluation Tool, completed by the preceptor (posted on the course
website):

at midterm (after 50% of the total required clinical hours have been
completed) and

at the end of the course, on or before April 22th , 2012.
6) Make copies of all paperwork submitted to faculty for their personal records.

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Online Clinical Pearls: Seminar Presentation Guidelines
The TurnItIn anti-plagiarism technology will be used to evaluate this educational activity.
Seminar Presentations will follow this schedule:
Seminar 1
Online Orientation
First week of classes
(successful completion
required before 1st clinical
experience date)

Seminar 2

Schedule of dates
Posting
Students

Question posted on or
before 2-11-13

Question posted on or
before 3-11-13

Responding
Students

Referenced responses
posted on or before
2-18-13
Referenced answer
posted on 2-25-13
(not earlier)

Referenced responses
posted on or before
3-18-13
Referenced answer
posted on 3--21 (not
earlier)

Replies to responding
peers on or before
2-28-12

Replies to responding
peers on or before
3-25-13

Posting
students

 Clinical Seminar activity instructions:
 All students will be assigned to post on ONE clinical seminar question:
 The seminar question will be posted by course coordinator on the course web site
under the appropriate “Discussion Forum” by 12 midnight on the assigned date.
 A first student will be assigned to post a scholarly response to the posed seminar

question on the course web site under the appropriate “Discussion Forum” by 12
midnight on the assigned date.
 A second student will be assigned to respond to the first students posted scholarly
response to the posed seminar question on the course web site under the
appropriate “Discussion Forum” by 12 midnight on the assigned date.
 The first student will then reply to the second student’s response on the course
web site under the appropriate “Discussion Forum” by 12 midnight on the
assigned date.
 Failure to participate in the scheduled seminar as assigned (posting or
responding) will result in a zero score and unsatisfactory performance for
scheduled seminar activity. A rating of less than satisfactory in any of the areas at
semester end, will constitute a course grade of U.
 ALL seminar postings and responses are to be in MS Word file format.
 Students are responsible for submitting their postings through the TurnItIn technology
(see course website for this tool) and to ensure that the similarity index is less than 24%
(green on the tool) prior to submission via the course Discussion Board section of the
website for peers and faculty to review.
 ALL seminar postings must be HIPAA compliant (no identifiers).
 The seminar postings are to comply with the assigned dates and time frames as listed
above.
 Students will accrue a total of 4 clinical hours for seminar participation this semester as
assigned (successful completion of both seminars with a satisfactory score is required).
 All seminar presentation postings should be accompanied by at least one relevant specific

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reference from the current research literature (less than 5 years old). Textbooks or online text
resources will not be accepted as the sole reference for any answer.
 Current APA format is required for all references. The level of evidence (LOE) that the
reference presents and rationale for selection of the LOE must be included.
 Postings should be clear, concise (no more than 400 words), and scholarly.
 Seminar participation is graded using the participation grading criteria as posted on the
webpage.
 Students that obtain an unsatisfactory (U) for the seminar submissions will have one
opportunity per submission period to submit another seminar posting (as assigned by
faculty) for grading purposes. Students must demonstrate improvement in order to
obtain the minimum satisfactory score associated with this activity.
The UF Honor Code applies to this activity, as to all coursework.
Please refer to Student Policy S1-12 which is available via the College of Nursing website
in the “Current Student” area.

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University of Florida
College of Nursing
NGR 6242L: Adult Acute Care Nurse Practitioner Common Health Problems Laboratory
CLINICAL HOURS LOG
Student: _________________________
Clinical Site: ___________________
Semester: Spring 2013
Preceptor: _____________________
Total number of clinical hours needed 144.

Clinical date

Online seminar
x 2 participation

Hours
complete
d
4

Semester
hours
remaining
140

Preceptor signature

T. Hartjes DNP, ARNP

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University of Florida
College of Nursing
NGR 6242L: Adult Acute Care Nurse Practitioner Common Health Problems Laboratory
PATIENT SUMMARY LOG*
(*List all activities for each patient interaction on each clinical date)

Student: _________________________
Semester: Spring 2013
_____________________
Clinical
date

Age range
& gender

Chief
complaint

Differential
diagnoses (total of 5)

NGR 6242L (Section 0377) – Spring 2013 – Hartjes- Final

Clinical Site: ___________________
Preceptor:
BRIEF summary of clinical experience
(list activities toward course objectives)


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University of Florida
College of Nursing
NGR 6242L: Adult Acute Care Nurse Practitioner Common Health Problems Laboratory
Documentation Samples Guidelines

•

You will be expected to submit two (2) samples of clinical documentation for each
assigned date below (one complete assessment and one focused assessment).
o This activity will allow faculty to assess your ongoing progress toward the course
objectives. You may/may not be actually documenting your findings on the facility
records. However, you will need to demonstrate that you can accurately and
appropriately document your findings in a medical record. Faculty members may
request more than 3 submissions based on individualized needs of
students.
o Students that obtain an unsatisfactory (U) for their documentation submissions will
have one opportunity per submission period to submit another set of
documentation samples ON A NEW PATIENT(as assigned by faculty) for grading
purposes. Students must demonstrate improvement in documentation skills in
order to obtain the minimum satisfactory score associated with this activity.

•

Submit your 2 documentation samples along with a copy of your clinical hours log, and a
copy of your patient summary log to your clinical faculty as scheduled: (February 4, 2012
and March 18, 2012. Include your name and the date on the submission.
1. All required documents are to be typed and should be submitted via the
course website in the “Assignments” section.
2. Your documentation sample submissions should be typed and should be
organized using the format below. The documentation should not include any
patient identifier data (HIPAA compliant). COPIES FROM ASSIGNED
CLINICAL AGENCY MEDICAL RECORDS ARE NOT PERMITTED.
3. The content of the documentation samples should follow the format described
in Gomella, LG (2007). Clinician’s Pocket Reference (11th ed.) on pages 20-23
utilizing the following headings:

History/demographics (complete ROS for complete exams)
Physical Exam
Problem List
Analysis of pertinent data
Differential diagnoses
- Include a prioritized list of the top 5 differential diagnoses for the patient
based on the data above. Include rationale for your choices.
- Include rationale for “rule in” or “rule out” (what is your rationale based
upon?)
 Treatment plan- Include: patient education, diagnostics, appropriate
referrals, rationale for admission, patient disposition, pharmacotherapies,
and specific follow up needed






•

Students are responsible to make copies, for their own records, of all submissions
to the course faculty.

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University of Florida

College of Nursing
NGR 6242L
Documentation Samples: Evaluation Criteria
Criteria
Submitted as scheduled.*

Possible
points
10

Documentation is HIPAA compliant.

10

Documentation incorporates pertinent clinical data (as applicable for
complete/focused exam) to describe physical assessment findings:

70

-Hx & demographics (14)
-Physical exam (20)
-Analysis of pertinent data (20)
 Formulates problem list
 Identifies five (5) differential diagnoses with rationale to rule in/out
- Treatment plan (16 points)
• plan addresses problems
o prioritizes needs
o acknowledges other problems to be addressed
• patient and/or family education
• recommended diagnostics

• pharmacotherapies
• health promotion
• appropriate referrals
• patient disposition
o rationale for admission or discharge
• specific follow up needed
Documentation is pertinent to the clinical scenario
• accurate
• organized
• concise
• non-judgmental
Total possible points
*10 Points will be deducted for late submissions
Scores of 80-100% = Satisfactory
79-0% = Unsatisfactory

NGR 6242L (Section 0377) – Spring 2013 – Hartjes- Final

10

100


University of Florida
College of Nursing
NGR 6242L

Clinical Pearls: Evaluation Criteria
Evaluation Criteria (Student Posters)
Posting Student Criteria

(used when not assigned as the responding student)

Possible
points

Question posted on or before assigned date.

5

Question pertinent to ACNP practice in the management of patient
populations/conditions in the acute care practice setting:
-Contains information describing clinical relevance/problem/issue [5
points]
-Concise (100 words or less) [5 points]
-HIPAA compliant [5 points]

15

Answer to question posed:
-Contains organized, pertinent, key clinical data [10 points]
-Accurate and concise (400 words or less), reference list and addendum
are not included in word limit [5 points]
-Includes:
Standard of care based on most current guidelines [10 points]
Role of the NP specific to clinical issue [10 points]
Conclusions and recommendations [10 points]
-Posted on assigned date (not earlier) [5 points]

50

Scholarly format:
-Presentation is accompanied by at least one current, appropriate
evidence based reference listed in APA format [5 points]

10

(references should be published less than 5 years prior to the submission date to be
considered current)

-Compliance with current APA format guidelines. [5 points]

Minimum APA requirements: running head, pagination, double space, appropriate
use of citations, & reference list

Includes a brief description below each reference on the reference list of:
1] The level of evidence (LOE) that the reference provides including
correct rationale for LOE selection [5 points]
2] How the reference supported a particular aspect of the clinical
decision making. [5 points]
*Textbooks or online text sources will not be accepted.
**Correct integration of reference content is demonstrated.

10

Thoughtful, clinically pertinent replies to peer responses on or before assigned
date

10

Total possible points

Scores of 80-100% = Satisfactory
79-0% or TurnItIn similarity index >24% = Unsatisfactory

100


University of Florida
College of Nursing
NGR 6242L

Clinical Pearls: Evaluation Criteria
Evaluation Criteria (Student Responders)
Responding Student Criteria
(used when not assigned as the posting student)
Responds to TWO peer postings as assigned on or before assigned period.

Possible
points
10

Response is:
1] Scholarly, clear, and concise (400 words or less), reference list and
addendum are not included in word limit [15 points]
2] Includes:
Standard of care based on most current guidelines [20 points]
Role of the NP specific to clinical issue [20 points]
Conclusions and recommendations [15 points]

70

Response is accompanied by at least one current evidence-based reference.
Includes a brief description of:
1] The level of evidence that the reference provides and rationale [5
points]
2] How the reference supported a particular aspect of the clinical decision
making in the case.[5 points]
*Textbooks or online text sources will not be accepted.
**Correct integration of reference content is demonstrated
Compliance with current APA format guidelines.
Minimum APA requirements: running head, pagination, double space,
appropriate use of citations, & reference list

10

Total possible points
Scores of 80-100% = Satisfactory
79-0% or TurnItIn similarity index >24% = Unsatisfactory

10

100


University of Florida
College of Nursing
Graduate Student Clinical Visit Evaluation Tool
(could be used by either faculty or clinical preceptor or both)

Score*

Recommendations

Professional behavior
Communication written
Communication verbal
Interdisciplinary collaboration
History of the Present Illness
Past Medical History
Review of systems
Physical exam
Assessment & Differential Diagnosis
Treatment plan
Generation of appropriate related clinical questions
Utilizes research findings and content/concepts learned
previously to support and articulate rationale for diagnosis
and/or treatment

Key*

SATISFACTORY
5 = demonstrated in a primarily consistent, correct independent manner (demonstrated for all cases; 2/2 cases)
4 = demonstrated mostly in a consistent, correct manner with minimal assistance from preceptor (demonstrated for almost all cases; 1.5/two cases)
UNSATISFACTORY
3 = demonstrated in a moderately consistent, correct manner with moderate assistance from preceptor (partial demonstration; 2/2 cases)
2 = demonstrated inconsistently, needs preceptor to assist frequently (disorganization is obvious and assistance is almost complete for each case)
1 = very slow/ineffective, needs preceptor to do most of it (disorganized, disrupts facility flow and complete assistance is needed for 2/2 cases)
0 = unable to perform behavior, unsafe, needs preceptor to demonstrate/perform (2/2 cases; is an observational experience)
NA = no opportunity to demonstrate behavior