Title	Alternate Clinical Care Assignment	
Author	Minnesota West Community and Technical College	
	Put X in box to correspond with the SLO (s)	Put X in box to correspond with the Competency (s)	Knowledge/Practice/Ethical Comportment	
			K	P	E	

Student Learning Outcome(s)
	Patient Relationship Centered Care	x	Communication Skills			     	
			Nursing Process	X			
			Learning Needs				
	Informatics/Technology		Documentation				
			Informatics				
	Nursing Judgment/Evidence Based care	x	Prioritization				
			Nursing Judgment	X			
	Professional Identify and behaviors		Professionalism	X			
			Ethical/Legal				
	Quality Improvement		Patient Care Concerns				
			Systems				
	Safety	x	Patient Complications	X			
			Safe Nursing	X			
	Teamwork and Collaboration	x	Communication	X			
			Conflict Recognition 				
	Managing Care of the Individual Patient		Managing Care of the Individual Patient				
			Assign/Monitor 				

Where should this assignment be used:	
Classroom		
Clinical Setting	LTC	
Independent Study		
Online/Web Based		
Skills Lab		
Simulation		

Revised from Linda Caputi © (What type of assignment is this?)	
Patient Care Assignment	Non Patient Care Assignments	
Patient Care 
The assignments are related to the student while providing patient care in the clinical setting.
Example:  Concept mapping care for one or multiple patients. 	Thinking Focused
Assignments encourages critical thinking and clinical reasoning and teaches students to think like a nurse.	Patient Focused
The student focuses on specific aspects of patient care such as safety, falls, diabetes, other diseases, etc.	Systems Focused
Assignments help the student understand the clinical world, the nurse’s work therein, and the effect of the system on the nurse and the patient. 
Example:  How the system completes medication administration from order to delivery to patient.  	
	x	x		

 Alternate Clinical Care Assignment – Long Term Care
Student _______________________________________                 Instructor_______________________________
Alternate Care Clinical Assignment
Competencies addressed in this assignment: 
Nursing Judgment Competency: Identify (K), use (P), and appreciate (E) evidence based care when conducting a focused assessment, choosing nursing interventions within a plan of care, monitoring, and reporting changes in the individualized patient's condition  across the lifespan.
Patient Relationship Centered Care -  Nursing Process Competency: Describe (K), utilize (P), and value (E) the nursing process when participating with other health providers in the development and modification of a plan  of care for patients across the lifespan and in various health care settings.
Safety – Safe Nursing Practice Competency:  Explain (K), demonstrate (P), and value (E) safe nursing practice and the relationship between national safety campaigns and implementation in practice settings.
Safety – Patient Complications Competency: Identify (K), implement actions (P), and recognize (E) one's responsibility to detect and respond to actual/potential patient complications and report changes to the appropriate health care provider.
Teamwork and Collaboration – Communication Skills Competency: Describe (K), display (P), and value (E) effective communication skills including the responsibility to report to appropriate health care personnel when working with members of the interprofessional teams.	
Directions: 
•	Two students will be assigned to work together while at their clinical site.  This will be a non-patient assignment day. 
•	After the instructor assigns the students to these activities, the students will complete the written assignment during clinical day and present the information in post clinical.    
•	Student will be graded by the rubric at the end of this assignment. 
Read the Teamwork rubric PRIOR to starting the project (below). You will grade your team members on the following areas. 
Part I:  Teamwork Competency:  Grade your team members. 
Part II:  Safety Competency 
Part III:  Teamwork Competency
Part IV:  Nursing Judgment Competency and Patient Relationship Centered Care/Nursing Process Competency: Two Patient Comparison: 

Part I:  Teamwork and Collaboration: Communication Competency	
Grade your team members! 	
Criteria
	Satisfactory (__points each)
	Needs Improvement (__ points each)
	Unsatisfactory (__points each)
	
Roles/Tasks	•	All team members have a role. 
•	Tasks are defined and assigned prior to starting project. 
•	Team follows up with one another during the project. 	•	Most members contribute.
•	Tasks are defined and assigned informally.  
	•	Tasks are not defined. 
•	Few members participate actively. 
•	There is no follow-up.	
Team Member Support	•	Every team member is treated with respect. 
•	All members listen to all ideas. 
•	Members feel free to seek assistance from others or to ask questions.	•	There is a general atmosphere of
respect for team members, but
some members may not be heard. 
•	Some members may not feel free to turn to others for help.	•	The team atmosphere is competitive and individualistic rather than cooperative and supportive.	
Presentation of Team Work	•	All members take part in the presentation of information.	•	There are members that do not presen.t 	•	Everything is presented by one person.	
Total Points:	

The following information from the 2013 Joint Commission 
will be used in part 2 of this assignment. 

2013 Long Term Care
National Patient Safety Goals

The purpose of the National Patient Safety Goals is to improve patient safety. The goals focus on problems in health care safety and how to solve them.

Identify residents correctly

NPSG.01.01.01

Use at least two ways to identify residents. For example, use the resident’s name and date of birth. This is done to make sure that each resident gets the correct medicine and treatment.

Use medicines safely NPSG.03.05.01 NPSG.03.06.01

Take extra care with patients who take medicines to thin their blood.

Record and pass along correct information about a resident’s medicines. Find out what medicines the resident is taking. Compare those medicines to new medicines given to the resident. Make sure the resident knows which medicines to take when they are at home. Tell the resident it is important to bring their up-to-date list of medicines every time they visit a doctor.

Prevent infection

NPSG.07.01.01

NPSG.07.04.01

Use the hand cleaning guidelines from the Centers for Disease Control and Prevention or the World Health Organization. Set goals for improving hand cleaning. Use the goals to improve hand cleaning.

Use proven guidelines to prevent infection of the blood from central lines.

Prevent residents from falling

NPSG.09.02.01

Prevent bed sores

NPSG.14.01.01

Find out which residents are most likely to fall. For example, is the resident taking any medicines that might make them weak, dizzy or sleepy? Take action to prevent falls for these residents.

Find out which residents are most likely to have bed sores. Take action to prevent bed sores in these patients. From time to time, re-check residents for bed sores.

SAFETY: Safe Nursing Practice Competency	
1a.  Identify at least five safety concerns on your assigned unit. Consider safety in the resident rooms, hallways, medication room, utility room, tub and shower rooms, and/or dining room. 
1.  
2.  
3.  
4.  
5.  	1b.  Identify possible solutions to correct the safety issues. 

1.	 
2.   
3.  
4.  
5.  	
2.	  Visit with 2 classmates about their assigned patient and working together, identify factors that contribute to safety concerns in their care.	
3.	 Identify at least 3 national patient safety campaigns that are being implemented at the practice center.  Go to the following website for safety goals:  http://www.jointcommission.org/standards_information/npsgs.aspx or view the attached PDF with the 2013 Patient Safety Goals for LTC. 
1.	 
2.  
3.  	
Part II:  Rubric for grading safety
Circle the choice that represents the student’s achievement in assignment. Total points at bottom of page.	
Criteria
	Satisfactory (__ points each)
	Needs Improvement (__ points each)
	Unsatisfactory (__ points each)
	
Question 1	Identifies 5 actual safety concerns in multiple areas of the clinical site and identifies possible solutions to correct each one. 	Identifies 4 to 5 safety concerns but misses one or two ways to correct the safety issues. 	Identifies 3 safety concerns or less; unable to identify ways to correct the safety issues without supporting cues. 	
Question 2
	Visits with 2 classmates about their assigned patient and working together, identifies 3 factors that contribute to safety concerns in their care.	Visits with 2 classmates about their assigned patient and working together, identifies 2 factors that contribute to safety concerns in their care.	Visits with 0 to 1 classmates about their assigned patient and working together, identifies 1 - 2 factors that contribute to safety concerns in their care. 	
Question 3	Identifies 3 national patient safety campaigns at the facility. 	Identifies 2 national patient safety campaigns at the facility	Identifies 0 to 1 national patient safety campaign at the facility	
Total Points	

Part III:  Teamwork and Collaboration/Communication Competency	
1.	 Identify all nursing staff on the unit during your shift. 

	Nursing Staff Responsibility during your shift. 	Identify all ancillary staff on the unit during your shift. 	Ancillary Responsibility during your shift. 	
2a. What behaviors did you observe that promoted teamwork?	
2b. What behaviors did you observe that hindered teamwork?

3a.  What things are done to create a positive environment for both the residents and staff?
	
3b.  List positive and negative aspects of working in this environment. 
	
Rubric for grading Teamwork.
Circle the choice that represents the student’s achievement in assignment. Total points at bottom of page. 	
Criteria
	Satisfactory (__points each)
	Needs Improvement (__ points each)
	Unsatisfactory (__points each)
	
Question 1	Identifies at least 5 nursing and ancillary personnel and describes their responsibilities. 	Identifies 3 to 4 nursing and ancillary personnel and describes their responsibilities.	Identifies less than 3 nursing and ancillary personnel and has difficulty describing their responsibilities.	
Question 2 	Identifies 3 behaviors that promote teamwork and 3 behaviors that hinder teamwork. 	Identifies 2 behaviors that promote teamwork and 2 behaviors that hinder teamwork.	Identifies less than 2 behaviors that promote teamwork and less than 2 behaviors that hinder teamwork.	
Question 3 	Identifies 3 things that are done to create a positive environment for residents and staff. 	Identifies 2 things that are done to create a positive environment for residents and staff.	Identifies less than 2 things that are done to create a positive environment for residents and staff.	
Total Points

Nursing Judgment Competency and Safety Patient Complications Competency
Part IV:  PATIENT COMPARISON ASSIGNMENT
Instructor will assign 2 clients with a similar diagnosis to research.  You will not provide cares to these clients but will research their medical record and visit with the patient. Answer the following questions based on the diagnosis specified by your instructor.	
1.	 Explain the diagnosis that you researched:  	
2.	 Compare the medications that each client is taking to manage this illness. 
	Patient 1:  Medications

	Patient 2: Medications	
Give rationale for similarities and differences in their medications.	Rationale for Similarities: 

	Rationale for Differences: 

	
3.	Compare each client’s treatments used to manage this illness, give rationale for similarities and differences in their treatments. 	Patient 1:  	Patient 2: 	
	Rationale for Similarities: 

	Rationale for Differences: 	
4.	What complications (if any) are each of the clients experiencing related to their illness. If no complications, what are the potential complications for each of these patients? 	Patient 1: 	Patient 2: 	
5.	 What strengths and coping mechanisms can you identify in each of these residents that help them adjust to their health status and residence in the nursing home?	Patient 1: 	Patient 2: 	
Rubric for grading Compare and Contrast Assignment
Circle the choice that represents the student’s achievement in assignment. Total points at bottom of page.	
Criteria
	Satisfactory (__points each)
	Needs Improvement (__ points each)
	Unsatisfactory (__points each)
	
Question 1	Able to explain the main diagnosis without prompts	Able to explain the main diagnosis with a few prompts. 	Unable to explain the main diagnosis without multiple prompts and cues. 	
Question 2	Able to identify 1 - 2 medications for each patient that are being used for this specific disease.  Able to give reasons for similarities and differences for the medications without cues. 	Able to identify 1 medication for each patient that are being used for this specific disease.  Able to give reasons for similarities and differences for the medications but needs a few prompts. 	Unable to identify medications for each patient for the specific disease without multiple prompts and cues.   	
Question 3	Able to identify 1 - 2 treatments for each patient that are being used for this specific disease.  Able to give reasons for similarities and differences for the medications without cues. 	Able to identify 1 treatment for each patient that are being used for this specific disease.  Able to give reasons for similarities and differences for the medications but needs a few prompts. 	Unable to identify treatment for each patient for the specific disease without multiple prompts and cues.   	
Question 4	Able to identify 1 to 2 different potential/actual complications for each of the patients. 	Able to identify 1 different potential/actual complications for each of the patients.
With cues is able to identify additional potential/actual complications. 	Unable to identify potential/actual complications for patients. 	
Question 5	Able to identify 2 strengths and coping mechanisms for each of the residents that help the resident adjust to their health status and residence in the nursing home. 	Able to identify 1 strengths and coping mechanisms for each of the residents that help the resident adjust to their health status and residence in the nursing home.	Able to identify 1 strengths and coping mechanisms for each of the residents that help the resident adjust to their health status and residence in the nursing home but needs cues to identify them. 	
Total Points		

Total Grade	Possible Points	Student Score	
Teamwork for Group Team Members 			
Safety  			
Teamwork 			
Compare and Contrast 			
Total Points