High Midwifery Diploma
Transcription
High Midwifery Diploma
2011 College of Nursing Pediatric Nursing Department Simulated Clinical Experience (SCE) Edited By - Dr. Afkar Ragab - Dr. Laila Abu Salem - Dr. Ahlam Hussien - Dr. Ahlam Hussien Pediatric Nursing Course (MDNU: NURS431) First Semester Academic year 2010-2011G 1431/1432 H Skills Lab. Protocol of Work Training of pediatric nursing students in skills lab is necessary before starting the clinical experience in different clinical settings. Skills lab training will support students’ psychomotor skills in real situation in the hospital clinical settings and increase student's self confidence during caring with children Setting of Practice: Neonatal & Pediatric skill Laboratories Length of Practice: 2 weeks (2 days/ week) Number of students: 10-15 students/ group Learning Objectives: At the end of this rotation (6 days) the student nurse will be able to: Perform physical assessment. Measure weight, length, height, circumference of the head, chest, and mid-arm for infants and children Measure vital signs Bathe infant Restraint infants and children Feed infant and children (nasogastric tube and bottle feeding). Administer oxygen through mask, nasal cannula, and oxygen hood. Demonstrate care of newborn in incubator. Practice care for infant with colostomy. Administer medication by different routes of administration. Insert peripheral venous access to pediatric model and demonstrate care of intravenous line. Apply principles infection control in all pediatric procedures. Resuscitate newborn Collect specimens (sputum, urine , stool) Student’s Activities 1. Prepare and discuss the assigned topic presentation. 2. Create and prepare learning audiovisual material. Methods of evaluation: - Observational check lists. - Assignment preparation and presentation - Preparation of audiovisual material - Post clinical examination - Attendance Topic presentations for lab experiences are - Incubator care - Infection control in pediatric settings (neonatal unit( - Collection of specimens NB Post clinical exam held in the last day of skill lab experience. Pediatric Nursing Skill Practice Lab Academic Year 1431/1432 H 2010/2011 G Students’ Guidelines: Pediatric nursing skill laboratory is established along many years ago. It is equipped with the most recent educational tools including appliances and models. Students are trained on simulators, to simulate the actual management on infants and children. Emphases also will focuses on pediatric nursing skills commonly practiced with pediatric patients. Goal: The students will be able to utilize basic scientific principles and concepts to provide safe and accurate care to infants and children with deferent medical / surgical conditions Objectives The student will be able to: 1- Provide proper physical assessment for children 2- Measure Vital Signs for an infant/ child simulator accurately and safely. 3- Perform growth measurement accurately and record them on growth chart. 4- Provide proper cannula care 5- Administer medication safely and accurately for children simulator. 6- Provide proper bathing for a bed ridden child 7- Perform proper ostomy care. 8- Provide proper Naso-gastric Tube Feeding. 9- Perform CPR. Accurately for older children 10- Apply proper types of restraints Pediatric Nursing Skill Practice Lab. Procedures 1. Complete physical assessment for Children 2. Vital Signs 3. Colostomy Care 4. Growth measurement 5. Breast Feeding Techniques/ bottle feeding 6. Gastrostomy feeding 7. CPR. 8. Iv therapy 9. Cannula care 10. Oxygen Therapy 11. Suctioning 12. Drug administration 13. Restraining Neonatal Skill Practice Lab Academic Year 1431/1432 H 2010/2011 G Students’ Guidelines: Newborn skill laboratory is established along many years ago. It is equipped with the most recent educational tools including appliances and models. Students are trained on simulators, to simulate the actual management on the newborn babies as well as infants. Emphases also will focuses on pediatric nursing skills commonly practiced with newborn infants. Goal: The students will be able to utilize basic scientific principles and concepts to provide safe care to newborn baby. Objectives The student will be able to: 1- Measure Vital Signs for a newborn simulator accurately and safely. 2- Perform growth measurement accurately and record them on growth chart. 3- Provide proper eye care, cord care. 4- Identify the indications of sponge bath. 5- Provide proper sponge bath for a newborn. 6- Perform infant bathing. 7- Provide deferent methods of newborn and infants' feeding 8- Perform neonatal CPR. Accurately and safely Neonatal Skill Practice Lab. Procedures 1- Complete physical assessment for neonates. 2- Assessment of Gestational Age. 3- incubator care 4- Vital Signs 5- Sponge bath 6- Infant bath ( Table Tub Bath) 7- Eye & Cord care, diaper care 8- Growth measurement 9- Breast Feeding Techniques 10- Feeding baby with Gastrostomy 11- Neonatal CPR. 12- Infant CPR 13- Iv therapy Pediatric Nursing Course (MDNU: NURS431) First Semester Academic year 2010-2011G 1431/1432 H Student's Skills Lab Evaluation Sheet Student's Name: ……………………………….. ID: ………………. Group No.: ………………. Date: from ………. to …………. Procedure Performed: ……………………….. Items Maximum Marks 25 Marks 1- Nursing procedure (25 Marks) - Preparation of equipment/environment and child 3 - Carry out procedure accurately 20 - Returning equipment 2 II- Knowledge (10 Marks) 10 Marks III- Preparing Audio visual Materials (10 Marks) 10 Marks - Clear 2 - Colored 2 - Relevant 4 - Submitted on time 2 VI- Professional Behavior (5 Marks) 5 Marks - Eager to learn 1 - Show punctuality 1 - Complete uniform 1 - Communicate effectively with instructor / colleagues 1 - Respects rules, regulations, and constructive criticism 1 Total Total Marks obtained: Instructor signature: 50 Date: Student's Marks Roles and Regulations for Using Skill Labs. Students have the right to demonstrate procedures with her own based on written request from lab. Coordinator. Students should have the right to re-demonstrate procedures in the front of instructor once, twice, or more to master the skills Students are forbidden to enter the lab. Without wearing uniform and lab. Coat. An evaluation tools and lab objectives should be explained prior actual conduction of Training. Students are not allowed to be in the lab without instructor or staff member from the pediatric department. Students are not allowed to handle Sim Baby or other sensitive equipment without the presence of assigned pediatric Nursing staff Students are not allowed to take any drinks or food in the lab. Students are not allowed to take any bags inside the lab during training. Any accidental damage in equipment or simulator must be recorded and reported to labs. Coordinator to take an action. Equipment list should be prepared prior any procedure by the lab technician or assigned instructor Each student should come with her checklists and procedure manual. Skill labs can be used by other specialty staff after filling request from the lab technician and acceptance from lab. Coordinator. Students have the right to accept or reject to be a model taking picture in the Lab. Universal infection control measures are used for students' safety in skill Labs. In case of accidental injuries student should be referred to the nearest facilities to take vaccine and proper management. Occupancy of Newborn & Pediatric nursing labs along the academic year Time 1st. Semester Newborn Lab Newborn master students Pediatric nursing undergraduate students 2nd. Semester Obs/ Gyne undergraduate students Pediatric nursing lab Newborn master students Pediatric nursing undergraduate students Pediatric Nursing Master Students Under graduate M. S. Students Pediatric Nursing Skill Practice Lab Sample of Performance Checklists Performance Check List for Naso / Oropharyngeal suctioning Student’s name : Area : Group : Action 1. 1-Wash hands. 2. 2-Turn on suction apparatus and set vacuum regulator to appropriate negative pressure. 3. 3-Select appropriately sized suction catheter. 4.Secure one end of connecting tube to suction machine and place the other end in a convenient location within reach. 5.Open sterile catheter package on a clean surface using the inside of the wrapping as a sterile field. 6.Set up the sterile solution container or sterile basin on the sterile field. Be careful not to touch the inside of the container. Fill with approximately 100 ml of normal saline or sterile water. 7.Open lubricant and squeeze on to sterile catheter package without touching package. 8.Provide 3 hyperinflation, hyperoxygenation breaths with a bag valve mask connected to a manual resuscitation bag attached to 100% oxygen. 9.Don sterile glove. 10.Pick up suction catheter, being careful to avoid touching the nonsterile surfaces. With the nondominant hand, pick up connecting tubing and secure the suction catheter to the connecting tubing. 11.Check equipment for proper functioning by suctioning a small amount of sterile saline from the container. 12.Coat the appropriate length of suction catheter with water-soluble lubricant or sterile water, 13.Leave catheter air vent open. 15.Slowly withdraw the suction catheter while rotating it back and forth between dominant thumb and forefinger. Apply intermittent suction of the air vent during withdrawal. 16.Rinse catheter and connecting tubing with sterile water or saline. 17.Suction both sides of mouth and pharynx. 18.Repeat steps 14 through 17 to clear nasopharynx and oropharynx. 19.Monitor patient’s ECG tracing and heart rate between suction passes. 21.Reposition patient. 22.Reassess patient’s respiratory status. Yes Date : No Comments 23.Discard remainder of supplies in appropriate receptacle. 24.Wash hands. 25.Dispose of suction cannisters and connecting tubing every 24 hours and set up new system. Performance Check List For Endotracheal Suctioning Student’s name : Area : Group : Date : Action 1- Explain to the child and the family the need for endotracheal suctioning, as time permits. 2-Note the child’s cardiac monitor and pulse oximetry readings. 3-Wash your hands thoroughly with Betadine, don gloves and mask. 4- Connect suction catheter to the tubing of the suction device and set the suction pressures to the desired negative pressure. 5- Ventilate the child with 100 % oxygen for 3 hyperinflation, hyper oxygenation with a bag valve device. 6- Lubricate the appropriate size of catheter with sterile water. -Auscultate anterior lungs bilaterally. 7-Without applying suction, quickly and gently insert catheter into the endotracheal tube and apply suction while rotating the catheter between the thumb and forefinger. and use a septic technique. 8 –Apply suction by occluding the on / off port, and gently withdrawing the catheter with a twisting motion. -limit suction not more than 5 seconds. 9- After withdrawal of catheter, rinse it with sterile water. 10-Ventilate child in-between and after attempts with 100 % oxygen. Yes No Comments 11 –Monitor child’s heart rate, color throughout the procedure. 12- Repeat steps 7-11 as needed. 13- Return child to previous oxygen setting, auscultate anterior lungs bilaterally. 14- Comfort child during and after procedure. 15- Discard reminder of equipment according to institution policies. 16- Document the child’s response to suctioning, the type and amount of suctioned secretions, any changes in heart and respiratory rates. Oxygen Therapy Performance Check list for simple face mask Instructor ‘s name : Student’s name : Action Simple face Mask 1. Wash hands. 2. Attach humidifier to flowmeter . 3. connect flowmeter to oxygen source, and check operation of flowmeter and humidifier . Set prescribed oxygen flow . 4. Attach oxygen mask to connecting tubing and then to humidifier and flowmeter . 5. Turn on oxygen . 6. Place mask on patient’s mouth and nose, adjust elastic or tubing for a snug fit . 7. Check oxygen flow . 8. Stress fire hazards involved with oxygen administration . 9. Wash hands. Area : Group : Date : Yes No Comments Performance Check list for nasal cannula Instructor ‘s name : Student’s name : Date : Area : Group : Action Oxygen therapy through nasal cannula 1. Wash hands . 2. Attach humidifier to flowmeter . 3. connect flowmeter to oxygen source, and check operation of flowmeter and humidifier . 4. Open cannula package and attach to humidifier with care to avoid contamination of cannula nasal tips . 5. turn oxygen flowmeter on to prescribed liter flow/ oxygen concentration prior to applying cannula. Observe that water in humidification container is bubbling . 6. Insert the nasal tips into the nares. Direct prongs posteriorly . 7. Loop the two plastic tubes of the cannula over the ears and under the chin, or place elastic band around the head . 8. Gently adjust the plastic slide until cannula is secure . Yes . No Comments Performance Checklist for Table Tub Bath Nursing Action Explain the procedure to the child’s mother. Check room temperature and free from drafts (close windows and doors). Assemble the equipment. Fill the baby tub half to two third full of warm water Assess water thermometer (37.8C°) (40.68C°) Spread the bath towel on the bed or table. Wash hands. Place the infant still dressed on the bath towel. Wash the infant eye, starting from the far eye, wipe the eye with moist cotton, then dry it with clean dry cotton in one direction. Water only. Wipe the infant’s face, forehead, cheeks and mouth (clean inside the mouth if needed and nose with a moist cotton). Soap the scalp; support the infant using the football hold. Close ears with your fingers lather your hand with soap then apply it to the scalp Soap the scalp; support the infant using the football hold (the baby is supported under the nurse’s arm and no her hip) first lather your hand with soap then apply it to the scalp Rinse the soap off the infant quickly. Again lift the infant from the tub back to the towel and dry well. Dress the infant, comb his/her hair gently. Clean all used equipment and return to its place. Wash hands. Record time and observations. Yes No Comment Performance Checklist for Colostomy Care Nursing Action Explain procedure to the mother/ child Prepare Equipment Place tray to be easily accessible Place mackintosh and towel well tucked under the patient. Wear disposable gloves to remove soiled dressing, Assess the stoma output for volume, consistency and odor in relation to the type and location of the stoma. Gently and thoroughly wash the skin using warm water and mild soap (not irritant) or any solution. Assess the stoma and surrounding skin by using gauze or wash cloth. When the stoma became clean, repeat with gauze or wash cloth soaked in clear water. Wipe the peristoma skin with mild soap and water and dry it put zinc oxide, or any soothing cream If bag is used: Measure the circumference of stoma and choose appropriate bag size. Fix bag on skin applying even, firm pressure tight to stick bag. If bag is not used: Apply a folded wash cloth over the stoma and secure it with long gauze or a tape (Tape must be not irritant if available). Remove and clean all used equipment. Wash hands. Record condition of dressing and stoma color of stools and character, time and signature. Reassure child, and mother, praise him for co-operation. Yes No Comment INVENTORY OF PEDIATRIC SKILL LAB. & NEWBORN SKILL LAB. New born care LABORATORY SIMULATOR / MANIKIN CLA Hospital Training Baby 1 2004 Flexible baby female 1 MS5275290504/RU Flexible baby male 1 MS 53-4782.8.04 FK; new Infant Airway Management Trainer 1 LF 03623U; new Infant ECG Crisis Manikin 1 old; w/ accessories Infant ECG Crisis Manikin 1 new ; w/ accessories Infant Arterial Training Arm 1 2006 Intubation Phantom of NB 1 Old Intubation Phantom of NB 2 CLA 8/58-262.3.04/FR; new Kevin Infant CPR 1 Kim NB CPR manikin 1 2004 Kim NB CPR manikin 1 Old NB intubation training model 2 2004; 2008 Nita NB 1 2004 Pediatric Injectable Training Head 1 2004 Premature baby-female 1 2004 Premature baby-male 1 2004 Resusci Baby 1 Old FURNITURE QTTY Model 34200 Baby care crib trolley w/ REMARKS 1 double locker accessible through doors complete w/ baby crib, mattress Steel Cabinet w/ glass door 5 Swivel chair (lab) 16 Table (lab) 5 Patient's screen (white) 1 Bedside table 1 Returned from CCL2 01/11/08 Incubator 2 1 donation from KFHU & 1 2006 Infant warmer (Hill-Rom Airshields) 1 2006 ELECTRONICS TV (colored; JVC 29") QTTY 1 1 broken REMARKS Model:AV-29WX11; SIMULATOR / MANIKIN SN/ 09981100; w/ RC Video cassette recorder (JVC) 1 Model: HRV-401AS SN/: 10970085; w/ RC Data Show 1 Eiki model; w/ RC; 30775 Ip 3000 Primax Canon Printer 1 feb. 2007; w/ CD & manual Dell CPU Optiplex GX520 1 SN:H3LBJ2J; SC 37222508107 LCD Monitor 1 67I-4KRU Keyboard 1 71616-697-11N9 Mouse 1 HC622QA036T CD (Neonatal & Pediatric Assessment) 4 IP Fast Dome Camera 1 13/11/07 INSTRUMENTS REMARKS Ambu bag 1 pedia size; old Laryngoscope 1 w/ 3 straight blades Physical Assessment kit 1 03/05/08 1 missing penlight Oxygen hood, transparent 1 Stethoscope (Riester) 1 Stethoscope (Allgaier) 1 Rectal thermometer 1 Thermoscan 1 Urine bag stand 1 Portable suction machine 1 2006 OTHERS QTTY REMARKS Bath basin 1 Compiled Catalogue for manikins 1 Mounted / piped in O2 & suction 1 Filing trolley 1 Draw sheet yellow 3 Bath towel 4 Children gown blue 2 Children suit 4 2 blue; 2 pink Koken baby boy/girl 2 12/11/2007 Baby IV head Laerdal 1 12/11/2007 ALS baby 200 1 12/11/2007 Multivenous trng. Arm 1 12/11/2007 Special needs infant female 1 12/11/2007 IV baby arm Nasco 1 12/11/2007 Pediatric injection head Adam 1 12/11/2007 29/10/07 3 yellow; 1 white NEW DELIVERIES: SIMULATOR / MANIKIN Nita Newborn 1 12/11/2007 Alaris IV pump 1 02/03/2008 Thermometer electronic suretemp plus 1 10/11/2008 Balance baby scale digital 1 10/11/2008 Balance baby scale 1 10/11/2008 Sphymomanometer miniature 3 10/11/2008 Stethoscope littmann classic II 7 10/11/2008 Ambu bag resuscitator w/ connector 1 10/11/2008 Trolley w/ 1 drawer 2 shelves 1 10/11/2008 Pulse oximeter audio & visual 2 10/11/2008 Abdominal colostomy model 1 IV Arm, Laerdal 1 Pediatric care LABORATORY ITEM # EQUIPMENT / SUPPLIES QTTY. REMARKS A SIMULATOR / MANIKIN 1 Child Crisis Manikin 1 old 2 Child Nursing Doll 1 w/ accessories 3 Infant model for nursing practice 1 2004 4 Kyle 3y/o child CPR 1 04 5 Kyle 3y/o child CPR 1 old 6 Mike/Michelle 1 old; R-lower leg removed 7 Mike/Michelle 5y/o 1 old 8 Mike/Michelle infusion leg 1 old; worn out 9 Mike/Michelle injection arm 1 old; worn out 10 Laerdal Sim Baby: 1 14/11/07 11 Dell Laptop gray 1 SN: 3ZG3F1 12 HP iPAQ Bluetooth 1 13 Logitech webcam 1 14 Entuitive monitor 1 14 link box 1 15 Compressor 1 16 Dell CPU Optiplex 745 1 3GNJFDI 17 Dell keyboard 2 759-GBIW;7BE-ODJM 18 Dell mouse 2 ODJ301; G1401JL0 19 Virtual IV 1 SN: 33070082-C 20 Laerdal mega-code vitalsim w/ RC 1 12/11/2007 21 Little Junior 1 11/09/2008 22 Disposable lungs 25 11/09/2008 23 Resusci Junior w/ skillguide 1 11/09/2008 24 Disposable lungs 25 11/09/2008 25 Manikin face shields pk/6 11/09/2008 B FURNITURE 1 Bed (electronic) 1 from KFHU 2 Child Bed 1 3 Bedside locker 1 4 Computer table 2 from KFHU; from Comp. Lab. 5 Laboratory table 4 from KFHU 6 Swivel chair 17 7 Steel cabinet w/ glass door 4 2006; 3 big; 1 small 8 Steel cabinet w/ glass door 1 from KFHU 9 Filing trolley 1 29/10/07 new, replaced on 14/07/2009 ITEM # EQUIPMENT / SUPPLIES QTTY. REMARKS C. ELECTRONICS 1 Dell Optiplex GX520 CPU 1 SN: 36VBT1J 2 Dell monitor 1 67I-1YUU 3 Dell keyboard 1 6AB-A1GU 4 Dell mouse 1 ODJ301 5 Dinamapp 1 from KFHU 6 Terumo IV pump 1 from KFHU;in Store room 7 EIKI data show w/ RC & manual 1 11/11/2007; 39719 8 Alaris IV pump 1 02/03/2008 D INSTRUMENTS 1 Laryngoscope 1 2006; w/ 3 blades curved 2 Physical Assessment kit 2 3 Oxygen hood 2 4 Stethoscope (Spectrum) 2 5 Thermoscan 1 E OTHERS 1 Screen projector 1 from KFHU 2 Footstool 1 from KFHU; store room 3 Patient's screen white 1 4 Piped in O2 & suction (mounted) 1 5 Bedsheet (blue) 2 6 Draw sheet (yellow) 2 7 Bath towel 18 16 yellow; 2 white old 8 Hamper 9 2006; 1 old 9 Pillow 2 10 Bed cover blue 4 11/11/2007 11 Bed cover white 2 11/11/2007; 3 old 12 Bed sheet white 8 11/11/2007; 4 old 13 Bed sheet w/ design cream 3 11/11/2007 14 Pillow case (blue) 17 11/11/2007; 12 old; 5 new 15 Face towel white 15 11/11/2007 16 Flannel sheet white 12 11/11/2007 17 Children gown 8 11/11/2007;3 blue, 5 pink 18 Children suit blue 1 11/11/2007 NEW DELIVERIES 1 Thermometer electronic 1 11/10/08 missing probe 2 Weighing scale electronic 1 10/11/2008 3 Balance baby scale digital 1 10/11/2008 4 Balance baby scale regular 1 10/11/2008 ITEM # EQUIPMENT / SUPPLIES QTTY. REMARKS 5 Sphygmomanometer miniature 2 10/11/2008 6 Stethoscope (Littman) 3 10/11/2008 7 Ambu bag resuscitator 1 10/11/2008 8 Trolley w/ 1 drawer 1 10/11/2008 9 Automatic Voltage Regulator 2 23/11/08 List of Equipment Requiring Maintenance - One swivel chair (broken). List of Equipment to Be Purchased 1- Gastrostomy Manikin. 2- Colostomy Manikins 3- Gastrostomy feeding tubes. 4- Napkins. 5- Different types of baby feeds. 6- Educational Stethoscopes