Wright State University

College of Nursing and Health

Spring 2018

COURSE NUMBER: NUR 7203

COURSE TITLE: Adult-Gero Acute Care Nurse Practitioner Practicum

PRE-REQUISITES: NUR 7101, 7102, 7103, 7201, 7202

(Students must be eligible for graduation and have successfully completed all courses listed on their
POS.)

COURSE LOCATION: 158 University Hall

SEMINAR DATES AND TIMES: See syllabus

CATALOG DESCRIPTION: The focus is on synthesis of theory and implementation of the

role of the acute care nurse practitioner. Experiences emphasize clinical decision-
making in an inter-professional environment with focus on the acute care practitioner as
a principal provider of care for young adult, adult and older adult patients with acute or
emergent health problems.

CREDIT ALLOCATION: 6 credits (2 didactic; 4 clinical 224 hours)

COURSE FACULTY: Kristine A. Scordo, PhD, ACNP-BC, FAANP

120 University Hall
(937) 775-2628
Office hours: 12:00 P.M. - 1:00 P.M. Monday and Wednesday
or by appointment
Virtual office hours: kscordo@cinci.rr.com

ADJUNCT CLINICAL FACULTY:

Angela Dunigan, MS, RN, ACNP-BC angies001@aol.com
Beth Croucher MS, RN, ACNP-BC bacroucher@yahoo.com

COURSE WEBSITE: https://pilot.wright.edu

Students are responsible for daily checking their e-mail.

COURSE OBJECTIVES:

1. Utilize research and theoretical frameworks to implement the acute care nurse
practitioner role.
2. Analyze the impact of health care variations related to gender, race, ethnicity and culture
for individuals experiencing acute and emergent health problems.
3. Demonstrate leadership skills necessary for ethical and critical decision making,
effective working relationships and a systems perspective that promotes high quality and
safe patient care for individuals experiencing acute and emergent health problems.
4. Apply quality principles within an organization and articulate the methods, tools,
performance measures, and standards related to quality in caring for individuals with
acute or emergent health problems.
5. Apply the American Association of Critical Care Nurses standards of clinical practice for
an acute care nurse practitioner.
6. Use communication strategies and patient-care technologies to integrate, coordinate,
deliver, and enhance care in caring for individuals with acute or emergent health
problems.
7. Maintain collaborative relationships in a clinical setting to enhance role development for the
adult-gero acute care practitioner role.
8. Analyze research supporting the role and efficacy of the adult-gero acute care nurse
practitioner.
9. Incorporate knowledge of social, ethical, legal, economic, political, technological, and
environmental issues in the care of individuals with acute or emergent health problems.
10. Demonstrate responsibility and accountability for maintaining standards as an adult-gero
acute care nurse practitioner.
11. Demonstrate diagnostic reasoning through assessment, differential diagnosis and
prioritization in the care of individuals with acute and emergent health problems.
12. Initiate appropriate intervention strategies in the care of individuals with acute or emergent
health problems Evaluate progress toward attainment of expected outcomes in the care of
individuals experiencing acute or emergent health problems.
13. Demonstrate advanced professional behaviors reflective of autonomy, intellectual
independence, accountability and lifelong learning.

TEACHING STRATEGIES: Lecture, seminar, case studies, student presentation, group discussion,
guest speakers, computer assisted instruction, interactive videos, integration of reading assignments,
student journals and faculty supervised preceptorships.

TEXTBOOKS:
Required:
1. Kasper et al. (Ed). 2015. Principles of Internal Medicine. 19th ed. New York: McGraw Hill.
2. Tierney, L., McPhee & Papadakis, M. (2017). Current medical diagnosis and treatment. 52nded CT:
Appleton & Lange
3. Marino, P. (2016). The Little ICU Book 2nd Ed Philadelphia: Williams & Wilkins.
4. ANCC list of recommended texts for ACNPs. Access on-line at the ANCC website.
6. Kleinipell, R., & Piano, M. (Eds). (1998). Practice issues for the acute care nurse practitioner. New
York: Springer Publishing Co., Inc.

TEACHING METHODS: Lecture, discussion, group discussion, group presentations, world

wide web, webct and integration of reading assignments, video

EVALUATION METHODS: The final grade for Nursing 7203 is determined by all forms of
evaluation. The weight assigned to the parts are:

Leadership and peer collaboration in seminars

Verbal evidence in class of having read and thoughtfully considered the learning materials.
Contributions are based on quality, and not simply quantity of your input. It is not possible to
earn credit for a class you did not attend. For each seminar, be prepared to discuss additional
articles you’ve read that are related to the topic of discussion. Check syllabus and dropbox for
due dates.

Editorial review. 5% (5 points)

Editorial review. You will be given an article to critique for publication in Heart and Lung
and are expected to submit comments to the editor and author(s).
Development of a job description 10% (10 points)

Standard Care Arrangement (SCA) 5% (5 points)

Clinical Project 10% (10 points)

Evidenced Based Clinical Paper 15% (15 points)

Completed Portfolio 5% (5 points)

(To include a completed copy of your resume and cover letter-see syllabus for due date)
Self-evaluation of practicum 10% (10 points)

Comprehensive Final 40% (40 points)

To pass the course, students must earn a minimum of 75% on the final examination. Only
after achieving a 75% will other assignments be calculated into the final grade average.
There are no retakes on any exams or on any assignments.

Late papers: Late papers are those not received on the due date. They are not accepted or
excepted. The ONLY exception is an emergency, such as a family death or severe illness.
Twenty percent is automatically deducted for papers not turned in on the due date. No credit for
papers turned in after the due date that have not been negotiated prior.

Job Description:
Develop a job description for your role as an AG-ACNP. This must be computer generated and
properly referenced, and includeB but not limited toB reporting structure, qualifications, specific
roles components.

Clinical Project:
Based on a needs assessment, identify and complete a project that is of value to the clinical
agency where you are precepting. Examples: development of a brochure, pamphlet on
medication(s), low sodium diet, patient teaching aids, and sit & be fit exercise program for elderly
clients. Be creative. Bring your project on the last day of class (or a representation of the project),
and be prepared to discuss the Ahow, whats and whys@ of your project. Write up: Headings:
Needs Assessment, Purpose, Audience, Overview of Project and Summary

Evidence Based Clinical Paper

A paper of publishable quality in which the student appropriately discusses an issue related to a
specific disease entity, common problem or issue in acute careBone you are not familiar with and
have not previously written about during your graduate studies. You must address specific
concerns in the elderly. A thorough extensive review of current research articles is expected. For
each study include: main objectives of the study, population studied, number of subjects,
males/females, major findings, any limitations, and how you would apply the findings clinically.
Examples: treatment of fever in sepsis, what do we really know about WCH (white coat
hypertension), does renal dose dopamine exist, management considerations of abdominal
trauma in the elderly, chronic pain management in an elderly person, issues in weaning from
mechanical ventilation, sleep deprivation in hospitalized patients, illness and circadian rhythms,
management of the infection in the immunocompromised patient, identification and management
of substance abuse, age-and culture-related considerations in disease management, etc.

Follow APA format; use headings. Please limit the paper to 10 pages or less (not including
references). The paper should include, but not be limited to the following topics: significance of
the problem, discussion of the problem (etiology, epidemiology) consequences, treatment issues,
concerns, relevant research, and role of the AG-ACNP in relation to the problem. When
appropriate include developmental, pathophysiological, spiritual and psychological theories,
relevant economical, political, and social issues. Turn in to drop box in Pilot.
No credit is given for papers that contain more than 15% from previous papers.

Portfolio: The portfolio should include: (can be paper or electronic-put link on discussion page)
Resume; Job Description
State Nurse Practice Act
Rules and Regulations for APN Practice
Malpractice Insurance Information; Salary Ranges for APN positions; Certification Materials
Brochure/Articles Describing the APN role you wish to secure

NUR 7203: K.A. Scordo Page 3

Standard Care Agreement; Other materials of professional significance (a scholarly
paper/publication)
AG-ACNP Curriculum at WSU, CoNH

Standard Care Arrangement

You are to develop a standard care arrangement. This must be computer generated and cover
all aspects as required stated in Ohio Senate Bill 154. You are encouraged to use the one where
you will be employed.

Self-Evaluation of the Practicum Experience

Each student is expected to develop a set of personal objectives for the practicum. (Save a copy
for yourself and submit a copy on week 2.) At the end of the practicum, put the experiences into
an evaluation framework and analyze them in a logical manner. Include in this evaluation an
assessment of your initial personal objectives. Turn into drop box on course site on Pilot. No
credit if not submitted to turnitin.com prior to submitting to drop box.

Clinical (Satisfactory/Unsatisfactory) Minimum 224 clinical hours

To pass the course, you must pass both the didactic and clinical portions. To pass the clinical
portion, all assignments must be completed at a minimum of a satisfactory level.
Students are expected to assist in the coordination of agency choice and system entry
negotiations with the preceptor. Preceptors must be in practice for a minimum of one year
prior to precepting. APN preceptors must be recognized by the Ohio Board of Nursing as an
APN (if practicing in Ohio). Physician preceptors must be board certified. Students should
plan to spend approximately 16-24 hours per week in the practice settings. This is a
functional rotationB your time must be spent providing direct patient care and not simply
observing. Specifically, clinical practice hours refer to hours in which direct clinical care is
provided to individuals, families, and populations in specific areas of AG-ACNP practice;
clinical hours do not include skill lab hours, physical assessment practice sessions, or a
community project.

Submit a completed preceptor information form by week one along with a schedule of your
hours for the first five weeks. E-mail your clinical instructor with this information. If
changes are made in this schedule, it is your responsibility to e-mail your clinical
instructor within 24 hours. If you will be absent from clinicals on a previously
scheduled day, you must notify your clinical instructor by 8 AM that day. Failure to do
so will jeopardize your ability to continue in the acute care program. The remainder of your
hours must be submitted each week or according to the guidelines set by your clinical
instructor (see below). Be certain to give your preceptor the evaluation forms. These are due
the last day of class.

Misrepresentation of clinical hours results in an AF@ for the clinical course and you will not be
allowed to continue in the AG-ACNP program. You are responsible for knowing the WSU code of
student policy. https://www.wright.edu/community-standards-and-student-conduct/code-of-
student-conduct Be aware that violations are subjected to dismissal from the ACNP program.

You cannot graduate until all hours of NUR 7203 are completed.

Before the start of clinicals, submit a completed preceptor information form to

kscordo@cincirr.com. Be certain to obtain all required information. Give your preceptor the
evaluation forms.

It is YOUR responsibility to obtain the evaluation forms. Failure to do so results in an

incomplete for the course.

NUR 7203: K.A. Scordo Page 4

Clinical Logs/SOAP Notes/Admitting H&Ps/Discharge Summaries:

Students are expected to maintain documentation of their clinical experiences. (Complete

and keep the AWeekly AG-ACNP Clinical Practicum Log@ for your documentation.) Be
certain to keep a copy of the log for your portfolio.

Complete a total of 40 SOAP notesBat least 4/week on patients seen this quarter. In
addition, you must submit four admitting H & P and four discharge summaries. All
notes must be co-signed and reviewed by your preceptor. If the note is not co-signed, it
will not count toward your assignment. Do not ask your preceptor to sign blank SOAP
notes—this is grounds for immediate dismissal. You may choose to photocopy your
work; there’s no need to rewrite the note. Be certain your handwriting is legible and that you
use standard abbreviations (see handout) See syllabus for due dates. Consecutively
number your SOAP notes, discharge summaries and H&Ps. Unless approved by your
clinical instructor, computerized notes will NOT be accepted.

When you submit your weekly clinical log to your clinical instructor, also submit via e-mail
the hours completed that week along with a running total. You are required to also submit a
paper copy with your preceptor's signature for verification each week. Failure to do so
results in an F for clinical. You need to add an additional column to your weekly log
with the heading E/M level. For each visit, evaluate what level service you provided. For
further information, refer to handouts.

Clinical Day. To successfully pass the clinical component of the course, you may be required to
work at least one day with Dr. Scordo at Kettering Cardiology Practice. Failure to do so will
result in an incomplete until you have met this requirement. The purpose of this day is to
evaluate your performance as an AG-ACNP. You are expected to see a minimum of four
patients, complete a thorough history, physical, compile a list of differentials, and write your
specific plan.

Unless directed otherwise, your assignments are to be done as an individual effort. The
University Guidelines for Academic Integrity apply to all work for the class. Please refer to your
student handbook for general policy and procedures regarding student conduct. You are
responsible for knowing these policies.

DISABILITY STATEMENT: Any student with any type of disability (physical, emotional, learning,
etc.) is expected to accept responsibility for seeking whatever accommodation is necessary to
meet the objectives of the course. Please see your faculty member at the earliest possible
point in the quarter to discuss your issues. Accommodation requests will be discussed among
the course faculty, the student, CONH administration, and WSU Disability Services (as needed).
Type of accommodation will be determined on an individual basis depending on the nature of
the disability and the objectives to be met.

NUR 7203: K.A. Scordo Page 5

 NUR 7203 Acute Care Nurse Practitioner Practicum yellow-online only
Date Topic
Jan 8th (1)Introduction to the course
Monday (2) Assessment of student needs.
(3) AWhat you are is where you were
10AM-2:30PM
then.@
(4) Drama in the Courtroom: Do and
Don’ts of Depositions and More
Kristine A. Scordo, PhD, RN, ACNP-BC
Review of Critical Care Topics
Jan 22nd
Panopto lectures
Monday
10AM-2:30PM
Feb 5th
(1) Creating a job description and
Monday
developing the advanced practice role
10AM-2:30PM
(2) Evaluation of the APRN
(3) Gaining entry into the system.
Securing and implementing the ACNP
role.
(4) Getting paid what you=re worth:
Negotiating salary and benefits
Kristine A. Scordo, PhD, RN, ACNP-BC
Feb 12th (1) Consultation
Monday (2) Share job descriptions
10AM-2:30PM (3) Reimbursement and
Evaluation/Management Codes
Kristine A. Scordo, PhD, RN, ACNP-BC
The Business of Medicine
Timothy J. Kappes, PhD
Panopto lectures
Review of Critical Care Topics
March13th
Panopto lectures
Monday
10AM-2:30PM
March 19th
The Ethics of Medicine
9AM-1:30PM Jeff Kaufold, MD (confirmed)
Nephrology Assoc of Dayton
Chief, Ethics Committee
Good Samaritan Hospital
Publishing: Discuss reviewer comments
DUE: Editorial assignment (to be
discussed in class)
April 9th (1) Doctor of Nursing Practice (DNP)
NUR 7203: K.A. Scordo
Required Readings Recommended Readings
(1)Cullley & Spisak. (2002). So you=re being sued: Do=s &
Don’t’s for the defendant. Cleveland Clinical Journal of
Medicine, 752-760.
Diagnostic Reasoning
James E. Brown MD
Panopto lecture
DUE: Clinical Goals (see Pilot for how to write
objectives)
Check course site
(1) Kleinpell, R., M, & Perez, F. (2006). Negotiation
strategies for ACNP practice. The Nurse practitioner, 31(5),
6-11.
(2) Hartigan, C. (2011). APRN Regulation. AACN
Advanced Critical Care, 22,1, 50-66
LUNCH: Courtney Kresge MS, AGACNP-BC, CCRN
MICU1 Critical Care CNP
APP Critical Care Fellowship Program Coordinator
Riverside Methodist Hospital Cell 740-310-1551
Due: Resume-in class discussion-see drop box date
Munro, N. (2013). What an Acute Care Nurse Practitioner
Should Know About Reimbursement. AACN Advanced
Critical Care, 24(2), 110-113 4p PART I
Munro, N. (2013). What Acute Care Nurse Practitioners
Should Understand About Reimbursement: Critical Care
Issues. AACN Advanced Critical Care, 24(3), 241-244 4p
PART II
DUE: Job Description —in class discussion-see dropbox date
Check course site for previous criteria
Publishing:
(1) Miracle, V. (2008). The peer review process. Dimensions
of Critical Care Nursing, 27(2), 67-9.
(2) Brazeau, G., Dipiro, J., Fincham, J., Boucher, B., &
Tracy, T. (2008). Your role and responsibilities in the
manuscript peer review process. American Journal of
Pharmaceutical Education, 72(3), 69.
Ethics:
Spikes: Breaking Bad News
https://www.mdanderson.org/.../10%2027%2016%20E
CHO-PACA%20SPIKES.
(1) Blowing the whistle on healthcare fraud: Should I?.
Journal Of The American Academy Of Nurse Practitioners,
18(11), 512-517
(2) Truog,R. et al. (2008). Recommendations for end-of-life
care in the ICU: A consensus statement of the AACCM. Crit
Care Med Vol 36, 3, p. 953-963.
(1) The Essentials of Doctoral Education for Advanced
Nursing Practice. AACN Task Force on the Practice
Page 6
 Date Topic Required Readings Recommended Readings
10AM-2:30PM (1) Should I get a DNP? Doctorate in Nursing Essentials-on line
PANEL (2)Test Taking Strategies
(3) ACNP PANEL 11-12 noon
(4) Share clinical projects
DUE: Evidenced-Based Paper; Clinical project
Kristine A. Scordo, PhD, RN, ACNP-BC
presentation

April 23rd Examination and Review SCA Self-evaluation of the practicum due April 20th
Monday 9:00AM-12 Noon Completed portfolio (paper or electronic) due April 22nd

NUR 7203: K.A. Scordo Page 7