Minimum Course Hours: 180

Course Description

Learners apply nursing knowledge through the practice of clinical decision making, nursing assessments, and nursing interventions aimed at promoting the health, independence, and comfort of clients. Cultural safety, cultural humility, anti-racism, and trauma-informed practice are integrated into the learning with a focus on Indigenous-specific anti-racism. A variety of approaches, such as simulation, will help learners integrate theory from other Level A courses.

Prerequisites: Admission to the Practical Nursing Program; completion of Human Anatomy and Physiology for Practical Nurses or equivalent course with a minimum grade of 65%

Corequisites: Professional Communication A; Professional Practice A; Variations in Health A; Health Promotion A; Pharmacology A

Learning Outcomes

Upon successful completion of this course, within the simulated learning environment, the learner will be able to:

1. Use the current British Columbia College of Nurses and Midwives (BCCNM) LPN Professional Standards, Practice Standards, and Entry-Level Competencies to guide practice in complex care settings.
   • 1.1 Demonstrate comprehensive holistic nursing assessments and interventions with older adults, including those with chronic illnesses and/or mental health conditions, in a competent and safe manner.
   • 1.2 Demonstrate a trauma-informed, culturally humble, and person-centred approach with clients.
   • 1.3 Document assessments and care provided using objective and non-stigmatizing language.
   • 1.4 Use appropriate practice standards and clinical guidelines to support the implementation of specific clinical skills used in complex care settings.
   • 1.5 Use critical thinking and clinical judgment to assess clinical situations where select medications can be given without an order (asthma, anaphylaxis, and hypoglycemia medications).
   • 1.6 Discuss the legal implications of restraint use in complex care settings.
   • 1.7 Identify personal learning needs to enhance competence and take actions to remediate.
2. Use clinical skills and assessments competently and safely in complex care settings.
   • 2.1 Define nursing management.
   • 2.2 Demonstrate personal safety practices when providing care (e.g., safe disposal of sharps, ergonomics andbody mechanics).
   • 2.3 Use critical thinking, clinical judgment, and knowledge of assessment to autonomously plan, implement, and evaluate care.
   • 2.4 Use decision support tools to assist with decision making and implementation of care.
   • 2.5 Demonstrate safe medication administration.
3. Collaborate with older adults, including those with chronic illnesses and/or mental health conditions, as well as the interprofessional health care team, peers, and faculty.
   • 3.1 Provide a caring environment for older adults, including those with chronic illnesses and/or mental health conditions, by connecting, sharing, and exploring with them in a collaborative relationship.
   • 3.2 Initiate, maintain, and conclude a therapeutic relationship when caring for older adults, including those with chronic illnesses and/or mental health conditions.
   • 3.3 Discuss the practical nurse role in providing leadership, direction, assignment, and supervision of unregulated care providers.
4. Analyze potential sources of violence de-escalation and safety strategies in complex care and home and community care settings.
   • 4.1 Describe a quality practice environment.
   • 4.2 Describe factors that put individuals at risk for injury in complex care and home and community settings.
   • 4.3 Describe fall risk management tools and related assessments.
   • 4.4 Demonstrate nursing management of clients at risk for unintended injury.
   • 4.5 Complete incident reports and other documentation related to quality practice environments.
5. Provide person-centred care that recognizes and respects the uniqueness of each individual and demonstrates cultural safety, cultural humility, and anti-racism.
   • 5.1 Identify one’s own values, biases, and assumptions as a self‐reflective, responsible, and accountable practitioner.
   • 5.2 Demonstrate appropriate and required actions in a simulated environment when observing racist or discriminatory behaviour.

Course Concepts

Course outcomes will be met through examination and exploration of the following:

• BCCNM Professional Standards, Practice Standards, and documents that guide scope of practice
• Principles of asepsis
• Standard precautions
• Musculoskeletal injury prevention
• Comprehensive health assessment of older adults, including those with chronic illnesses and/or mental health conditions
• Vital signs
• Digital stimulation and rectal disimpaction (see more information below)
• Clinical decision making and critical thinking
• Nursing interventions with older adults
• Safety specific to the care of older adults
• Infection control
• Chronic wound management
• Pain management
• End-of-life care
• Foot assessment and care (see more information below)
• Oral and nasal suctioning
• Oxygen therapy
• Care of established ostomies
• Specimen collection (sputum, urine, and stool)
• Blood glucose monitoring
• Enteral feedings and medications via nasogastric, jejunostomy and gastrostomy tubes
• Quality practice environments
• Cultural safety, cultural humility, and anti-racism
• Diversity, equity, and inclusion
• Individualizing nursing care plans
• Medication administration, including opioids
• Medication routes: oral, subcutaneous, intramuscular, intradermal, percutaneous
• Inserting a subcutaneous infusion device
• Decision making in administering medications (e.g., medications “as needed,” for asthma, anaphylaxis, and hypoglycemia)
• Taking and transcribing physician orders
• Documentation of response to medication
• Reporting and documentation in complex care settings