Nursing 405

Community Health Practicum

Spring 2004

 

Instructor: Sandra DeBella Bodley, RN, EdD
Department of Nursing
Sonoma State University

This clinical course is designed to be a synthesis of community-based nursing and community/public health nursing with the goal of promoting and preserving the health of populations. The ability to prevent disease, maintain well being and promote health through organized community effort is derived from public health. This course also recognizes that community health practice is responsible to the community as client with services provided to individuals, families and groups to promote health and prevent disease. Students will have an opportunity to participate in Home Care Nursing as a component of their community health experience. Students will apply knowledge and skills from nursing and public health sciences to expand their understanding of caring for a community's health. The community of southwest Santa Rosa will be primary focus of this clinical.

Courses objectives:

  1. Apply a knowledge base of community health nursing and related sciences (i.e., public health, biostatistics, epidemiology, community organizing) to providing care to clients in a community context.
  2. Use the nursing process, therapeutic interventions, critical thinking and professional communications to provide caring services to clients in the community.
  3. Demonstrate therapeutic communication skills with clients, with interdisciplinary members of the community team and with community members.
  4. Demonstrate culturally competent care for the community and its members by recognizing the sociopolitical, economic and ethnic characteristics of the community.
  5. Apply the principles of self-direction , accountability, leadership and case management in meeting the needs of clients in the community.
  6. Demonstrate professional role development as a client advocate in the community by becoming well informed on a client health related issues.
  7. Demonstrate health teaching skills by assessing the learning needs of a selected client group, preparing and presenting an appropriate health teach and evaluating it.
  8. Compare and contrast the role of the Home Care nurse to other community health nursing roles.

The course objectives encompass the 8 core competencies of public health nursing as they fulfill the AACN Essential Components for BSN Education.* These essentials are

I. Professional Values,

  • Caring, Altruism , Autonomy, Human dignity, Integrity, Social justice

II Core Competencies,

  • Critical thinking, Relationship centered skills, Communication, Assessment, Technical skills;

III Core Knowledge,

  • Health promotion/risk reduction/disease prevention , Illness and disease management, Information and health care technologies , Ethics , Human diversity, Community focus , Global health, Health care system and policy

IV Role Development.

  • Provider of care, Designer/manager/coordinator of care, Leader, Member of a profession.

* The evaluation tool for the course uses the public health competencies as they address these essential components of BSN education.

Formative and Summative Evaluation

At midterm and end of term, complete the Course Objective Form by clearly and explicitly describing clinical activities that you have been involved in that have assisted you in meeting the course objectives.

Due: Mid-term and Final week at individual conference.  

Course Objectives | Learning Activities | Course Requirements | Clinical Schedule | Website Resources

Clinical days: 8:30-5:00 Tuesdays (please refer to Clinical Schedule) January 27 through May 16, 2004
Conference times 8:30-10 at the SWCHC.

There are 5 major learning activities through which the students can meet the course objectives. These learning activities for N405 are varied and designed to assist the student in acquiring basic community and public health nursing knowledge and skills.

1.    Community Assessment

Complete the community survey forms in your syllabus and put them in your clinical binder. Other experiences throughout the semester may be added into your community assessment, meetings you attend, or community projects in which you participate. This community assessment includes observations, interviews, and data collecting. How would you determine what it would feel like to live in this community? The form for this assignment is in your supplemental syllabus.

Due __________ 5%

2.    Case Management in the Community

Review several definitions of case management from various sources including your community health text. Identify the principles of case management specific to community health nursing. Describe the role and responsibilities of the nurse doing case management in a community setting. You may use any community setting, your home care agency, the SWCHC, House Calls or any agency that is part of your clinical experience this semester. Who are the clients, and what is the nature of the services being provided? What are the direct nursing care and the indirect care, such as coordination or collaboration?

Summarize and reference (2-3 pgs) and this assignment will be emailed.

Due __________ 10%

3       High Risk Population/Aggregate Focus

 

This learning activity will include your assessment of a high risk population , a health teaching activity matching the population’s needs and at least one community meeting that describes the organization’s role in assisting this population. This learning experience will include about 50 hours of your 135 hours and therefore will be 35% of your total grade.

 

The available settings for this learning experience are:

1          Southwest community Health Center 

2          Community Benefits Programs of St. Joseph’s Health System

3          The Northern California Center for Well Being

4          The Drug Abuse Alternative Center (DAAC)

5          Native American Health Center

6          Elsie Allen High School  Health Center

 

A) Program assessment: (To be presented in clinical conference on an assigned date.)

·        Who does this organization/program serve?  Is this a high risk population; what puts this population at Risk?

·        Describe the scope and function of the organization and or program

·        How effective is this organization or program in meeting its stated goals and purpose? What criteria does the organization/program use to evaluate its services?

·        Who are the staff, do they reflect the people they serve? How does this organization /program demonstrate cultural competency?

·        How is this organization/program organized and funded?  ( Organizational chart, funding sources, community boards)

B) High Risk Population Assessment: Select a high risk population that is of interest to you.

·        What factors place this population at risk (psycho/social factors, economic, environmental, physical, genetic or any other factors that put this group at risk.)? Explain the risk factors in your presentation.

·        Describe the health promotion opportunities that are currently available for this identified population.

·        Describe specific population focused interventions that could be employed for this risk group.

·        Identify community resources for this group including the agency you have been working at this semester. You will write up and turn in to me both part A and B at the time of your presentation please include references for your description of this populations risk factors.

         C) Health teaching with High Risk population

Within your high risk population, identify a learning need or teaching opportunity. Describe your assessment that identified the learning need.  Choose a topic to present to your group and develop a teaching plan for this topic. Assess the clients’ learning abilities or learning level and match your teaching plan and any resource materials you use to the group’s level and abilities (literacy, language skills, educational level). Include in your presentation the basic elements of teaching:

·        Develop objectives and a method of evaluation for you’re teaching presentation

·        Set induction (introduction of topic)

·        Development of topic (keep it simple cover only one or two main ideas)

·        Summarize to reinforce ideas

Write up your teaching plan with references and resources

         D) Community Meeting related to organization or program

Attend a community based meeting relating to your high risk populations. It may be a self help group, a community base action group, or an advisory board to a program serving your population. Discuss the mission of the organization, include the agenda, and discuss what occurred at the meeting. Clearly discuss how this organization is meeting the health needs of the population.

                                                                                                                                                                                    Due ____________ 35%

4       Family Case Work / Home Care Experience

Students will be assigned to a Home care agency to explore the role and responsibilities of home care nursing from a community health perspective. You will spend about 50 hours in this setting so this assignment accounts for 35% of your total grade. You are to follow all agency policies and procedures and request an orientation to the agency. You are also encouraged to attend at least one interdisciplinary conference with the staff of your agency.  When allowed you should be charting on clients and for selected clients you should take the lead in their care. From your caseload of families select one family for a comprehensive family case study to present at a clinical conference. Students will use SOAP charting and nursing diagnosis for their visits with their chosen families

In order to be able to present the family you need to gather information related to:

·        Environmental assessment (the home, the setting, the area around the home, and the neighborhood)

·        Family data base and family structure

·        Family health history

·        Medication profile with explanation

·        Socioeconomic status, health plans etc.

·        Mini mental status exam (as indicated)

·        Goals for this family

·        List of Nursing Diagnosis

·        Soap charting for at least 3 consecutive visits with summary and conclusion.

 All of this information will be compiled into a client chart to be handed in at the time of your presentation.

Note: the oral presentation will not exceed 15 minutes                                                                                                   Due _______________ 35%

 

5       Weekly Journal (e-mailed to the Instructor)

Students will keep a weekly clinical journal describing their learning activities, progress and plans. The description of the activity should present what you are doing.  I need to know what activities you are experiencing with some analysis of how this activity is meeting your learning objectives. One activity may address more than one objective for example a home visit may include family assessment, advocacy, community resources and working with a high risk population. Your case management assignment is to be included as journal entree. The journal may include questions for the instructor or issues to be discussed in clinical conference. The journal entries will be timely, comprehensive, clear, and reflective of the clinical activities that you are involved in. They are to be emailed by Friday or notify me why you haven't sent your journal.

Due weekly __________ 15%

Course Objectives | Learning Activities | Course Requirements | Clinical Schedule | Website Resources

Grading policy: This is a 3-unit course which equals 9 hours/week of clinical time; students will be responsible for logging their clinical hours in their journal. Missed clinical time will be made up by arrangement with your instructor. Grades are not only based on effort but on the outcome of the activity and its evaluation. A self assessment of your progress in the course is due by the 8th week. If your progress is not satisfactory (i.e., a C or better), I will arrange an individual conference to discuss your plans for improvement.

 

Clinical Requirements:

Students are requested to purchase a 3-hole medium-size 8½ x11 binder for your journal and other assignments in this course.

Students are responsible for their own transportation; therefore you need a valid current driver's license and auto insurance.

Students must carry malpractice insurance. Information and forms are available in the nursing office. Students must present verification to me by the third week of clinical before you start in Home Care.

Students must have an SSU name tag. There is no uniform for this clinical, but professional attire is required. Sportswear or jeans are NOT appropriate.

Students may put together a home visit supply bag for their use in clinical. You may use a small backpack or something similar. I would suggest that you include a quality stethoscope, a blood pressure cuff, pen light, alcohol wipes, hand wipes and a small notebook. You may confer with your home care nurse for other items that they find useful.

When students are involved with activities that require instructor supervision such as home visits on days other than Tuesday, please let me know ahead of time.

Course Objectives | Learning Activities | Course Requirements | Clinical Schedule | Website Resources

Clinical Website Resources:

Here are some URLs that you will find helpful in learning more about the community.

Course Objectives | Learning Activities | Course Requirements | Clinical Schedule | Website Resources