- Expectations - It is understood that throughout the courses in the program, nursing care will be given:
- Safely - so that the patient is not endangered by the environment; treatments and medications; by lack of knowledge of the student; or by disregard of agency policies.
- Honestly - so that in every interaction between student and patient, health care team member, and instructor, the student’s communicates ethically and truthfully.
- Professionally so that in all actions, a student follows policies and procedures. Maintains appropriate boundaries and communicates clearly and effectively.
- Evaluations
- Each student will receive a mid-term and final evaluation of clinical performance.
- Each student will have the opportunity to discuss the evaluation with the clinical instructor.
- Each student who receives an unsatisfactory final clinical/lab evaluation will fail the clinical portion of the course.
- Remediation
- An Academic Improvement Plan (AIP) will be completed for any student who has unsatisfactory mid-term or final evaluations for future clinical settings.
- It is the student’s responsibility to follow through with remediation recommendations on the AIP.
Approved list of the Rights to Medication Administration:
- Right client
- Right medication/drug/reason
- Right dose
- Right route
- Right documentation
- Right client education
- Right to refuse
- Right assessment
- Right evaluation
Right client
- Is this the right client to receive this medication?
- Verify the identity of the client using at least two identifiers including name and date of birth (check wrist band and ask client to state their name).
Right medication/drug/reason
- Does the client condition, symptoms and health status warrant receiving this medication?
- Has the client symptoms and diagnosis, does it make sense for the client to have this medication?
- Is it the correct time for the medication to be administered?
- Determine if the client has any known allergies or sensitives
- Assess the client’s other medication to detect possible contraindications
- Make sure the right medication, packaging, labeling, and spelling of some drugs look alike-watch for visual clues.
- Have another person double-check medications and mathematical calculations.
- Check when the medication was last administered. If the drug is new, document when it was first given.
Right dose
- Is the correct dose being administered?
- How is the medication administered?
- Does administration require medication math to calculate the dose?
- Ensure that labeling is legible and clearly understood.
- Follow institution medication protocols as written.
Right route
- Is it appropriate to administer the medication orally, intravenously, by injection, or other route?
- Check the original orders to verify the route of administration.
Right documentation
- Has the correct documentation been completed according to facility policy?
- Complete documentation according to facility policy immediately after administering any medication.
- Document and communicate to the appropriate health care provider any signs and symptoms indicative of any adverse effects.
Right client education
- Is the client familiar with the medication?
- Does the client understand the purpose, dosing, and administration information, as well as other information specific to the medication?
- Assess client’s level of knowledge. Provide client education as necessary.
Right to refuse
- Has the client verbally agreed to take the medication?
- Has the client expressed any concern with the medication?
- Acknowledge the client’s right to self-determination.
- Provide education, then document, and notify the provider about the refusal.
Right assessment
- Is it appropriate to administer the medication, based on the specific data collected?
- Collect appropriate assessment data related to mechanism of action and or therapeutic action.
Right evaluation
- How has the client responded to the medication?
- Monitor the client to determine the efficacy of the drug, detect and prevent complication and evaluate and document changes.
- When applicable, assess the client’s laboratory values to detect changes.
- Provide client education, when possible so client is alert to adverse effects.
Skill statement
Goal:
- Define satisfactory vs unsatisfactory
- Provide examples of satisfactory vs unsatisfactory
- Set disclaimer of sterile technique and number of identified breaking of technique that is allowed.
- Set up remediation guidelines for all faculty related to student failure
- Provide time frames per skill
Testing (Check-off)
- Students will be provided a review day or study content related to the skills required for the check-off.
- Students must be able to demonstrate proficiency for a satisfactory performance.
- Retesting will be required if the skill level is unsatisfactory.
- Retesting will be on the student’s own time and is to be scheduled through the lab coordinator.
- Students will not be able to retest until remediation has occurred.
- Repeat testing cannot occur on the same day as the unsuccessful attempt.
- Skill remediation will be determined by the instructor that evaluated the student.
- Skill remediation may include:
- Attendance of open laboratory times with lab coordinator.
- Review videos, ATI content, and more
Satisfactory and Unsatisfactory Definition
Satisfactory:
- Performs safely and accurately during the performance.
- Demonstrates coordination and dexterity.
- Generally, appears relaxed and confident most of the time with the occasional display of anxiety.
- Completed the skill within a reasonable time frame.
- Focuses on the client initially, but as the skill progresses, focuses on the task.
- Applies knowledge of the principles of the skill accurately.
Unsatisfactory:
- Requires direction or cues from the instructor.
- Demonstrates partial lack of dexterity; is awkward.
- Takes a longer time to complete the skill.
- Wastes energy due to poor planning/anxiety.
- Focuses primarily on the task, not the client.
- Needs direction in the application of the principles of the task.
- Unable to complete the skill within the allotted time.
Break in Technique
The student is only allowed 1 student identified and reported by the student break-in technique. Any break in technique needs to be recognized and identified by the student prior to proceeding to the next step of the procedure.
More than one break in technique reported by the student will results in an unsatisfactory check off regardless of points awarded.
If a break-in technique occurs and is not identified by the student, this will result in an unsatisfactory check-off.
Any break in technique identified by the instructor will result in an unsatisfactory check-off.