DOC. #268

SAULT COLLEGE OF APPLIED ARTS & TECHNOLOGY

SAULT STE. MARIE, ONTARIO

COURSE OUTLINE

UNIT 2 - CLINICALCOURSE TITLE:

vCODE NO:

PROGRAMME:

AUTHOR:

DATE:

APPROVED:

HCA 103-11 IISEMESTER:

HEALTH CARE AIDE

GWEN IBURG

SEPT/93 SEPT/92PREVIOUS OUTLINE DATED:

I /c))~@@10~~ [Q)I.n1 JUN 1 8 1993SAUL! I..A".I L..'-'c: LiLjr"fARY

SAULT STE. MARIE

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UNIT 2 - CLINICAL HCA 103-11

Course Name Code No.

TOTAL CREDIT HOURS: 120

Unit II Clinical (HCA 103) has 24 lab practice hours and 96 hours ofclinical practice for a total of 120 hours.

PREREQUISITE(S): HCA 100, HCA 101

I. PHILOSOPHY/GOALS:

Unit II provides the student with opportunities to practise anddemonstrate skills related to elimination (bowel and bladder)mobility, vital signs, special skin care and activation and leisure.The student is expected to continue to demonstrate competency ofUnit I skills.

II. STUDENT PERFORMANCE OBJECTIVES:

Upon successful completion of this course, the student will meetthe following objectives with 2-3 clients:

1) utilizes measures to promote rest and sleep.

2) performs active and passive Range of Motion exercises.

3) uses measures to prevent contractures.

4) assists client with ambulation needs.

5) promotes activation and leisure activities.

6) demonstrates special skin care of decubitus ulcers.

7) promotes the care and use of prosthetic devices.

8) promotes urinary elimination.

9) accurately records and reports Intake and Output.

10) demonstrates care of the incontinent, uncatheterized andcatheterized client.

11) promotes bowel elimination.

12) practises universal precautions with all clients at all times.

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II. STUDENT PERFORMANCE OBJECTIVES:

13) demonstrates various isolation practices as the situationwarrants.

14) demonstrates accurate observations and recording of temperature,pulse and respirations.

III. TOPICS TO BE COVERED:

1) Rest and Sleep2) Range of Motion Exercises3) Prevention of Contractures4) Ambulation5) Activation and Leisure Activities6) Special Skin Care7) Rehabilitation8) Promotion of Urinary Elimination9) Intake/Output10) Incontinent Client11) Bowel Elimination12) Universal Precautions/Isolation Practice13) Vital Signs

Lab Topics:

1) Range of Motion Exercises2) Ambulation Assistive Devices3) Urine Testing4) Intake/Output5) Urinary Catheter Care6) Isolation Technique7) Use of bedpans, urinals, commode chairs8) Vital Signs

IV. LEARNING OBJECTIVES7cONTENT REQUIRED RESOURCES

1. Rest and Sleep

a) Promotes the client's needs forrest and sleep.(5.14)

b) Uses measures to promote sleepsuch as comfortable environment,back rubs, warm baths, adjustmentof clothing.(5.14)

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IV. LEARNING OBJECTIVES/CONTENT REQUIRED RESOURCES

c) Takes measures to reduce worryand emotional stress.(5.14)

d) Assists client to establishregular sleeping habits and restperiods.

2. Ranqe of Motion Exercises

a) Communicates to resident thevalue of exercise for improvedcirculation, digestion, elimination,muscle tone, maintenance and/orimprovement of range of motion.( 9. 09)

b) Identifies contra-indications toexercise such as pain, swollenjoints, fatigue and certainmedical conditions.(9.09)

c) Develops an appropriate exerciseprogram for the client.( 9 . 09 )

d) Demonstrates other methods thatencourage the resident toexercise, such as self care,household activities, andrecreational activities, includingmusic and crafts.( 9. 09)

e) Positions client appropriatelyand carries out full range ofjoint motion according tofunctional capacity of the client.(5.16)

f) Identifies and reports anychange noted in resident'srange of motion.( 5. 16)

3. Prevention of Contractures

a) Uses supportive devices such asfootboards, bed cradles, bed-boards, rolls to preventcontractures.(5.18)

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Text: pp.Workbook:Study Projects:Study Questions:Lab Practice

Text:Workbook:Study Questions:Lab Practice

308-311Ch. 18

1-311-13

pp. 306-308Ch. 18

1-10

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IV. LEARNING OBJECTIVES7cONTENT REQUIRED RESOURCES

b) Promotes mobility of joints bychanging position frequently,exercises and ambulationactivities.

4. Ambulation

a) Provides assistance withambulation based on client'slevel of activity.

b) Assists the falling, clientto prevent injury to self andthe client.

c) Assists the client with theuse of walking aids such ascrutches, canes, walkers, braces,walking belt.(9.08)

5. Activation and Leisure Activities

a) Assists client to arrange roomwith own belongings to suitclient's wishes.(4.03 )

b) Encourage client to use radio,television and telephone.(4.03)

c) Encourages resident's participationin facility's activities.(4.03)

d) Assists client to common rooms,including recreational areas foractivities.(4.03)

e) Stimulates interaction betweenclients by arrangement offurniture.

(4.03)f) Stimulates resident's awareness

by utilizing clocks, calendars,newspapers and colours.(5.19)

g) Encourages resident with personalhobbies or creative pursuits aswell as new activities.(9.11 )

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Text:Workbook:Study Questions:

pp. 312-318Ch. 1814-20

Print-outs in class

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IV. LEARNING OBJECTIVES/CONTENT REQUIRED RESOURCES

h) Suggests activities suitable forthe physical or mental status ofthe client.

(5.19 )i) Provides instructions, materials

and guidance for activities.(5.19)

j) Praises client to reinforceinterest.(5.19)

k) Assists client with the arrangementand care of personal flowerarrangements.(3.04)

6. Special Skin Care

a) Takes measures to ensure theclient's skin remains intactand protected from irritation.( 5 . 10)

b) Takes measures to preventdecubitus ulcers.(5.10)

c) Cares for decubitus ulcers asdirected.(5.10)

d) Reports signs of irritation ofskin/mucous membrane breakdown.(5.10)

e) Encourages diabetic client tomaintain good skin care.(3.10)

7. Rehabilitation

a) Encourages resident to applyand properly utilize an artificiallimb or eye.(5.17)

b) Applies splints and braces tomaintain body alignment.(5.17)

c) Takes measures to ensureprosthesis fits properly, and isclean and in good repair.(5.17)

Text:Workbook:Study Questions:

pp . 2 2 1- 2 2 6

Ch. 1327-32

Text: pp.Workbook:

Study Project:Study Questions:

382-390Ch. 24

1-21-11

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IV. LEARNING OBJECTIVES/CONTENT REQUIRED RESOURCES

d) Identifies and reports anyirritations from splints orprosthesis.(5.17)

e) Stores prosthetic devices toprevent loss or damage.(5.17)

8. Promotion of Urinary Elimination

a) Ensure privacy.(7 .02)

b) Warms bedpan or urinal as necessary.(7.02)

c) Assists resident to assume aposition which aids elimination.(7.02)

d) Assists client as necessary withcleansing peri-anal area andhands.(7.02)

e) Reports the eliminationto policy with relationfrequency and amount ofvoided, incontinence orof incontinence.(9.02)

f) Reports any problem encounteredby a client regarding difficultyinitiating voiding, urgency,dribbling or unawareness of theneed to void.(9.02)

g) Makes a 24-hour plan with residentwho has nocturnal frequency,which shows an appropriate patternof fluid intake.(9.02)

h) Establishes a plan with incontinentresident for regular toilet visits.(9.02)

i) Implements bladder training programaccording to care plan previouslydetermined by RN/RNA.

j) Reports any abnormalities in stoolor urine and saves specimen forinspection.

accordingtourineepisode

Text: pp.Workbook:Study Project:Study Questions:

230-240Ch. 14

1-31-15

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IV. LEARNING OBJECTIVES/CONTENT REQUIRED RESOURCES

9. Intake/Output

a) Measures an records all fluidstaken orally by resident asdirected.(8.08)

b) Measures and records urineoutput as directed.(8.09 )

c) Records and reports total intakeand output at the end of eachtour of duty as directed.(8.08, 8.09)

10. The Incontinent Client

a) Keeps the client clean, dry andfree from odours.(7.04 )

b) Cares for soiled clothingaccording to agency acceptedprocedure.

c) Using aseptic techniqueprovides care of urinarycatheters.

11. Bowel Elimination

a) Provide client with privacy.(5.03)

b) Provides bedpan, commode chair,or assists to bathroom asneeded.(5.09)

c) Provides equipment for cleansingfollowing elimination and assistsas necessary.(5.09 )

d) Reports any difficulty orabnormality with elimination.(5.09)

e) Teaches resident importance ofregular routine with boweland bladder habits according toresident's previous lifestyle.(5.09)

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Text: pp.Workbook:Study Project:Study Questions:Lab Practice

276-278Ch. 16

2-326-27

Text: p. 235,254

Text: pp.Workbook:

Study Projects:Study Questions:

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252-254Ch. 15

1-21-9

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IV. LEARNING OBJECTIVESlcONTENT REQUIRED RESOURCES

f) Assists client in normal bowelfunction by ensuring adequatefluid intake, roughage in diet,and exercise.(5.09 )

g) Implements a bowel trainingprogram according to care planpreviously determined by RN/RNA.

h) Reports any abnormalities instool and saves specimen forinspection.(8.07)

i) Reports on any client in his/hercare who is constipated or incontinentwhich includes observations onconsistency, amount and frequency,reporting results of enema and/orsuppository.(9.03)

12. Universal Precautions/IsolationPractices

a) Practises Universal Precautionswith all clients at all times.

b) Demonstrates knowledge ofisolation technique for:

i) wound and skin isolationii) blood and body fluids

isolationiii) enteric isolationiv) respiration isolationv) strict (protective) isolation

c) Demonstrates isolation practiceswith:

i)ii)

iii)iv)v)

vi)vii)

viii)

Print-out inText:Workbook:Study Questions:Lab Practice

classpp. 133-142

Ch. 913-22

handwashinggowningwearing a face maskglovingdouble baggingcollecting specimensfood traysvital signs

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IV. LEARNING OBJECTIVES/CONTENT REQUIRED RESOURCES

13. Vital Signs

Temperature

a) Cares for oral and rectalthermometers separately.

b) Demonstrates care, cleaningand storing of thermometers.(3.05)

c) Uses alternative sites fortaking resident's temperatureif oral method is contra-indicated and makes requiredadjustments to obtain accuratereading.(8.03 )

d) Holds, inserts, removes, readsthermometer maintaining aseptictechnique and observing safetyprecautions.(8.03)

e) Controls factors which mayinterfere with accuracy ofreading and reports and recordsresults immediately.(8.03 )

Pulse

f) Counts and records pulseaccurately, reporting rate andcharacter.(8.04)

g) Uses alternative sites forobtaining pulse if radial pulsecannot be obtained.(8.04)

h) Controls factors which mayinterfere with accuracy of pulserate recording, such as emotionand exercise.(8.04 )

Text: pp.Workbook:Study Projects:Study Questions:

Lab Practice

286-300Ch. 17

1-41-21

28,30

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IV. LEARNING OBJECTIVES/CONTENT REQUIRED RESOURCES

Respirations

i) Counts rate of respirationaccurately.(8.05)

j) Reports and records the time,rate, depth and regularity ofrespiration.(8.05)

k) Correlates the effect of age,exercise, infection, environmentand emotions on respiratory rateand control factors which mayinterfere with accuracy of ratecount.(8.05)

Note: 1. Numbers in parenthesis refer to objectives from theMinistry of Education Health Care Aide ProgrammeGuide and Performance Objectives.

2. Sequencing of objectives and content subject to changebased on the learning needs of the students.

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UNIT II - CLINICAL HCA 103-11

Course Name Code No.

V. EVALUATION METHODS: (includes assignments, attendancerequirements, etc.)

Clinical experience is essential to gain competence and the levelof skill necessary to meet the programme objectives. Therefore,students must attend all clinical experiences including collegelaboratories.

All students are expected to come prepared with knowledge ofcontent and understanding of nursing skills taught to date.

Daily assignments, participating in conference, questions re:skills and performance are assessed daily in lab and clinical areas.

Weekly self evaluations and weekly teacher evaluations of clinicalperformance are carried out.

A final evaluation by both student and teachercompletion of Unit II. Students must obtain aon final evaluation. Students who do not meetbe given an "Unsatisfactory" grade.

are done on"Satisfactory" gradethe objectives will

VI. REQUIRED STUDENT RESOURCES:

1. Mosby's Textbook for Nursing Assistants, 3rd edition, bySorrentino, Sheila, R.N., B.S.N., M.A.

2. Mosby's Workbook for Nursing Assistants, 3rd edition, byKelly, Relda Timmeney, R.N., B.S.N.

VII. ADDITIONAL RESOURCE MATERIALSAVAILABLEIN THE COLLEGE LIBRARYBOOK SECTION: (title, publisher, edition; date, library callnumber if applicable)

VIII. SPECIAL NOTES:

Objectives follow the Health Care Aide Skills Checklist developedby the Professional Advisory Council of the Ontario Nursing HomeAssociation, 1990.

Students with special needs (eg: physical limitations, visualimpairments, hearing impairments, learning disabilities) areencouraged to discuss required accommodations confidentiallywith the instructor.

Your instructor reserves the right to modify the course ashe/she deems necessary to meet the needs of students.