School 1 of Nursing NURS 127A Table of Contents Item Course Overview Sections, locations, & instructors Calendar Weekly Objectives Class Outlines Page 2 6 7 8 12
NURS 127A course description revised January/09
2 SAN JOSE STATE UNIVERSITY School of Nursing NURS 127A - Nursing Theory V-A - 2 units COURSE DESCRIPTION Concepts for nursing in psychiatric-mental health settings with clients from culturally diverse backgrounds. Systems approach integrates psychiatric/mental health nursing care for individuals, families and communities with complex health problems. PREREQUISITE Completion of Semester 6. COURSE OBJECTIVES Upon completion of this course, the student will: 1. review research findings from nursing and other disciplines related to psychiatricmental health nursing; 2. recognize therapeutic nursing interventions that are safe and culturally sensitive for psychiatric-mental health clients and aggregates; 3. select communication skills that promote positive outcomes and understanding with at-risk psychiatric-mental health groups, aggregates, families, and multidisciplinary health team members; 4. indicate community focused nursing actions for psychiatric-mental health clients and groups through health promotion, health education, and disease prevention activities; 5. describe community resources for collaboration with appropriate interdisciplinary team members to provide care for psychiatric-mental health clients and aggregates; 6. express strategies for collaboration with individuals, families, and community groups to plan and implement positive psychiatric-mental health behaviors; 7. identify therapeutic nursing interventions for ethnically diverse psychiatric-mental health clients and populations; 8. discuss leadership activities that include advocacy, case management, outcome evaluation, and cost effective strategies in psychiatric-mental health nursing; 9. locate information technology to improve care for psychiatric-mental health clients and at risk populations; and 10. explain responsibility for maintaining professional standards and for identifying and reporting illegal and unethical behaviors in psychiatric-mental health nursing.
NURS 127A course description revised January/09
3 COURSE REQUIREMENTS 1. 2. 3. 4. Completion of assigned readings. Completion of two 63 point examinations. Completion of a 64 point cumulative exam. Completion of a Psychiatric-Mental Health Nursing Standardized Achievement exam during the week of the finals.
Campus Policy in compliance with the American Disabilities Act "If you need course adaptations or accommodations because of a disability, or if you need to make special arrangements in case the building must be evacuated, please make an appointment with me as soon as possible, or see me during office hours. Presidential Directive 97-03 requires that students with disabilities requesting accommodations must register with the DRC (Disability Resource Center) to establish a record of their disability." Academic Integrity "Your own commitment to learning, as evidenced by your enrollment at San Jose State University and the University's integrity policy, require you to be honest in all your academic course work. Faculty members are required to report all infractions to the office of Student Conduct and Ethical development. The policy on academic integrity can be found at http://sa.sjsu.edu/student_conduct" TEACHING STRATEGIES Lecture, large group discussion, extensive reading, course reader modules, presentations, and learning activities. Collegial approaches are encouraged between students, and student and faculty, so that learning is viewed as a joint endeavor. Students are expected to take responsibility for their own learning. Students are to practice the art of independent study and develop sound intellectual habits and skills. Work should reflect care, thoroughness, precision and should reveal command of the process of critical reading, speaking, and thinking. EVALUATION AND GRADING Evaluation: 1. 2. Evaluation is a continuous process and is the responsibility of both the teacher and the students. Self-evaluation regarding mastery of content can be achieved by completion of pretests and posttests.
NURS 127A course description revised January/09
4 3. Students are provided the opportunity to evaluate this course in terms of stated course objectives and with respect to teaching strategies.
Grading: 1. 2. Grades will be assigned based on completion of exams. Students are required to take a standardized achievement test pertaining to psychiatric mental health nursing (ATI test). The score on the exam will be integrated into the course grade. The point distributions will be incorporated as part of the total possible points achievable for the course. Students will get 10 points (5% of the total score of N127A) if they get 78% or above on the ATI test, 6 points for 75% or above, and 2 points for 70% or above. Students receiving unsatisfactory grades on an exam are encouraged to see the faculty member.
3. 4.
Grades will be calculated using the following school established ranges for 200 total points: Satisfactory Range Unsatisfactory Range A = 93-100% C- = 70-72% A- = 90-92% D+ = 67-69% B+ = 87-89% D = 63-66% B = 83-86% D- = 60-62% B- = 80-82% F = 0-59% C+ = 77-79% C = 73-76% 5. Policies on examinations and incompletes. 5.1 The student must present a written petition/request with documentation to the faculty member for special arrangements for an exam or in order to take a make-up exam. 5.2 6. See SJSU Bulletin regarding regulations for taking final exams and the initiation and removal of an incomplete grade.
Students who receive a C-, D or F in this course should refer to School Student Progression Policies. A copy is in the Student Handbook purchased for NURS 33.
REQUIRED READINGS American Nurse Association (2007). Scope and standards of psychiatric-mental health clinical nursing practice. Washington, D.C.: Author Keltner, N. L., & Folks, D. G. (2005). Psychotropic drugs. (4th ed.). St. Louis: Mosby. Mohr, W. K. (2005). Johnson's psychiatric-mental health nursing (6th ed.). Lippincott
NURS 127A course description revised January/09
5 SUGGESTED READINGS Arnold, E. & Boggs, K.U. (2003). Interpersonal relationships (4th ed). Saunders. Johnson, S.T. (1997). Antipsychotics. RN, 60(8), 45-50 Riley, J. B. (2000). Communication in Nursing (4th ed.). Mosby Smoyak, S.A. (2000). The history, economics, and financing of mental health care. Part 1: 17th to 19th Centuries. Journal of Psychosocial Nursing and Mental Health Services, 38(9), 26-33. Smoyak, S.A. (2000). The history, economics, and financing of mental health care. Part 2: The 20th Century. Journal of Psychosocial Nursing and Mental Health Services, 38(10), 26-37. Smoyak, S.A. (2000). The history, economics, and financing of mental health care. Part 3: The present. Journal of Psychosocial Nursing and Mental Health Services, 38(11), 32-38. Mental Health Report Surgeon General: hyyp://www.mentalhealth.org/specials/surgeiongeneralreport/
NURS 127A course description revised January/09
6 School of Nursing NURS 127A Sections, Locations, & Instructors Section 1 at IRC 302; & section 95, websteamed live or archived at http://www.sjsu.edu/depts/atn &, videostreamed to Section 85 at Cabrillo, Section 89 at Nativida
Instructor Chia-Ling Mao, Ph.D., R.N. Office: HB 308 Phone: [phone] Office Hours: Monday: 3:00 4:30 Tuesday: 2:00-4:00 Wednesday: 2:00 3:30 Email: [e-mail] Homepage:
http://www.sjsu.edu/faculty_and_staff/faculty_detail.jsp?id405
NURS 127A course description revised January/09
7 Calendar Date 1/23 1/30 2/6 2/13 2/20 2/27 3/6 3/13 3/20 3/27 4/3 32 4/10 4/17 4/24 5/1 Topic Introduction to Psychiatric-Mental Health Nursing Therapeutic Nurse-Patient Relationship Psychopharmacology Roles of nurse in different treatment modalities Examination #1 Introduction to Psychopathology Schizophrenia and Other Psychoses Mood Disorders & anxiety disorder Anxiety Related Disorders Legal & selected issues Cognitive Disorders Special Population Spring break Personality Disorders, substance disorder & forensic nursing Ch 20, 27, Examination #2 Forensic nursing by guest speaker ATI exam Sexual Disorders Easting Disorders Sleep disorder Ch. 26 Ch. 28 Ch. 23 Ch. 9, 30 Ch. 24, Ch. 25, 29 Ch. 7, 17, 21, 31 Ch. 33 Ch. 22, 34, 35 Preparation Ch. 1,3, 8 Ch 4, 6 Ch 2,14 Ch 8, 10-12
5/8
Community Care, Spiritual care and complimentary therapies Ch. 5, 13, 15-19
Final Week Examination # 3 (50% Cumulative) Calendar is subject to change
NURS 127A course description revised January/09
8 Objectives under different subjects Introduction to Psychiatric-Mental Health Nursing 1. Explain the historical foundations psychiatric of care and services and psychiatric mental health nursing 2. Discuss the current status of psychiatric care and psychiatric-mental health nursing 3. Describe the components of the psychotherapeutic management model. 4. Compare and contrast models/frameworks used in psychiatric care and nursing 5. Identify the importance of psychobiological issues for psychiatric nursing Psychiatric care 1. Explain the continuum of psychiatric care, including the impact of managed care 2. Describe the advantages and disadvantages of hospital-based psychiatric are and services 3. Discuss the advantages and disadvantages of community-based psychiatric care and services 4. Explain case management in psychiatric care and services 5. Describe the roles of the psychiatric nurse in the therapeutic milieu management Selected issues 1. Describe five legal issues in psychiatric care: commitment, least restrictive alternative, confidentiality, freedom from restraint and seclusion, and right to treatment and the right to refuse treatment 2. Explain the influence of legal issues on psychiatric nursing 3. Identify nursing interventions and care for working with aggressive, passive aggressive, and assertive psychiatric patients, including use of seclusion and restraints. 4. Discuss the factors in the interlocking paradigm of cultural competence model 5. Identify the influences of cultural competence in psychiatric nursing. Therapeutic nurse-patient relationships 1. Describe the stages and tasks of a therapeutic nurse-patient relationship, including therapeutic communication 2. Relate the nursing process to psychiatric nursing practice. 3. Explain the relationships between and among anxiety, coping, and crisis intervention goals and strategies 4. Discuss group intervention strategies for support, activity, education/ problem solving, therapy, and self-help 5. Identify the benefits, problems, and strategies for including families in the care of psychotic patients. Psychopharmacology 1. Define the nursing roles and responsibilities related to psychopharmacology in psychotherapeutic management 2. Describe methods and strategies for teaching patients about psychotropic drugs.
NURS 127A course description revised January/09
9 3. Identify the therapeutic use and side effects of antiparkison drugs in psychiatric care and services, including extrapyramidal symptoms and reactions. 4. Explain the clinical uses of antipsychotic drugs, including the effects, toxic levels, and drug interactions. 5. Discuss implications and problems for teaching patients about antipsychotic drugs. 6. Describe the neurobiological concepts of mood disorders 7. Explain the clinical uses of antidepressants, including side effects, toxic levels, and drug interactions 8. Identify the clinical uses of antimanic drugs, including side effects, toxic levels, and drug interactions 9. Define the clinical uses of antianxiety drugs, including side effects, toxic levels, and drug interactions 10. Discuss implications and problems for teaching patients about antidepressant, antimanic, and antianxiety drugs. Psychopathology 1. Discuss the extent of mental illness in the United States. 2. Recognize the most common mental disorders in the United States 3. Recognize the criteria for mental disorders 4. Discuss the prevalence rate and epidemiology of various mental illnesses 5. Apply the guidelines of psychotherapeutic management 6. Recognize the symptoms related to ego defenses, ego affects, and ego defects. 7. Define relapse and relapse triggers 8. Identify NANDA diagnoses related to different mental illnesses 9. Apply collaborative interventions with families and care providers 10. Identify outcomes and evaluation of treatment based on a care plan 11. Assess the potential for violence for persons with schizophrenia 12. Recognize the potential risk of suicide of persons with mood disorders 13. Identify the stages of anxiety and nursing interventions 14. Recognize interventions for anxiety reduction and problem solving Personality disorders 1. Discuss the characteristics, prevalence, and theories of each personality disorder 2. Identify the three clusters of personality disorders 3. Identify nursing interventions for specific behaviors 4. Identify communication techniques to deal effectively with persons with personality disorders Sexual disorders 1. Recognize key areas of nursing assessment of sexual concerns 2. Describe the DSM IV categories of sexual disorders 3. Identify disorders related to human sexual activity Additional resources Healthy sexuality: http://www.uiuc.edu/departments/mck...healthinfo/sexual/intro/intro.htm Sexual information and Education Council of the United States (SIECUS) http://www.siecus.org NURS 127A course description revised January/09
10 Eating disorders 1. Recognize the criteria and terminology related to eating disorders 2. Describe the priority nursing problems and key nursing interventions 3. Select outcomes and evaluations relevant for persons with eating disorders 4. Discuss the health problems of obesity Substance-related disorders 1. Discuss the personal and societal toll of substance abuse 2. Recognize the criteria and terminology for substance-related disorders 3. Describe physiological, emotional, and interpersonal theoretical explanations for the development of substance related disorders 4. Identify the treatment modalities for substance abuse 5. Develop a nursing care plan for substance abuse/dependence patient 6. Recognize the characteristics of co-dependency 7. Identify the stages of change in addictive behaviors 8. Select appropriate nursing interventions for a client with self-care deficit related to drug abuse Dual diagnosis 1. Discuss the major perspectives related to etiologies for dual diagnosis 2. Identify the treatment components for patients with dual diagnosis 3. Evaluate the outcomes of the effective treatment for a patient with a major depression and alcohol abuse Cognitive Disorders 1. Differentiate dementia, delirium, and depression 2. Recognize the psychotherapeutic management for persons with cognitive impairment 3. Identify an appropriate care plan for a patient with cognitive impairment Additional resources Alzheimer's Association: http://www.alz.org Family caregiver alliance: http://www.caregiver.org Behavior therapy 1. Discuss the principles of behavior therapy 2. Identify at least three techniques for increasing a behavior 3. Identify three techniques for decreasing a behavior 4. Understand the principles and limitations of a token economy 5. Recognize the use of the nursing process and behavioral modification principles Electroconvulsive and other somatic therapies 1. Discuss modern electroconvulsive therapy (ECT) wit traditional ECT 2. Identify three indications for ECT 3. Recognize the nurse's role in caring for patients before and after ECT 4. Discuss the ethical, legal, social and biological concerns related to psychosurgery
NURS 127A course description revised January/09
11 Victims of violent behavior 1. Recognize the reactions of nurses to violence 2. Differentiate violence, aggression, and agitation 3. Identify the risk factors for aggression 4. Recognize the role of milieu and violence 5. Recognize the principles and safety guidelines of aggression reduction Child and adolescent psychiatric nursing 1. Discuss the major categories of child psychiatric disorders 2. Recognize the symptoms of the common child and adolescent developmental disorders 3. Recognize the role of resilience and negative effects of psychosocial adversity and genetic vulnerability 4. Identify management techniques for disruptive behaviors. 5. Select appropriate nursing diagnoses and interventions for children and adolescents 6. Recognize the impact, needs and role of the family Mental illness in the elderly 1. discuss the continuum of care available for the elderly 2. Identify the losses most frequently experienced among the elderly 3. Describe the barriers to mental health care experienced by elders 4. Recognize the symptoms of depression evident in the elderly 5. recognize the anti-anxiety agents appropriate for the elderly 6. Recognize the major substance abuse issues in the elderly 7. Recognize the pharmacokinetic changes in the elderly that impact pharmacotherapy 8. Identify the use of reality orientation and reminiscence Psychosocial issues and persons with HIV 1. Review the groups most at risk for HIV transmission in the U.S. 2. Recognize the relationship between stress and poor social support and progression to AIDS 3. Identify neurological and neuropsychiatric complications for persons with HIV 4. Recognize the ethical responsibility of the nurse in safeguarding the privacy and confidentiality of the person with HIV
NURS 127A course description revised January/09