1. competency based advanced practice

KINGDOM OF SAUDI ARABIAMinistry of Higher Education

University of HailCollege of Nursing

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ADVANCED ADULT CARE NURSING PRACTICE(NURS 314)

COMPETENCY BASED CLINICAL EVALUATION RUBRICStudents progress towards achievement of field experience learning outcomes and competencies will beevaluated based on their performance on written work, and clinical experiences. Below are the criteriathat will be used to determine student achievement of the field experience learning outcomes andcompetencies. Students behavior will be assessed during each interaction throughout the course andfeedback will be provided on an ongoing basis. A rating for each criterion will be assigned at the end ofthe course, based upon patterns of observed behavior, using the five-point scale described below.4 = Excellent* Performs safely and accurately without supportive cues.* Assumes responsibility of behavior with initiative and in a self-directed manner.* Synthesizes appropriate data and knowledge.3 = Very GoodPerforms safely and accurately with minimal supportive cuesAssumes responsibility of behavior; frequently takes initiative.Synthesizes appropriate data and knowledge with some assistance.2 = SatisfactoryPerforms safely and accurately; requires frequent supportive cues.Assume responsibility of behavior; occasionally takes initiative.Synthesizes appropriate data and knowledge with frequent assistance.1 = Provisional* Performs safely and accurately only with supervision.* Assumes responsibility; lacks initiative.* Synthesizes appropriate data and knowledge only with assistance.0 = Unsatisfactory* Performs unsafely and inaccurately.* Does not assume responsibility of behavior; displays no initiative.* Unable to synthesize appropriate data and knowledge



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Competencies1 COGNITIVE DOMAIN 0 1 2 3 41.1 Utilize theoretical knowledge to practice the skills of focused assessment, documentation

and application of the nursing process to the care of adult clients in acute health caresetting.

1.2 Implement holistic, patient-centred care that reflects an understanding of human growthand development, pathophysiology, pharmacology, medical management, and nursingmanagement across the healthillness continuum, across the lifespan in acute healthcaresettings.

1.3 Revise the plan of care based on an ongoing evaluation of patient outcomes.1.4 Explain acute and chronic illness, its etiology and manifestations, diagnosis, treatment,

nursing management, and how it affects the bio- psychosocial functioning of individuals.1.5 Formulate and prioritize nursing diagnosis based on physical assessment and findings of

patients needs to provide total or holistic patient care.2 INTERPERSONAL SKILLS & RESPONSIBILITY 0 1 2 3 42.1 Demonstrate professionalism in the provision of nursing care in variety of health care

setting, including attention to appearance, demeanor, respect for self and others, andattention to professional boundaries with patients and families as well as amongcaregivers

2.2 Collaborate with various health care team members in the completion of total client careto adult patients in acute health care setting.

2.3 Uphold ethical standards related to data security, regulatory requirements, confidentiality,and clients right privacy.

3 COMMUNICATION, INFORMATION TECHNOLOGY, NUMERICAL 0 1 2 3 43.1 Communicate effectively with all members of the healthcare team, regarding the clients'

care needs and responses.3.2 Provide appropriate patient teaching that reflects developmental stage, age, culture,

spirituality, patient preferences, and health literacy considerations to foster patientengagement in their care.

3.3 Utilize effective and appropriate communication and caring skills for adult patients todevelop relationships with client and family members in acute health care setting.

3.4 Utilize professional verbal and written communication skills and terminology to discuss,document and report focused assessment data, provision of care, and client responseswhen working with the health care team to provide patient care

3.5 Utilize all relevant sources of information, including but not limited to technology,databases, and Internet resources to inform the delivery of care.

3.6 Appraise the range of tools, instruments and procedures used in the gathering ofinformation and the auditing of care.

3.7 Establish rapport with the patient and relatives for patient health assessment, historytaking and providing care.

4 PSYCHOMOTOR 0 1 2 3 44.1 Operate specialized medical devices and manipulate various type of equipment with

appropriate and safe mannerSpecify equipment operated:

a. _________________________________________________b. _________________________________________________c. _________________________________________________



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d._________________________________________________4.2 Conduct comprehensive and focused physical, behavioral, psychological, spiritual,

socioeconomic, and environmental assessments of health and illness parameters inpatients, using developmentally and culturally appropriate approaches.

4.3 Apply principles of infection control using personal protective equipments in acute healthcare settings with adult patients

4.4 Follow standard protocol, precautions, and safety measures for all nursing interventionalprocedures and with adult patients in acute health care settings

4.5 Practise safe and effective medication management including Preparation, calculation andadministration.Specify medications managed:

a. _________________________________________________b. _________________________________________________c. _________________________________________________

_________________________________________________4.6 Provide safe and competent practical advance medical-surgical nursing care for adult

clients in the acute care setting.4.7 Record and document patient data accurately and appropriately using appropriate audit

tools in the health care setting.4.8 Perform and demonstrate the procedures safely and effectively to meet the needs of their

assigned patients.



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The following Procedures should be covered/ demonstrated by the students during the entiresemester:

Procedures Covered Met Not Met PreceptorSignature1 Obtaining an Electrocardiogram (ECG)2 Applying a Cardiac Monitor3 Administering a Blood Transfusion4 Obtaining an Arterial Blood Gas Specimen for Blood Gas Analysis5 Measuring Arterial Oxygen Saturation6 Care of a Patient with a Chest Drainage System7 Measuring Output from a Chest Drainage System8 Administering an Eye Irrigation9 Administering an Eye Irrigation10 Care of a Client With Hearing Aid11 Care of a Client With Eye Prosthesis12 Assessing Mental Status and Level of Consciousness13 Assessing Cranial Nerves14 Assessing Deep Tendon Reflexes15 Assisting with Hydrotherapy for Burn Injury16 Care of Patient with Burn Injury (Closed Method)17 Care of Patient with Burn Injury (Open Method)18 Administering a Continuous Closed Bladder Irrigation19 Caring for a Patients Vascular Access on Hemodialysis20 Caring for a Patients Peritoneal Dialysis Catheter21 Caring for a Patient in Skin Traction22 Caring for a Patient in Skeletal Traction23 Care of Patient with Immobilization Device (Cast, Splint, or Collar Brace)24 Applying a Sling25 Assisting a Patient with Ambulation Using a Walker, Crutches, or Cane26 Assisting With Cast Application27 Caring for a Cast28 Care of a Patient During Cast Removal

The following Systems should be covered/ demonstrated by the students during the entiresemester:

Physical Examination Systems Covered Met Not Met PreceptorSignature1 Ears2 Eyes3 Skin4 Heart and Neck vessels5 Thorax and lung6 Neurologic System7 Musculoskeletal system8 Abdomen - Renal System



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Basis for AssessmentsItem Frequency Mark

1 Competency Based Clinical Evaluation Rubric Once Per Area 15%2 Attendance Daily 5%3 Nursing Care Plan Once/Semester 5%4 Case Study Once/Semester 10%5 Worksheet Weekly 5%6 Midterm Clinical Exam Skills/OSCE 7th or 8th week 20%7 Final Clinical Exam OSCE 15th week 20%8 Final written exam 15th week 20%

Total 100%

OR

Item Frequency Mark1 Competency Based Clinical Evaluation Rubric Once Per Area 20%2 Attendance Daily 5%3 Nursing Care Plan Once/Semester 10%4 Case Study Once/Semester 10%5 Worksheet Weekly 5%Group Assignments (Change agent, Patienteducation pamphlet, staff teaching materials) Once/Semester 10%7 Final Clinical Exam OSCE 15th week 20%8 Final written exam 15th week 20%

Total 100%

Suggestion: In the last table Midterm exam removed and Group Assignments such as change agent, Patienteducation pamphlet, staff teaching materials added instead, to help student work in groups, encourage creativitythrough being change agent, and concentrate on some nursing roles such as patient education



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An Objective Structured Clinical Examination (OSCE) is an assessment instrument used to examine aCandidates/students clinical skills and knowledge competencies. An OSCE involves a set of timedactivity stations where a nurse Candidate must perform simulated professional tasks with aStandardized Patient in the presence of an Examiner.The strengths of an OSCE include:1. Ensures equity, as all students are presented with the same examination containing an objectivespecification of content2. Measures clinical competence cross-sectionally using standardized means3. focuses on observable behaviours using a wide sample of activities4. Allows the assessment of complex competencies without endangering the client by mapping tothe field experience5. Ensures an adequate sampling of activities from across many subject areas6. Permits feedback by using structured interaction between the Examiner and the student.The clinical skills assessed in OSCE examination include:1. History taking2. Physical examination3. Ordering and interpreting diagnostic tests4. Developing management plans (plan of care)5. Patient education and counseling6. Performing interventional nursing care procedure7. DocumentingAttaching the "COMPETENCY BASED CLINICAL EVALUATION RUBRIC" to assess our students in the fieldexperience based on the intended learning outcomes (ILOs) and competencies of the program and fieldexperience, which is the only way to prove that we are measuring or assessing the intended learningoutcomes (ILOs) and competencies for the field experience.Please note the guideline for nursing program learning outcomes by National Commission for AcademicAccreditation & Assessment (NCAAA) which listed the psychomotor skills outcomes and recommendedusing OSCE.In addition, there is a number of extra and not needed procedures which are applied in nursing fieldexperience, these procedures not listed by NCAAA and prevent our student to focus on the requirednursing roles, attributes, learning outcomes, and competencies of the field experience and program.Our recommendation is to review the NCAAA psychomotor skills, include it only in our program andfield experiences, and remove the not listed procedures by NCAAA to achieve the desirable learningoutcomes and competencies.



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Patient teaching should be included and evaluated as one of the nursing roles as educators, more focuson patient teaching in the "COMPETENCY BASED CLINICAL EVALUATION RUBRIC", and it should beincluded in "CASE STUDY".Attaching the following:1. COMPETENCY BASED CLINICAL EVALUATION RUBRIC for Advance Field Experience as anexample, and new evaluation system2. Recommended templates to be used "Work sheet"3. Guideline for nursing program learning outcomes by National Commission for AcademicAccreditation & Assessment (NCAAA)4. Sample of practice-OSCE-scenarios5. Documentation sheet to be used in OSCE by students.Please note that the "COMPETENCY BASED CLINICAL EVALUATION RUBRIC" will be different from fieldexperience to other according to it's the intended learning outcomes (ILOs) and competencieshttp://www.ncbi.nlm.nih.gov/books/NBK2628/

1. competency based advanced practice

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