Big Sandy Community and Technical College

Course Syllabus

PS Number: 80548 Semester: Spring Year: 2017

Faculty Name: Terri E. LeBrun Title: Professor

Course Prefix and Number: RCP 250 Course Credit Hours: 3

Course Prerequisites: RCP 200 with a grade of C or better.

Course Title: Clinical 5 Second 8 weeks of Spring Semester Instructor: Kathy Allen Days and Times: TBA

Catalog Course Description: Prepares students to participate in effective and efficient planning, managing and delivering respiratory care to diverse client populations in various settings

Instructor Contact Information:

Campus Location: Mayo Building & Room: Building-D Room- 202

Office Hours: See attached Instructor Schedule

Office Phone Number: 606-788-2813 Alternate Number: 606-789-5321, Ext.82813

Best Times to Call: Afternoons

KCTCS Email: terri.lebrun@kctcs.edu

Special Instructions: Please leave a voice mail or email if unable to contact instructor.

Supervisor Contact Information:

Name: Myra Elliott

Campus Location: Prestonsburg Building & Room: Student Center 202-A

Office Phone Number: 606-889-4715, Ext. 94715

KCTCS Email: myrat.elliott@kctcs.edu

Text and Supplies:

Clinical Manual

KCTCS General Education Competencies

Students should prepare for twenty-first century challenges by gaining: A. Knowledge of human cultures and the physical and natural worlds through study in the sciences

and mathematics, social sciences, humanities, histories, languages, and the arts. Method to Achieve Competency:

B. Intellectual and practical skills, including

inquiry and analysis

critical and creative thinking

written and oral communication

quantitative literacy

information literacy

teamwork and problem solving Method to Achieve Competency:

C. Personal and social responsibility, including

civic knowledge and engagement (local and global)

intercultural knowledge and competence

ethical reasoning and action

foundations and skills for lifelong learning Method to Achieve Competency:

D. Integrative and applied learning, including synthesis and advanced accomplishment across general and specialized skills.

Method to Achieve Competency:

Course Specific Competencies (Student Outcomes):

Upon completion of this course, the student can: 1. Interpret the results of fundamental laboratory tests for hematological, blood chemistry/fluid and electrolyte balance. 2. Demonstrate a working knowledge of the principles and techniques of hemodynamic monitoring and assistance of the insertion and maintenance of hemodynamic monitoring systems. 3. Demonstrate a working knowledge of the principles and techniques of pulmonary and cardiac exercise/stress testing. 4. Demonstrate a working knowledge of the principles and techniques of the performance of sleep studies. 5. Demonstrate a working knowledge of the principles and techniques of metabolic testing and nutritional assessment. 6. Assist the physician in the performance of special therapeutic and diagnostic procedures pertaining to the respiratory patient.

7. Participate in ground and/or air transportation of patients. 8. Assess the respiratory condition of neonatal and pediatric patients. 9. Initiate, adjust, monitor, and provide quality assurance for neonatal and pediatric mechanical ventilation systems. 10. Modify respiratory care in response to the special needs of neonatal and pediatric patients. 11. Demonstrate professional behavior appropriate to the current educational level. Lab Competencies: (Enter N/A if this does not apply.) N/A Required Experiments/Activities: Experiments/Activities: 1. Practice Medical Asepsis 2. Gather information 3. Report and record information 4. Patient assessment 5. Medical Gas administration 6. Humidity and aerosol therapy 7. Chest physiotherapy 8. Bronchial hygiene therapies 9. Lung inflation therapy 10. Airway management 11. Noninvasive ventilation /CPAP techniques 12. Drug therapy 13. Mechanical ventilators 14. Monitoring oxygenation and ventilation status 15. Pulmonary function testing and interpretation 16. Electrocardiography 17. Assessing chest radiographs 18. Cardiopulmonary exercise testing 19. Assessing and modifying patient ventilation systems 20. Assist in emergency and special procedures 21. Assist in patient transport Course Outline: Assume Role of Respiratory Therapist A. Professional behavior B. Member of team C. Embracing diversity D. Ethical considerations E. Medico legal aspects F. Relationships with others G. Personal Attributes II. Practice Medical Asepsis A. Hand washing B. Utilization of universal/standard precautions C. Equipment cleaning D. Materials handling III. Gather Information A. Confidentiality B. General Condition

C. Orders D. Physical E. Progress notes F. History G. Lab, radiology, and other tests IV. Report and Record Information A. Legal aspects B. Communication V. Patient Assessment A. Interview B. Inspection C. Palpation D. Percussion E. Auscultation F. Vital signs VI. Airway Management A. Emergency airways B. Intubation C. Trach care of the intubated patient D. Extubation E. Tracheobronchial aspiration F. Specialty airways VII. Mechanical Ventilators A. Devices B. Systems C. Techniques D. Assessment E. Quality Control VIII. Assessing and Modifying Patient Ventilation Systems A. Measuring and adjusting parameters B. Assessing through graphics C. Modifying therapy D. Measuring ventilation mechanics e.g., resistance, compliance, inspiratory force etc. E. Calculating and reporting data F. Care of patient based on need G. Weaning H. Patient Education IX. Monitoring oxygenation and ventilation status A. Invasive 1. Arterial blood gases by puncture and arterial line 2. Operating blood gas analyzer and CO-Oximeters 3. Quality control procedures 4. Interpretation B. Non-invasive 1. Pulse oximetry 2. Capnometry 3. Transcutaneous C. Calculations and Reporting Data

X. Hemodynamic Monitoring Systems A. Devices B. Systems C. Techniques D. Calculations E. Assessment F. Quality Control XI. Cardiopulmonary Exercise Testing A. Devices B. Systems C. Techniques D. Assessment E. Quality Control XII. Sleep Studies A. Devices B. Systems C. Techniques D. Assessment E. Quality Control XIII. Metabolic Testing A. Devices B. Systems C. Techniques D. Assessment E. Quality Control XIV. Assist in Emergency and Special Procedures A. ACLS B. NRP C. PALS XV. Assist in patient transport A. Air B. Ground

Lab Competencies (Student Outcomes): (Enter N/A if this does not apply.)

N/A Required Experiments/Activities: Experiments/Activities: 1. Practice Medical Asepsis 2. Gather information 3. Report and record information 4. Patient assessment 5. Medical Gas administration 6. Humidity and aerosol therapy 7. Chest physiotherapy 8. Bronchial hygiene therapies 9. Lung inflation therapy 10. Airway management 11. Noninvasive ventilation /CPAP techniques 12. Drug therapy

13. Mechanical ventilators 14. Monitoring oxygenation and ventilation status 15. Pulmonary function testing and interpretation 16. Electrocardiography 17. Assessing chest radiographs 18. Cardiopulmonary exercise testing 19. Assessing and modifying patient ventilation systems 20. Assist in emergency and special procedures 21. Assist in patient transport

Course Outline:

Assume Role of Respiratory Therapist A. Professional behavior B. Member of team C. Embracing diversity D. Ethical considerations E. Medico legal aspects F. Relationships with others G. Personal Attributes II. Practice Medical Asepsis A. Hand washing B. Utilization of universal/standard precautions C. Equipment cleaning D. Materials handling III. Gather Information A. Confidentiality B. General Condition C. Orders D. Physical E. Progress notes F. History G. Lab, radiology, and other tests IV. Report and Record Information A. Legal aspects B. Communication V. Patient Assessment A. Interview B. Inspection C. Palpation D. Percussion E. Auscultation F. Vital signs VI. Airway Management A. Emergency airways B. Intubation C. Trach care of the intubated patient D. Extubation E. Tracheobronchial aspiration F. Specialty airways

VII. Mechanical Ventilators A. Devices B. Systems C. Techniques D. Assessment E. Quality Control VIII. Assessing and Modifying Patient Ventilation Systems A. Measuring and adjusting parameters B. Assessing through graphics C. Modifying therapy D. Measuring ventilation mechanics e.g., resistance, compliance, inspiratory force etc. E. Calculating and reporting data F. Care of patient based on need G. Weaning H. Patient Education IX. Monitoring oxygenation and ventilation status A. Invasive 1. Arterial blood gases by puncture and arterial line 2. Operating blood gas analyzer and CO-Oximeters 3. Quality control procedures 4. Interpretation B. Non-invasive 1. Pulse oximetry 2. Capnometry 3. Transcutaneous C. Calculations and Reporting Data X. Hemodynamic Monitoring Systems A. Devices B. Systems C. Techniques D. Calculations E. Assessment F. Quality Control XI. Cardiopulmonary Exercise Testing A. Devices B. Systems C. Techniques D. Assessment E. Quality Control XII. Sleep Studies A. Devices B. Systems C. Techniques D. Assessment E. Quality Control XIII. Metabolic Testing A. Devices B. Systems

C. Techniques D. Assessment E. Quality Control XIV. Assist in Emergency and Special Procedures A. ACLS B. NRP C. PALS XV. Assist in patient transport A. Air B. Ground

Course Structure:

This class shall include lecture and directed clinical practice in the hospital setting, under supervision of adjunct clinical instructors. Physician interaction is a student requirement and provides vast learning experiences for the student in the clinical setting. Credentialed hospital staff provides clinical teaching on a voluntary basis and are referred to as Clinical Preceptors. The Director of Clinical Education directs all Clinical rotations.

Technology/Media Component:

Power Point, lecture notes, overheads, videos, handouts, seminars by physicians and internet assignments.

Service-Learning:

N/A

Course Requirements and Evaluation:

Explanation of Course Requirements and Evaluation: 1. Attendance-20 pts. Per day 20% (Attendance points may vary with each clinical group based on the Academic Calendar). The student must sign in daily on the attendance log located in the clinical manual and your clinical instructor must sign his or her signature to verify the student’s attendance. 2. Daily Evaluation 25% (This form is to be filled out daily by your clinical instructor and is used to evaluate the student’s competencies in the clinical setting). 3. Clinical Proficiency Evaluation Rotation Summary 10% (This form is to be filled out by your clinical instructor at the end of each clinical rotation). 4. Behavioral Rating Scale 7% (This form is to be filled out by your clinical instructor at the end of each clinical rotation). 5. Completion of Written Objectives and Written Patient Assessment Final 7% (Written objectives are to include all assigned sections of the Clinical Manual on CD ROM.) Please see the assigned sections for each clinical located in the Objective section of the clinical manual. 6. Clinical Procedure Check-offs 10% (Must complete all required checkoffs in the laboratory and clinical setting for RCP 150. Please note the checkoff list in the RCP 150 Syllabus). 7. Daily Log-5 pts. Per day 2% (The entire log sheet is to be filled with comments of what the student’s clinical experiences were for the day. If the log sheet is not complete, you will not receive points for this day). Library Time located on this form is no longer available as each college campus has a designated library for student use. This form will be edited in the coming months to exclude the Library Time castigatory at the bottom of the page. Please draw a line through Library Time on each daily log until changes in the document are completed.

8. 1- Patient Profile 7% (Graded by the clinical instructor using a standard form with assigned points for each category of the patient profile). Timelines to submit your patient profile are located in the clinical Syllabi. Please use the form located under Patient Profile Timelines in the clinical manual. 9. 1- Clinical Simulation 2% (The clinical simulation is to be completed by the timelines set forth in the clinical Syllabi). The student is to complete the simulation in the laboratory. The simulations are located on the computers in the lab. The student is assigned specific clinical simulations for each clinical course and the assignment is located in the Clinical Simulation section of the clinical manual. 10. Physician Interaction 10% (15 points are required each semester with no carry-over of extra points). (The student must have the Physician’s Original Signature, the student’s evaluation of the physician, and the physician’s evaluation of the student to receive credit for Physician Interaction Points). TOTAL = 100%

Grading Policy:

The scale below shows the relationship between your semester percent average and the letter grade you will receive. Note: The student must have a 78% in any Respiratory Class to pass the class. 93-100% A Excellent 85-92% B Good 78-84% C Satisfactory 70-77% D Unsatisfactory (failure of class) <70% E Unsatisfactory (failure of class)

Attendance Policy:

Each student will have an attendance sheet on which he/she will sign in and out daily. Attendance shall be worth 20 pts. per day. When a student is tardy or leaves early, daily attendance points will be dropped to 10. A student who leaves more than 2 hours early shall have his/her points dropped to 5. A student who is absent will receive a “0” for attendance points on that day. Tardy is anything after 7:00 a.m. for day shift clinical and anything after 3:00 p.m. for evening shift. “Early” is anything before 6:45 am for day shift clinical and anything before 2:45 p.m. for evening shift.

Missed Exam Policy:

There shall be no opportunity for make-up on participation in clinical—lost points are lost points, even when the student must make-up hours. Patient profiles and other written work will be accepted on designated date. Work will not be accepted late. In extenuating circumstances, the individual case shall be reviewed by the Director of Clinical Education. Failure to turn in required clinical paperwork on timeline dates which are listed on the syllabus will result in a grade of ‘0’. Explanation of Course Requirements and Evaluation: 1. Attendance-20 pts. Per day 20% (Attendance points may vary with each clinical group based on the Academic Calendar). The student must sign in daily on the attendance log located in the clinical manual and your clinical instructor must sign his or her signature to verify the students’ attendance. 2. Daily Evaluation 25% (This form is to be filled out daily by your clinical instructor and is used to evaluate the student’s competencies in the clinical setting). 3. Clinical Proficiency Evaluation Rotation Summary 10% (This form is to be filled out by your clinical instructor at the end of each clinical rotation). 4. Behavioral Rating Scale 7% (This form is to be filled out by your clinical instructor at the end of each clinical rotation).

5. Completion of Written Objectives and Written Patient Assessment Final 7%. (Written objectives are to include all assigned sections of the Clinical Manual) Please see the assigned sections for each clinical located in the Objective section of the clinical manual. 6. Clinical Procedure Check-offs 10% (Must complete all required checkoffs in the laboratory and clinical setting for RCP 225. Please note the checkoff list in the RCP 225 Syllabus). 7. Daily Log-5 pts. Per day 2% (The entire log sheet is to be filled with comments of what the student’s clinical experiences were for the day. If the log sheet is not complete, you will not receive points for this day). Library Time located on this form is no longer available as each college campus has a designated library for student use. This form will be edited in the coming months to exclude the Library. Time castigatory at the bottom of the page. Please draw a line through Library Time on each daily log until changes in the document are completed. 8. 1- Patient Profile 7% (Graded by the clinical instructor using a standard form with assigned points for each category of the patient profile). Timelines to submit your patient profile are located in the clinical Syllabi. Please use the form located under Patient Profile Timelines in the clinical manual. 9. 1- Clinical Simulation 2% (The clinical simulation is to be completed by the timelines set forth in the clinical Syllabi). The student is to complete the simulation in the laboratory. The simulations are located on the computers in the lab. The student is assigned specific clinical simulations for each clinical course and the assignment is located in the Clinical Simulation section of the clinical manual. 10. Physician Interaction 10% (15 points are required each semester with no carry-over of extra points). (The student must have the Physician’s Original Signature, the student’s evaluation of the physician, and the physician’s evaluation of the student to receive credit for Physician Interaction Points). TOTAL = 100% Explanation of Clinical Rules Objectives and Check-offs ALL objectives and check-offs must be completed unless otherwise directed by the instructor or the student shall receive an INCOMPLETE for the course. Procedures/Check-Offs Students are allowed two attempts to complete check-offs; if a third attempt is needed and done unsuccessfully, the student will be recommended for dismissal from the program. Student Responsibilities in regards to Physician Interaction Physician Interaction is any student interaction with a physician. The student is responsible for initiating contact with a physician to obtain these points. The student is also responsible for Evaluation of the Physician and Physicians Evaluation of the Student. Unsatisfactory Clinical Rotation Summary and Behavioral Rating Scale/Policy and Procedure of Evaluation KEY: S=SATISFACTORY (2 POINTS) U=UNSATISFACTORY (0 POINTS) 1 U= 1 hour of subject remediation in the Laboratory. 2 U’s= 2 hours of subject remediation in the Laboratory 3 U’s = Dismissal from the Respiratory Care Program Students have 24 hours from the date of receiving one or two U’s to complete their remediation or the student will receive a failing grade in clinical.

Clinical Instructors will assign the students laboratory dates, times, and remediation materials to be completed and attached to the Behavioral Evaluation Form. Note: The student that receives Unsatisfactory may be referred to other college resources as needed for remediation of the identified unsatisfactory behavior. Please refer to the RCP 225 Clinical Rotation Summary (pages 136-138) and Behavioral Rating Scale forms (pages 154-182) located in the clinical manual. Unsatisfactory: Includes but is not limited to: Improper patient care, risking his/her own life, that of his/her peers, or that of a patient, grossly ignoring policies and procedures, inappropriate clinical behavior, excessive absence, failure to adhere to confidentiality, performing procedures on which a lab check-off has not been completed unsuccessfully, inability to successfully complete check-offs, and any other critical behavior/action (use of alcohol, failure to chart patient rounds, failure to keep course requirements up to date etc.) shall be grounds for unsatisfactory clinical grades and result in the student being dismissed from the respiratory care program!! Attire and Behavior The complete clinical uniform includes the following: clean, neat, pressed scrubs in designated color, matching or white socks or hose (no low rise or no show socks are allowed in the clinical setting), clean, white leather shoes, clean, white, pressed lab coat, watch with second hand, stethoscope, clinical manual, name badge, notepad, and pen. Failure to adhere closely to these uniform requirements may result in loss of points and/or being sent home with an unsatisfactory grade! The instructor usually sends students home if the uniform requirements are not followed. Keep in mind that NO scents should be worn during clinical—perfumed lotions, powders, perfumes or aftershaves due to the Respiratory patients, such as Asthma patients who have very sensitive airways. Also, jewelry or nail polish should not be worn. Absolutely, No acrylic or artificial nails are allowed. In some clinical facilities, artificial nails are grounds for dismissal because studies have proved that artificial nails harbor bacteria, which could be harmful to the immunosuppressed patient. Students may wear his or her wedding ring only. Studies have shown that jewelry harbors bacteria which can be transmitted to the immunosuppressed patient. Absolutely, no body piercings of any type are to be worn to clinical. Tattoos are to be covered and not visible. The student should behave professionally at all times while in the clinical setting. He/she should avoid speaking loudly, horseplay, profanity, etc. Professional behavior includes appropriate grooming. The instructor will send students home from the clinical site for failure to adhere to grooming policies. Professional behavior includes courtesy and respect—two things, which should always be part of your daily activities in clinical. As students in these facilities, we are “guests.” All therapists, nurses, physicians, other healthcare personnel, and especially patients, deserve our most professional behaviors and attitudes. ALWAYS. Confrontation of any type will not be tolerated and may be grounds for dismissal from the program. Any student who has a problem with a therapist, nurse, patient, etc. should see the instructor or department head immediately for assistance and should not put himself/herself in any situation which may be harmful. While students must be assertive, they should not be aggressive! Assignments and Timelines Assignment Timelines One Neonatal or Pediatric patient profile should be completed on the designated form, and to be turned in April 25, 2017. Late patient profiles will not be accepted. One clinical simulation is due April 25, 2017. Late Clinical Simulations will not be accepted. A complete clinical manual is due to your clinical instructor, April 28th 2017. The Clinical Grade sheets are due to Mrs. LeBrun on April 28th 2017. If the clinical notebook is incomplete, the instructor will not allow late work to be added to the notebook. The student will receive a “0” for the incomplete items.

One patient profile and one clinical simulation should be graded by your clinical instructor and to be placed in the front of your clinical manual. Please give your patient profile and clinical sim to your clinical instructor to grade. A clinical Patient Profile and Clinical Simulation Timeline/Due Date Form is to be used to record the date the clinical instructor received and returned the graded patient profiles and clinical simulations. The clinical instructor will fill this form out each semester for the student. This form is located on Page 387 in the clinical manual. The student is responsible in giving this form to the clinical instructor. After these items have been graded, your clinical instructor will return them Mrs. LeBrun for posting of grades. The last day for students to attend the RCP 225 Tuesday April 25th and Wednesday 26th 2017. Students will attend their assigned clinical on these dates. Final Exams are May 1st through May 6th 2017. Clinical Manual must be reviewed each day by your instructors. Attendance sheets, Daily Evaluation, Daily Logs, Physician Interaction sheets, and Objectives/Check-offs must be kept up DAILY!

Late Assignment Policy:

Failure to turn in required clinical paperwork on timeline dates which are listed on the syllabus will result in a grade of ‘0’.

Withdrawal Policy:

You may withdraw from this course through January 13, 2017 without a grade. March 3, 2017 is the last day for a student to withdraw at his/her discretion and receive a grade of W; students may withdraw through April 28, 2017 at the discretion of the instructor and receive a grade of W. Please see the Academic Calendar for more detailed information on the withdrawal policy.

Additional information can be found at the following site: http://www.bigsandy.kctcs.edu/en/Academics/Office_Hours_Schedules_and_Syllabi.aspx