Troy University

School of Nursing

Child Health Nursing Practicum

NSG 4404
Fall Semester - 2015

Troy Campus
Instructors:
Judy Bazzell, RN, DNP - Course Coordinator Troy University
Sharon Bussey, RN, MSN Clinical Adjunct Southeast Alabama Medical Center
Cinnamon Banks, MSN Clinical Adjunct Childrens Hospital
Amy Davis, RN, MSN- Clinical Instructor Troy University

TABLE OF CONTENTS

Course Overview ....................................................................................................................................

Evaluation Methods ......................................................................................................................................

Child Health Dosage Examination.................................................................................................................

10

Child Health Clinical Examination................................................................................................................

11

Chapter 22 Objectives....................................................................................................................................

12

Chapter 23 Objectives ...................................................................................................................................

13

Chapter 4 Objectives ....................................................................................................................................

14

IV Therapy Objectives ..................................................................................................................................

15

Children's Hospital Clinical

16

. ....................................................................................................................

Childrens Hospital Information Sheet..

17

School Health Rotation .................................................................................................................................

19

School Health Sign In Sheet

22

Southeast Alabama Medical Center ..............................................................................................................

23

Clinical Snapshot ..........................................................................................................................................

24/25

Developmental Assessment Tool ..................................................................................................................

27

Nursing Diagnoses Form ..............................................................................................................................

31

Health Assessment Tool. ...............................................................................................................................

33

Criteria for Evaluation of Care Plans ............................................................................................................

45

Skills Checklist..............................................................................................................................................

47

Reach Out and Read Information and Sign In Sheet

49

Kid Check; Lets Pretend Clinical Experience. .............................................................................................

51

Evaluation Tool (Student)..

53

Troy University School of Nursing

2015 Spring Semester Syllabus

Course:
Credit
Hours/Clock
Hours:
Prerequisites
Course
Information:

NSG 4404 (Section TZPA) Child Health Nursing Practicum

2 Credit Hours (2-4)*
(Usually 60 70+ hours clinical time)

Faculty:

Mrs. Judy Bazzell, RN, DNP, FNP-C Course Coordinator

Collegeview Building, School of Nursing
Phone: 334-670-3428 ext. 3431
Email: jbazz@troy.edu
Office Hours: Check Weekly Schedule/Office #170

All 3000 level courses. Co-requisite: NSG 4403.

Clinicals are located in Montgomery, Troy, Dothan, Union Springs, and Birmingham.
Clinical hours: day shift, evening hours, and weekend shifts

Sharon Bussey, RN, MSN Clinical Instructor/Adjunct

Southeast Alabama Medical Center; sbussey@samc.org
Hospital number: 793-8111
Cinnamon Banks, RN, MSN Clinical Instructor/Adjunct
Childrens Hospital; Cinnamon.banks@chsys.org
Hospital number: 205-939-9100
Amy Davis, RN, MSN-Clinical Instructor
Troy University School of Nursing; adavisrn@icloud.com
Office Hours: Check Weekly Schedule
Course
Description:

Provides clinical learning opportunities for students

to provide illness and restorative care for children
experiencing alterations in health states. Emphasizes
use of the nursing process in facilitating human adaptive
responses to child health alterations.

Student Learning
Outcomes:

1. Analyze theoretical and empirical knowledge from nursing, scientific,

community, and humanistic disciplines in the nursing care of children
experiencing alterations in health states.
2. Engage in nursing roles designed to meet developmental and health needs of
children, using socially and culturally appropriate approaches.
3. Provide safe, evidence-based nursing care of children, including health promotion
and clinical prevention.
4. Demonstrate evidence-based clinical decisions in the application of the nursing
process for children with alterations in health states.
5. Incorporate research findings and current evidence into nursing care for
improvement of health states for children and their families.
6. Provide safe, cost-effective, and quality nursing care for children.
7. Use effective techniques for interpersonal communication with children of all
ages, their families, and other health care professionals for promotion of optimal
health states within a caring environment.
8. Assume responsibility and accountability for appropriate professional and personal
attitudes and behaviors in the nursing care of children and their families.
9. Preserve safe, legal, and ethical standards in the practice of child health nursing.
10. Use appropriate safeguards and information technologies to support safe, quality
nursing care of children and their families.

Required:
Hockenberry, M. & Wilson, D. (2015). Wongs Nursing Care of Infants and
Children (10th edition), ELSEVIER Mosby. ISBN 978-0-323-22241-9
Suggested:
Gahart, Betty J. (2015). Intravenous medications. St. Louis: Mosby.
Hockenberry, M. Wongs Clinical Manual of Pediatric Nursing, C.V. Mosby
Other
Resources:

Troy Library Databases: http://library.troy.edu/databases.html

Other Materials:

a. Scantrons will be furnished to students

b. The School of Nursing provides computers, Internet access, laser printers and other
technology resources. Students who wish to print must bring copy paper.
c. Students who wish to save files should purchase travel drives.

Evaluation:

Final letter grades for each course are to be determined by computation on the following
scale, based on the total number of available points assigned to each individual course.
90 - 100% of total points = A
82 - 89% of total points = B
74 - 81% of total points = C
66 - 73% of total points = D
Below 66% of total points = F
Evaluation Methods:
Activity
Clinical Performance Evaluation (all)
*Kid Check (Bazzell)
*Reach Out and Read (Bazzell)
*Lets Pretend Hospital (Bazzell) Spring ONLY
*SAMC Evaluation
Childrens Hospital Evaluation
Care Plan and Health Assessment Paper - SAMC
Weekly Developmental Assessment and Clinical Snapshot;
other paperwork
ATI Practice Exams (2) 95% required
Clinical Exam (74% or higher required) - Blackboard
Dosage Exam (74% or higher required)-Sept 9 after EX 1
Final Grade

Percentage Points
70%
Required
Required
Required
Required
10%
5%
Evaluated with
clinical evaluation
Pass/Fail
5%
10%
100%

*Make up examinations will be given on the day of the final exam unless other arrangements have been determined by
instructor. Make up exams may be in any format or combination (multiple choice, short answer, or essay format). Makeup exams are only given for excused absences.

Class Procedure:

This course is conducted with traditional classroom sessions and clinical experiences in the hospital
and community based centers. The computer lab in the School of Nursing building in Troy provides
access to the Internet and software for learning activities. The TROY library provides online access
to many scholarly resources, reference books and material in the library or through Interlibrary
Loan. Students are expected to maintain an email account during the duration of the semester;
TROY provides email accounts to all students free of charge.
Students must assume accountability for their own learning through a variety of learning activities.
The course instructor serves as a guide for student learning, but the students interaction with the
course material is the learning focus.

Student Support:

Troy University Libraries http://uclibrary.troy.edu

Computer Works http://spectrum.troy.edu/~cw/

University
School of
Nursing Policies

TROY Writing Center http://troy.troy.edu/writingcenter/

Math Assistance Lab http://troy.troy.edu/naturalsciencecenter/
TROY Career Services http://www.troy.edu/careerservices/
Online Technology Help https://it.troy.edu/students/index.html
Troy University Email http://mail.troy.edu
BSN policies apply to all students, regardless of major, unless a policy is specifically targeted
toward nursing majors. BSN policies are available on the School of Nursing website
(http://troy.troy.edu/nursing) or at http://troy.troy.edu/nursing/pdf/BSNorientation.pdf
Non-Harassment, Hostile Work/Class Environment:
Troy University expects students to treat fellow students, their instructors, other TROY faculty, and
staff as adults and with respect. No form of hostile environment or harassment will be
tolerated by any student or employee.
Americans with Disability Act (ADA):
Any student whose disabilities fall with ADA must inform the instructor at the beginning of the
term of any special needs or equipment necessary to accomplish the requirements of the course.
Troy University supports Section 504 of the Rehabilitation Act of 1973 and the Americans with
Disabilities Act of 1990, which insure that postsecondary students with disabilities have equal
access to all academic programs, physical access to all buildings, facilities and events, and are not
discriminated against on the basis of disability.
Eligible students, with appropriate documentation, will be provided equal opportunity to
demonstrate their academic skills and potential through the provision of academic adaptations and
reasonable accommodations. Further information, including appropriate contact information, can
be found at the following link for Troy Universitys Office of Human Resources at
http://www.troy.edu/humanresources/index.html under Policies.
HONESTY AND PLAGIARISM
Honesty Statement: In accordance with the Standards of Conduct in the Troy University academic
catalogs and Oracle, a student or organization may be disciplined, up to and including expulsion, if
deemed in violation of the STANDARDS OF CONDUCT for the commission of or the attempt to
commit the offense.
The awarding of a University degree attests that an individual has demonstrated mastery of a
significant body of knowledge and skills of substantive value to society. Any type of dishonesty in
securing those credentials therefore invites serious sanctions, up to and including suspension and
expulsion (see Standard of Conduct in each TROY Catalog and Troy Student Handbook-Oracle).
Examples of dishonesty include actual or attempted cheating, plagiarism, or knowingly furnishing
false information to the University, faculty, or other officers or employees of the University.
Cheating/Plagiarism Policy: The School of Nursing will adhere to guidelines set forth in the
Academic Code as printed in the Troy University Oracle (Student Handbook). Cheating and
plagiarism will NOT be tolerated.
Plagiarism is defined as submitting anything for credit in one course that has already been
submitted for credit in another course, or copying any part of someone elses worktheir ideas
and/or wordspublished or unpublished, including that of other students, and portraying it as ones
own. APA format is required. All students are required to read the material presented at:
http://troy.troy.edu/writingcenter/research.html.

Students must properly cite any quoted material. No term paper, business plan, term project,
case analysis, discussion board, or assignment may have any more than 20% of its content
quoted from another source. Students who need assistance in learning to paraphrase should ask
the instructor for guidance and consult the links at the Troy Writing Center.

This university employs plagiarism-detection software, (www.Turnitin.com) through which all

written student assignments are processed for comparison with material published in traditional
sources (books, journals, magazines), internet (to include essays for sale) and papers turned in
by students in the same and other classes in this and all previous terms.
Absence Policy: Students are expected to attend all lecture classes and lab classes at designated
time and place scheduled as stated in the Troy University Bulletin and the Oracle. If the student is
unable to be in class, the course instructor or the School of Nursing secretary should be notified.
The student is responsible for all missed assignments/examinations and should meet with the
course instructor as soon as possible after an absence. Should an absence occur, it will be
considered with either excused or unexcused.
A. Determining Excused Absence
The student will provide faculty with a report for the reason of absence to determine whether
excused or unexcused.
1. Excused absences for LECTURE CLASS/CLINICAL:
A student will be excused if he/she has been absent from a class/clinical by reason of
circumstances beyond his/her control or if he/she has been required to attend an
activity sponsored by the University. Faculty members who sponsor activities that
require class absences must send a list of student names to each concerned at least
three days before the scheduled absence. The student will notify the instructor in
charge of the lecture class/clinical prior to the absence or as soon as possible. If a
student misses more than 2 lecture classes (9-12), 3% will be deducted from
the final course grade will be for each unexcused class period. Attendance will be
taken. A student cannot miss more than one 8 hour clinical or will need to drop the
clinical course or if approved, make up all hours in an assigned area.
B. Lab Absences (clinical labs, lab classes, and simulated labs):
The student is responsible for informing the instructor of an absence prior to the lab period or
clinical. The instructor must be informed if at all possible by the student directly, rather than
through a third party. Home telephone numbers of instructors will be given to the class for early
a.m. notification or hospital unit numbers. If the instructor cannot be reached at home, he/she
should be called at the clinical agency within the first ten minutes of the scheduled clinical or lab
period or as soon as possible.
1. When a student missed his/her second clinical day, he/she must
drop the clinical course and the co requisites theory course.
2. In-house clinical will be counted as regular clinical days as well as community
activities (ROR, Lets Pretend, and KidCheck).
C. Make-Up Work
If absent from class, the student is responsible for all information
presented and must make up all written work. A student missing class
may make arrangements for make-up work within one week after
returning to classes if the absence is excused. It is the students
responsibility to seek out the appropriate instructor to arrange for
make-up work. No quizzes or graded class work will be accepted from
students with an unexcused absence from the class or lab. Blackboard assignments must be
completed by the assigned due date. If a student does not complete the clinical exam by the
assigned due date, they will be required to drop the practicum and lecture course.
D. Late Submission of Written Assignments
1. All written assignments will be due at the beginning of the class
or clinical period of the date they are due. Papers may be turned
in before the due date.
2. All written work will be graded and students will be given an

opportunity to review the graded paper. However, ALL papers

must be returned to the instructor before a grade is recorded.
The instructor will retain ALL papers for one year.
3. In the event of an excused absence on the day the assignment is
due, the student is expected to send the assignment to the faculty
by a classmate or by email. In the event this method is not
possible, the assignment will be due on the date the student
returns to university classes.
4. Professional Nursing Students are expected to be responsible for
their behavior. Penalties for late assignments are as follows:
a. 1 day late 5 % off grade of the assignment
b. 2 days late 10% off grade of the assignment
c. 3 days late 15% off grade of the assignment
d. No credit will be given for assignments over three days late
except in cases of excused absences. In the event of the
excused absence, the above schedule will become effective at
the time the student returns to classes. Students, who fail to
submit assigned work, even though there is no point value
remaining, will receive an incomplete grade for the course
until the assignment has been completed.
Incomplete Work Policy: No credit will be given for assignments over three days late, except in
cases of excused absences. In the event of an excused absence, the above schedule will become
effective at the time the student returns to classes. Students, who fail to submit assigned work, even
though there is not a point value remaining, will receive an incomplete grade for the course until
the assignment has been completed. It is the responsibility of the student to make arrangements
with the instructor regarding make-up assignments.
Grades below 74%: Students who make below a 74% on any examination are encouraged to make
an appointment with the instructor so arrangements can be made with the nurse tutor to review the
exam.
Information Technology Usage Policy: The Universitys Information Technology System includes
computing, information, technology, and network resources. All users of this technology system are
obligated to utilize the various resources responsible, legally, and ethically for their intended
purpose. All students should read the policy before participating in online course activities.
Other Important
Information:

No object that beeps or rings should be present in the classroom. No texting or cell phone use during
clinical rotation.
Students enrolled in clinical nursing courses must present proof of the following to the course
instructor on the first day of the clinical course:
a. current liability insurance
b. BCLS certification
c. physical exam statement including TB skin test
d. review OSHA guidelines
e. review HIPAA guidelines
f. titers must be on file with appropriate follow-up as indicated
g. background check must be on file
h. drug screen must be on file
i. specific requirements as listed by the SON or facility
Students are expected to read and follow BSNStudentPolicies at all times. The policy
booklet was reviewed and provided during the first semester of nursing coursework.
All School of Nursing requirements related to background check, CPR, liability insurance, drug
screen, physical exam, and OSHA and HIPAA guidelines are expected to be met prior to clinical

experiences. Any student not meeting the requirements will not be allowed to participate in clinical. A
grade of zero (0) will be given for each day until requirements are met. Students will be expected to
present a completed clinical card before attending hospital orientation.
The clinical performance must be passed to pass the course. Please refer to the clinical evaluation tool
for specific criteria.
The student is required to participate in all scheduled laboratory and clinical experiences.
The students will arrive at their assigned facility at the time determined by the instructor.
The clinical instructor or facility must be contacted prior to lab time when you cannot be
present or if you will be late for a simulated lab or reality lab experience. Should you fail to properly
notify the instructor or facility will result in an automatic zero (0) for that day.
Should your absence not be excused as defined in the NSG 4403 syllabus, the result will
be an automatic zero (0) for that day. The student will be responsible for obtaining the
covered information. Should a student have a simulated lab absence, he/she will not be
allowed to go to clinical until the simulated lab is made up. A grade of zero (0) will be
given for each clinical missed. Two clinical absences results in an automatic course failure (excused
or not excused). The instructor reserves the right to decide what must be done
for one make-up lab.
The student is expected to be prepared for laboratory and clinical experiences. This
preparation will include skills practice in lab if needed. The student should be able to
perform the prerequisite skills with minimal assistance and be able to state the rationale
for each of these skills. A list of these skills can be found on the course web site.
The student is responsible for providing his/her own transportation to and from clinical agencies.
The student is required to wear the full nursing TROY BSN uniform to all clinical
experiences unless otherwise instructed, and to comply with the dress code rules and
regulations of the affiliating clinical agency. Shoes must be approved white nursing
shoes or athletic shoes. They must be clean and polished. Hair must be neat and back
from face. The length must not be longer than shoulder length or you must put up in
braids, etc. Small studs may be worn if you have pierced ears. No dangling colored
earrings. No perfume. Nails must be kept clean and a safe length. Chewing gum is
not permitted on patient units. Please present yourself as an example of cleanliness.
No body odor. Name tag shall be worn. Failure to adhere to the uniform code will
result in being sent home from clinical with a grade of zero (0) for the day.

Topical Outline:

1. Course Overview
2. Evaluation Methods Reviewed
3. Child Health Dosage Exam and Study Guide
4. Child Health Clinical Exam and Study Guide
5. Chapter 22 Student Learning Outcomes
6. Chapter 23 Student Learning Outcomes
7. Chapter 4 Student Learning Outcomes
8. IV Therapy Student Learning Outcomes
9. Childrens Hospital Rotation Requirements
10. School Health Student Learning Outcomes
11. Hospital SAMC Student Learning Outcomes
12. Clinical Snapshot Daily Clinical Requirements
13. Developmental Assessment Tool
14. Nursing Diagnosis Form
15. Health Assessment Tool and Grading Criteria
16. Grading Criteria for Care Plan
17. Skills Checklist
18. Evaluation Tool (Student)
19. Reach Out and Read- Purpose and Requirements
20. Lets Pretend Hospital Purpose and Requirements (Spring only)

10

Topic:

Child Health Dosage Examination

The following will be included on your dosage examination:

Conversions
IV problems
BSA
Dosage amounts (capsules, tablets, drops, syringe amounts, etc)
Label identification
*The test will be given one time. You are
required to make a 74 or above to continue in the
clinical sequence. The exam is 10% of your clinical grade.
Student Learning Outcomes/Requirements:
1.
2.

3.

4.
5.
6.

Commit to memory selected equivalents.

Accurately calculate and verify drug dosage for children utilizing:
A.
Clark's Rule, Frieds Rule, Young's Rule (review)
B.
Body surface area nomogram
C.
Dilutions
D.
Dosage by body weight using Pediatric dosage guidelines
Discuss and utilize special considerations in drug administration presented by various
developmental levels (infant-adolescent).
A.
Oral medications
B.
Drops
C.
Ointments
D.
Intradermal injections
E.
Intramuscular injections
F.
Subcutaneous injections
G.
Intravenous route
H.
Suppositories
Determine nursing considerations and modifications appropriate for various cultural
groups.
Ascertain legal, ethical and moral implications involved with drug administration.
Complete drug worksheet for practice in calculations.

REQUIRED READING:
Hockenberry, M. & Wilson, D. (2015). Wongs Nursing Care of Infants and
Children (10th edition), ELSEVIER Mosby. ISBN 978-0-323-22241-9
Dosage Handout/Practice

11

Topic:

Child Health Clinical Examination

The following will be included on your clinical examination:

Chapter 4: Physical Examination

Chapter 22: (Read) See Student Learning Objectives Below

Chapter 23: (Read)-See Student Learning Objectives Below

Lecture material

*The exam will include 25 or more questions from the areas listed above. You are required to make a 74
or above to continue in the clinical rotation. You will not be given an opportunity to repeat the exam.
The exam is 5 % of your clinical grade. This exam will be taken on Blackboard testing. The exam must
be completed by the assigned date. Failure to complete the exam will require the student to drop the
clinical course as well as the lecture course.

12

Topic: Chapter 22 - Family Centered Care of the Child During Illness and Hospitalization
(Clinical Examination)
Student Learning Outcomes:
1. Discuss the typical stressors of and reactions to illness or hospitalization for children in each stage of
development.
2. Identify three stages of young childrens reactions to separation and behaviors observed in each
phase.
3. List common posthospitalization behaviors of young and older children.
4. Discuss trends and changes in the hospitalized pediatric population.
5. Identify common parental reactions to a childs illness or hospitalization and factors that influence
these reactions.
6. List common sibling reactions to the hospitalization of a child in the family.
7. Discuss the significance of a philosophy of family-centered care in the pediatric clinical setting.
8. Identify functions of play for children in the hospital.
9. Identify ways that nurses can help minimize loss of control.
10. Identify components of the nursing admission history.
11. Explore examples of complementary therapies.
12. List important considerations in planning for discharge and home care of the hospitalized or ill child.
Key Terms:
1.
2.
3.
4.

Separation Anxiety
Loss of Control
Bodily Injury and Pain
Stressors

Required Reading: Chapter 22, Pages 864-882

13

Topic: Chapter 23 - Pediatric Variations of Nursing Interventions and Skills

(Clinical Examination)
Student Learning Outcomes:
1. Discuss the conditions that must be met to obtain valid informed consent.
2. Describe indications for informed consent for health-related procedures and other situations that require
consent.
3. Discuss essential components of assent.
4. Identify general approaches for preparing children for diagnostic and treatment procedures.
5. Identify age-specific strategies for preparing children for diagnostic and treatment procedures based on
stage of development.
6. List reasons for the use of play as a preparatory method for procedures on children.
7. Describe techniques and activities to incorporate play into nursing procedures and activities for
hospitalized children.
8. Discuss preoperative fasting recommendations to reduce the risk of pulmonary aspiration.
9. Discuss postoperative care of children undergoing anesthesia.
10. Discuss postoperative care.
11. Discuss factors that influence compliance with treatment regimens.
12. Discuss nursing care guidelines for skin care in the hospitalized child.
13. Discuss strategies for bathing, providing oral hygiene, and hair care for children.
14. Discuss nursing care guidelines for feeding sick children and means to promote the intake of nourishing
fluid and solids by the hospitalized child.
15. Compare the therapeutic management of fever and hyperthermia in children.
16. Describe strategies to ensure the safety of hospitalized children.
17. Identify risk factors for falls among hospitalized children.
18. Describe how to safely transport infants and children.
19. Describe indications and techniques for behavioral and nonbehavioral restraints.
20. Discuss general considerations and safe and effective positioning of children for the following
procedures: femoral venipuncture; extremity venipuncture; lumbar puncture; and bone marrow
aspiration and/or biopsy.
21. Discuss general considerations and safe and effective collection of urine, stool, blood, and respiratory
specimens.
22. List nursing measures for the preparation and administration of medications by the following routes:
oral, intramuscular, subcutaneous, intradermal, intravenous, nasogastric, orogastric, gastrostomy, rectal,
optic, otic, nasal, and aerosol.
23. Discuss indications for and safe and effective feeding via alternative methods using nasogastric,
orogastric, and gastrostomy means.
Key Terms:
1.
2.
3.
4.
5.
6.
7.
8.
9.

Informed Consent
Preparation for procedures (physical, psychological, play)
Surgical procedures (pre- and post operative care)
Hygiene (bathing, oral, safety)
Restraints (mummy, jacket, arm and leg, and elbow)
Positioning (jugular VP, femoral VP, lumbar puncture, bone marrow, etc.)
Specimens (clean catch, catheterization, stool)
Medications (oral, IM, IV, NG, Optic, Nasal, etc.)
Gavage feedings and gastrostomy feedings
Required Reading: Chapter 23 Pages 883-944

14

Topic: Chapter 4 - Communication, Physical and Developmental Assessment of the Child

(Clinical Examination)
Student Learning Outcomes:
1. Apply the concepts of physical assessment as it relates to the pediatric client.
2. Correlate development concepts with physical assessment techniques for various aged
pediatric clients
3. Prepare for pediatric hospital experience through orientation of concepts related to growth and
development and physical assessment.
4. Apply nutritional needs of the child.
5. Complete the physical assessment in an appropriate sequence.
6. Prepare to discuss the developmentally appropriate approaches that could be used when
7. preparing the infant, toddler, preschooler, school aged child and adolescent for a physical
assessment.
8. Explain how proper size of a blood pressure cuff is determined.
9. List acuity tests that are appropriate for the vision assessment.
10. Explain positioning of the pinna to provide proper visualization of the tympanic
membrane with an otoscope in a) children under 3 years old and b) children over 3 years.
11. Describe a Denver II.
12. Explain the components of performing a health history
13. Prepare for hospital experience by reviewing the concepts of communication with patients
and families.
Review Chapters independently. Note the differences in a pediatric assessment as compared
to the adult assessment you have completed in the past.

Topic: Pediatric IV Therapy

(Clinical Examination)

15

Student Learning Outcomes:

1. Recognize and discuss purpose and potential complications/hazards associated with intravenous
therapy of pediatric clients.
2. Identify types and uses of various types of solutions/fluids used for intravenous therapy in
pediatric clients.
3. Identify the recommended infusion sites for children of different ages.
4. Identify common types of needles and select appropriate needle based on critical factors of the
pediatric client.
5. Calculate with 100% accuracy flow rates for various IV infusion administration sets.
6. Describe significant findings from assessment of the intravenous infusion rate.
7. Identify signs and symptoms of infiltration.
8. Describe the procedure for using the heparin lock to administer fluids and medications to the pediatric
client.
9. Accurately communicate flow rate and other necessary information about IV therapy through the
pediatric client's nurse's notes.
REQUIRED READING:
Chapter 23
Hockenberry, M. & Wilson, D. (2015). Wongs Nursing Care of Infants and
Children (10th edition), ELSEVIER Mosby. ISBN 978-0-323-22241-9

Topic: Children's Hospital

Children's Hospital
1600 7th Avenue S.

16

Birmingham, Alabama 35233

205-939-9100
You will attend a brief orientation the day before the 2 day rotation. The orientation will be
conducted at Childrens Hospital. Arrival time will be provided prior to your rotation (usually at 1 pm).
You will participate in clinical rotation at Children's Hospital the following 2 days. The shift
will begin at 6:30 a.m. and end at 4:00 p.m. You will be assigned a preceptor to work with for
each shift. You are responsible for obtaining a motel room for the two nights. Parking is not
available at reduced rates. Try to stay close to the hospital and walk or car pool. The experience
should be invaluable. Keep notes during rotations concerning clients and experiences to present
during post-conference.
Student Learning Outcomes for clinical rotation at Children's Hospital:
A tour of the hospital is planned for you to see all the units, special services, and resources large
childrens hospital can provide for the people of this state and surrounding areas. It is an opportunity for
you to view the client in this setting. Please keep up with your group, listen, ask questions, and utilize
this occasion to observe and learn.
1.
2.
3.
4.
5.
6.
7.

Assess the growth and development level of the client.

Define the nurse's role and responsibility in assessing health alterations of the client.
Prescribe nursing interventions that foster adaptive responses to clients with health alterations.
Relate theoretical and empirical knowledge from nursing, scientific and humanistic
disciplines to the nursing care of children experiencing alterations in health states.
Describe methods for facilitating changes that promote adaptive responses in children and
families experiencing alterations in health states.
Collaborate with the health care provider the diagnosis, treatment, and prognosis of the client.
Compare this experience to other learning experiences provided this quarter.

Topic: Children's Hospital

CHILDRENS HOSPITAL ROTATION INFORMATION
Orientation - TBA Childrens Hospital. Wear lab coats and name tag (NO jeans). Orientation Mrs.Cinnamon Banks. Meet in the hospital front lobby.
Parking: You may park in the Childrens Hospital parking deck. There may be a parking fee.
Parking will be discussed during orientation.
The following list is to assist you in planning the Children's Hospital Rotation.
1.

Orientation (TBA) - Meet in the front lobby with nice clothes and Lab Coat (NO jeans).
During the orientation you will be introduced to the goals of the hospital. Several forms will
be provided and reviewed (confidentiality form, preceptor form, hospital evaluation form,
etc.). Orientation usually lasts 2-3 hours unless scheduled the morning of the first clinical
rotation.

2.

Day 2 - Arrive at 6:30 a.m. - Meet in front lobby or designated area. Disperse to units; post
conference and unit rounds; tour of ER and Burn Units; Hand in written material to instructor
(see list below)

3.

Day 3 (if available) - Arrive at 6:30 a.m. - Meet in front lobby. Disperse to units; post
conference; Hand in written material (PLUS hospital evaluation)

17

4.

Parking: Reviewed during orientation. There parking decks close by. During the weekend
you can park on the streets because Birmingham does not issue parking citations on
weekends.

5.

Meals: The hospital cafeteria is open for lunch and breakfast. Schedule lunch with your
preceptor and unit (the group will not meet to eat lunch together).

6.

Absence: Six students can attend clinical at one time. Contact the hospital front desk if you
need to leave a message for the instructor.

7.

Unit Assignments/Post Conference Assignments (time will be announced by instructor):

a.
Nursing Notes: Each student will be assigned a preceptor on a floor
or unit. You will need to chart on separate nursing notes (not on
patients chart) and turn in your notes after post conference.
Requirements will
be discussed during orientation.
b.
Clinical forms (similar to
those you have used)
c. Medication / Dosage Form
d.
Preceptor Evaluation Form (complete one for each preceptor record preceptors
name) and Hospital Evaluation Form (complete on last day).
e.
Post conference - present your information (diagnosis, treatment, medications & why
needed, lab work & why is it related to diagnosis, prognosis, etc)

8.

Dress: SON required uniform - except orientation

9.

Equipment: Bring supplies you bring to clinical (pen, scissors, stethoscope, paper, etc)

10.

Procedures: Participate in procedures

Medications: determine all of the safe dose ranges, etc. Find relevant information, figuring
minimal and maximum dosage, etc. Read medication labels, find the medication if
permitted, know exactly how and how much will be administered (PB, Buretrol, line,
medication pump, etc.).
Other: CPR, assisting with lumbar punctures (open trays, sterile technique, hold child, etc),
immobilize children, dressing changes,
respiratory treatments, suctioning, patient
education, catheterization, attend ultrasound and x-ray procedures, etc.
Preceptors work with many different schools. You MUST indicate you want to see
everything and participate in everything. This rotation is what you make it.

11.

Evaluations: Your evaluations for various rotations should be positive and

constructive.

12.

Objectives: Listed in syllabus.

13.

Professionalism: Professional behavior is desired and required. You are representing Troy
University both at clinical and in your private life. All information should remain
confidential.

18

Topic: School Health Rotation (if needed)

Montgomery Schools
Pike County Schools
Union Springs Elementary School
Each student will be assigned to a Montgomery School and Pike County Schools for one clinical
experience at each location. Read information from your textbook concerning school health
programs and health needs of the school age child.
Student Learning Outcomes:
1.
Identify different types of health problems in the school that are addressed most often.
2.
List medications administered at the school.
3.
Describe the policy and procedure for administering medication at school.
4.
List various types of health screenings conducted at school (lice screening, scoliosis screening,
vision screening, weight management, dietary screening, anemia, etc.)
5.
Indicate what grade level the screening is scheduled for and why.
6.
Describe referral procedures for problems identified from each screening.
7.
Indicate the need to bridge research and practice into the pediatric health care setting.
8.
Collect data (height, weight, body mass, etc.) and record accurately.
Other: School nurses can send a list of items they want you to do while working at the schools.
Please be prepared to teach or complete stated assignment.

19

Topic: School Health

Montgomery Public Schools, Montgomery Al.
Pike County Public Schools, Pike County, Al.
Union Springs Elementary
(Directions will be given by clinical instructor or posted
on Blackboard check often for changes)
Hours: TBA by instructor
Dress: Troy University School of Nursing uniform
Assignment: Bring paper, developmental assessment form, stethoscope, and penlight. In
some cases you will be required to teach a health topic, or assist with various screenings
(vision, hearing, scoliosis, etc)
This rotation will allow the students to participate in the care of physically and mentally
handicapped children.
Care of the Special Child Student Learning Outcomes:
1.
2.
3.
4.
5.
6.
7.
8.

Discuss the impact of the family structure of a physically/mentally handicapped child.

Participate in a planned activity program to assist the child to attain his maximum health
potential.
Demonstrate beginning skills in assisting the child with feeding problems.
Discuss major medical diagnosis that result in physically, mentally, and emotionally handicapping
problems.
Discuss briefly stressors requiring special adaptive assistance in a child.
Formulate an assigned childs nursing care plan and update as indicated.
Complete all written assignments as directed.
Identify appropriate nursing interventions to enhance the handicapped childs reaching their
optimal level of development and safe care.

Topic: School Health Rotation

20

SCHOOL HEALTH CLINICAL EXPERIENCE

Arrive no later than 7:30 a.m. to the assigned school health office. The telephone number is posted on
Blackboard with your assignment. You need to contact the school nurse prior to your experience to
receive your assignment. In some cases, you will be teaching health education topics to a variety of age
groups. You will need to prepare for the assignment. The Montgomery County Schools has resources
to use if you need them (must request in advance). Use MapQuest for directions to your assigned
school. Directions are provided on the Montgomery County School Website.
Clinical Requirements:
A. Wear Troy University Uniform with name tag
B. Arrive at 8:30 a.m. or earlier Sign in at the front desk (visitor)
C. Prepare school nurse experience write up/teaching assignment
to hand in for credit
D. Turn in signed time sheet to J. Bazzell
E. Minimum participation 5 hours (plan to stay 6 7 hours)
F. Must contact school nurse and get assignment in advance
G. Faculty cell phone: 334-268-1670 or call SON 334- 670-3428 if emergency.
School Health Rotation Assignment:
Respond in writing answers to the following questions during your participation with the school nurse.
Please type your responses.
1.
2.
3.
4.
5.
6.
7.

What role does the school nurse you are assigned to have in the school system?
Explain the role of the school nurse in promoting and maintaining the health of school age
children. What are some of the ways the nurse teaches a positive health style to this age group?
What health concerns have you identified in this age group?
Observe several students during your clinical rotation for gross and fine motor development.
Compare your findings to the expected motor development for this chronological age group.
Explain your findings.
Observe students in an elementary, middle school or high school classroom. Record the
behaviors of the teacher considered positive and valuable to the childs transition to the school
environment.
Interview a school age child as to his or her group of friends. What are the particular
characteristics of a school age group of friends? How does belonging to such a group benefit
the school age child?
If you were assigned a teaching project, please hand in your written material.

Topic: School Health Rotation

21

School Health Clinical

Sign In Sheet
Please have your assigned school health nurse sign your
log in/out form:

Student Name:_________________________________________
School Nurse:_________________________________________
School Assigned:______________________________________
Date:_________________________________________________

Sign
Date
In/Out

Time

Nurse Signature

In
Out
In
Out

**This form is required.

Turn in form during class time to J. Bazzell

Topic: Hospital Rotation

22

Southeast Alabama Medical Center

Southeast Alabama Medical Center
P.O. Box 6987 (Ross Clark Circle)
793-8111 - hospital
Head Nurse - Ms. Sharon Bussey
Peds Unit - 3 North, 793-8131
Orientation will be announced. Meet in the lobby of the hospital.
You are expected to be in FULL UNIFORM, conduct yourself professionally and keep client confidentially.
Please remember this in hallways, elevators, and etc.
Student Learning Outcomes for the Southeast Alabama Medical Center:
1.
2.
3.
4.
5.
6.
7.

Apply principles of growth and development to the age of the child.

Demonstrate the ability of preparing for clinical assignments by looking up information (diagnosis,
growth and development, lab findings, medications, and treatments related to your client)
Demonstrate knowledge of Pediatrics in writing and planning care of the child.
Apply knowledge of skills in caring for the child.
Utilize knowledge of IV therapy and medications in treatment of the child.
Utilize the teaching role in assisting the child and family to promote and maintain health.
Interpret the role of the nurse in working with children and families.

Topic: Clinical Snapshot (SAMC Clinical Activity)

Complete the clinical snapshot form for each of your assigned clients. The information provided
should include pathophysiology of the stated problem, expected assessment findings, and a

23

proposed plan of care. After your assessment, determine if your findings match the expected
findings listed prior to care. Prepare to discuss material in preconference.
This form must be completed before you leave from your hospital clinical.
Note: Clinical Snapshot, Development Assessment Form, Nursing Diagnosis Form, and Part IX of
Health Assessment Form Medications are due every hospital clinical rotation (usually 3).

*complete prior to clinical based on information you received

Clinical Snapshot
Student:

*complete prior to clinical based on information you received

Patient Initials:
Summary of Pathophysiology

Diagnosis:

24

Anticipated Assessment Findings

Plan of Care

Final Picture

25

Topic: Developmental Assessment Tool

Objectives:
1.
2.
3.

Identify the purpose of developmental assessment.

Apply growth and development concepts in completing a developmental assessment.
Demonstrate skills in completing a developmental assessment in the clinical setting with a pediatric

26

client.
REQUIRED READING:
Hockenberry, M. & Wilson, D. (2011) Wongs Nursing Care of Infants and Children. (9th Ed.)

**This form must be completed on every pediatric patient assigned

Topic: Developmental Assessment Tool

I.

CONCEPTS OF GROWTH AND DEVELOPMENT

Four important steps necessary for providing appropriate nursing care to children in relationship to
grow and development.
A. Learn the principles of child development.
B. Consider what effects illness, hospitalization, separation from the family, fear and
loneliness can be on a child at various developmental stages.

27

C. Learn what effects illness and nursing practice have on a particular child.
D. Apply nursing care to meet the particular needs of a particular child.
II.

PURPOSE OF THE ATTACHED DEVELOPMENTAL ASSESSMENT TOOL

A. To demonstrate the cephalocaudal progression of development.
B. To allow the student to view the interrelatedness of developmental tasks in the
developmental progression.
C. To assist the student to assess the developmental status of his/her particular client.
D. To assist the student to plan nursing care in relationship to the developmental status of
his/her particular client.

III.

DIRECTIONS FOR USE OF THE DEVELOPMENTAL ASSESSMENT TOOL

A. Select the age group that pertains to your particular client.
B. Write in under each area of development, all those behaviors present, (that you obtained
upon assessment) in your client. (A minimum of two behaviors in each category are
required.)
C. Describe how the information you obtained was elicited (BE SPECIFIC i.e., held a rattle
for him to grasp, had him read a story to me, observed him interacting with his mother,
etc.)
D. Record reported typical behaviors as told to you by significant others.
E. Estimate developmental level in each area assessed.

REQUIRED READING:
Hockenberry, M. & Wilson, D. (2011) Wongs Nursing Care of Infants and Children. (9th Ed.)

28
DEVELOPMENTAL ASSESSMENT
Circle Client's Chronological age from the following:
a.
1-3 mo.
e.
19-24 mos.
b.
4-8 mo.
f.
25-36 mos.
c.
9-12 mo.
g.
3-4 yr.
d.
13-18 mo.
h.
4-5 yr.
LANGUAGE
AND SPEECH

FINE
MOTOR

GROSS
MOTOR

Child's actual age:

i.
j.
k.
l.

5-6 yr.
6-7 yr.
7-8 yr.
8-9 yr.

PERSONAL/SOCIA
L
PSYCHOSOCIAL
(ERIKSON)

m.
n.

10-12 yr.
12-15 yr.

COGNITIVE

___ years ____ months

SELF-HELP
PLAY

MORAL/
FAITH
(KOHLBERG

HOW WAS
INFORMATION
ELICITED- DEVITATION
From

29

30
DEVELOPMENTAL ASSESSMENT
Circle Client's Chronological age from the following:
a.
1-3 mo.
e.
19-24 mos.
b.
4-8 mo.
f.
25-36 mos.
c.
9-12 mo.
g.
3-4 yr.
d.
13-18 mo.
h.
4-5 yr.
LANGUAGE
AND SPEECH

FINE
MOTOR

GROSS
MOTOR

Child's actual age:

i.
j.
k.
l.

5-6 yr.
6-7 yr.
7-8 yr.
8-9 yr.

PERSONAL/SOCIA
L
PSYCHOSOCIAL
(ERIKSON)

m.
n.

10-12 yr.
12-15 yr.

COGNITIVE

___ years ____ months

SELF-HELP
PLAY

MORAL/
FAITH
(KOHLBERG

HOW WAS
INFORMATION
ELICITED- DEVITATION From

31

LIST OF ALL RELEVANT NURSING DIAGNOSES

Physiological
Diagnoses

Educational
Diagnoses

Developmental
Diagnoses

Psychosocial Diagnosis

*Star the priority diagnosis in each area

must be turned in on every assigned patient

32

33

Topic: Health Assessment

One complete health assessment required

HEALTH ASSESSMENT TOOL NSG 4404 (5%)

Course number and name:

Students Name:

Faculty:

Date:

Medical Diagnosis:

Location of Assessment:

Formula:
Diet:
I.

Informant(s)/Source of Information:
Client Profile:
Initials_____

Age_____

II.

Chief Complaint:

III.

History of Present Illness:

IV.

Sex_____

Onset

Characteristics of complaint

Race_____

Religion_____

Type (dull, sharp, burning, itching)

Location (precise anatomical location)

Severity (rate on scale 1- 10, faces, etc)

Duration (intermittent, continuous, etc)

Influencing factors

Past treatment/evaluation of effectiveness

Current treatment and response

Present state (better, worse)

Reason for seeking care

Past Health History (5%)

A.
Pediatric and Adult Illnesses: (check any client has or has had)
_____Chickenpox
_____Scarlet Fever
_____Heart disease
_____Rheumatic fever
_____Pneumonia
_____Kidney disease
_____Arthritis
_____Tuberculosis
_____Hypertension
_____Cancer
_____Diabetes Mellitus
_____Jaundice

34

_____Other_______

_____Other:_______

B.

Surgeries:

C.

Serious Injuries:

D.

Allergies:

E.

Prenatal History:
i. Number of Pregnancies_____
ii. Miscarriages/stillborns_____
iii. Number of living children____
Prenatal Care:

Medications:

Diet:

Bleeding:

Blood type:

Transfusions:

Condition at Birth:

F.

Full term/Preterm/Post term:

Type of Delivery:

Length of hospital stay:_____

Needed oxygen:_____

Feeding Problems: (breast or bottle)__________

Birth wt:_____

Birth length:_______

Developmental History:
o

Appetite/suck_____

weaned_____

Age smiled_____

turned over_____

_____Other:______

35

Sat alone_____

crept_____

Walk alone_____

1st tooth_____

First word______

Toilet trained_____ bowel_____

Sleep (where, how long, any problems)___________

Is development of this child similar to others the same age and other siblings?

bladder_____

_____________
o

Parents overall evaluation of childs health?

___________________________________

G.

Immunizations and Screening Tests:

Immunization
Rubella
Rubeola
Mumps
Polio
DPT/DTap
Td or Dt
Tetanus Boost.
PKU TEST
Sickle Cell Test
TB Skin Test
Hepatitis B
Varicella
HIB
Pneumococcal
Flu
Other

Year Immunized

Disease Year

H.

Regular Check ups (regular health care received):

I.

Dental Care:

Test Year

Results

36

V.

Systems Review (30%) Fill out completely. (May require additional space- see health
assessment forms you completed in NSG 3309/10)
A.

General Assessment:

B.

Integument:

C.

Head, Eyes, Ears, Nose, Throat (HEENT):

D.

Respiratory:

E.

Cardiovascular:

F.

Gastrointestinal:

G.

Genitourinary:

H.

Genito-reproductive:

I.

Musculoskeletal:

J.

Neurological

K.

Lymphatic and Hematologic:

37

L.

VI.

Endocrine:

M.
Other:
Family History (5%)
A.

Relationship

B.

C.

Members

Age

Cause & Age of Death

Family History of:

Heart disease:

Tuberculosis:

Diabetes Mellitus:

Cancer:

Kidney Disease:

Blood dyscrasias:

Mental illness:

Environmental Situation (10 %)

1. Household members:
_______
_______
_______
_______
_______

D.

Health Status

relationship:

Nutritional Requirements:
1.

Typical Diet

2.

Supplements used (iron, vitamins)

3.

Eating Habits

4.

Formula

age:

38

E.

Average days activities:

F.

Special Cultural practices:

G.

VII.

Family Coping:
1.

Physical

2.

Psychological

3.

Financial: (insurance, etc.)

Physical Examination (40%):

A.

General Assessment Statement:

B.

Vital Signs: T_____

C.
.

Height:______

Integument:

HEENT:

Thorax:

Heart:

Lymphatic:

Abdomen:

Extremities:

P_____
Weight:______

R_____

BP_____

39

VIII.

Spine:

Male/Female Genitalia and Rectum

Neurological (including mental status, cranial nerves, sensory, motor, cerebellar functioning,
reflexes)

Diagnostic(5%)- see attached sheets

Laboratory (attach)
X-ray

IX.

Medications see attached sheet

40

VIII. Laboratory Data:

Test
CBC

Urinalysis

(look up normal values for children)

Purpose of test

Normal Values

Clients values

Significance of
abnormal results

41

VIII. Laboratory Data:

Test

Purpose of test

Other

VIII. X-Ray Data:

Normal Values

Clients values

Significance of abnormal
results

42

Test

Purpose

Findings

43

IX. Medications: (Include ALL meds even if you do not give them)
Name

*Ordered
**PRN

Classification

Pediatric Dosage
Ordered

Pediatric Dosage
Recommended

Why Was this

medication ordered for
pt.

44

Care Plan Score Sheet

45
NAME:________________________DATE:__________________________________
ADDENDUM
I.

Possible Percentage
Points

Current Illness (10%)

A. Textbook description of disease: normal symptoms, treatment,
and prognosis.
B. Your clients illness onset, symptoms, treatment

III.

Percentage
Received

5
5

Developmental Status (15%) see form**

A.

Stages of Development (Piaget, Erikson, Freud, etc).

B.

Play Stage (describe in detail) - Social

C.

Variations from normal (discuss)

3
Nursing Process
(Troy University Care Plan Form)

VII.

IV.

V.

Assessment (20%)
A.

Patient Profile review of physical assessment findings;

Family, social, and systems review data.

B.

Subjective and objective data must be relevant

(physical findings)

15

Analyze (15%)
A.
Nursing diagnosis supported by clearly stated data.
Contains statement regarding client state and
etiology of problem. Must be stated in priority.

15

Goals/Objectives (15%)
6

A.

Supported by data and diagnosis

B.

Contains condition, behavior, criterion, time, and subject.

Must be measurable.

C.

Realistic to client.

VIII.

Plans (prescriptions, interventions) (20%)

5
A.

Support goal (what will be done to meet goal.

B. Contents: who, what, where, & how. (include lab observations)

15

46

X.

Evaluation (5%)
A.

Degree to which criteria was met compared to outcome

criteria stated goal (Progress).

B.

Identifies factors which prevent goal from being

accomplished (reassessment). Identify further planning
needed for individual client.

2.5

2.5

TOTAL PERCENTAGE POINTS

100%

STUDENT NAME:

**Health Assessment Tool must be turned in with Care Plan

**Attach Developmental Assessment/Status form

Basic Criteria for Evaluation of Care Plans

BASIC CRITERIA
1. Handed in on time.
2. Summary data base included. Use assessment tool with Care
Plan

3. Drug List Included

4. Criteria sheet turned in with Care Plan
**Ten Points will be deducted for any basic criteria not included

Topic: Pediatric Skills

YES

NO

47

Checklist Clinical Rotation at SAMC and Childrens Hospital

Accurate and complete charting in concise and correct terminology will be expected in addition to
accurate and safe performance of each procedure. Performance of procedures includes accurate
selection of equipment appropriate for various ages (ex. NG insertionsize of tube needed for an
infant vs. a school-aged child). You will be asked to demonstrate to instructor in lab as required.
1. VITAL SIGNS
_____ apical pulse
_____ rectal temperature
_____ oral temperature
_____ blood pressure
2. GROWTH MEASUREMENTS
_____ head circumference
_____ chest circumference
_____ standard growth curves
3. FEEDING TECHNIQUES
_____ NG tube insertion
_____ NG tube feeding
_____ gastrostomy feeding
_____ mixing strengths of formula (dilutions)
4.

NEUROLOGICAL ASSESSMENT
_____ basic neuro check

5.

MOBILITY NEEDS OF THE CHILD

_____ passive ROM exercises
_____ neurovascular checks
_____ traction care
_____ cast care

6.

FLUID & ELECTROLYTE

_____ clean catch urine
_____ enema
_____ discontinuing IV infusions
_____ calculating flow rate
_____ starting IV
_____ adding IV medications to IV fluids

7.

MEDICATIONS FOR CHILDREN

_____ dosage calculations
_____ reconstitution of injectable medications
_____ oral medications
_____ intradermal injections
_____ subcutaneous injections
_____ intramuscular injections
MEDICATIONS FOR CHILDREN
(continued)

_____ 24 hour urine specimen

_____ intake & output
_____ catheterization
_____ strict intake & output
_____ setting up IV
_____ maintaining IV infusions

48

_____ intravenous medications

_____ ear drops
_____ nose drops
_____ eye drops
_____ pre-operative medications
_____ mixing medications
_____ topical medications
8. ASEPTIC TECHNIQUE
_____ dressing change
9.

PHYSICAL ASSESSMENT
_____ respiratory assessment
_____ cardiovascular assessment
_____ abdominal assessment

10. CPR FOR INFANTS & CHILDREN

11. DEEP BREATH & COUGHING EXERCISES
12. POSTURAL DRAINAGE & PERCUSSION
13. ORAL AND NASAL SUCTION WITH BULB SYRINGE
14. ISOLATION TECHNIQUES
15. BLOOD GLUCOSE MONITORING
Instructor Signature:
________________________________________
________________________________________
________________________________________

49

Topic: Community Service

REACH OUT AND READ COMMUNITY SERVICE
Reach Out and Read hours are required. You should complete 3 hours reading time at the Charles Henderson
Child Health Center. You will have orientation with Rosemary Hanson at the Center followed by your
participation in reading to children. No more than two students may participate at any given time. You should
dress in your uniform and wear your Troy University name tag.
What is Reach Out and Read?

Reach Out and Read is a national, non-profit organization that promotes early literacy by
making books a routine part of pediatric care.
Reach Out and Read started as a simple solution to an obvious problem: waiting rooms without books. Reading
aloud was important for young children, and pediatricians had a special opportunity to reach their parents. It was a
patently good idea. But if it had been nothing more than that, it would have withered away. Instead, ROR has
grown, nurtured by the passionate and inspired efforts of many-educators, doctors, volunteers, parents,
corporations, foundations and politicians.
Robert Needleman, MD

*Mission
Reach Out and Read makes literacy promotion a standard part of pediatric care so that children grow up with
books and a love of reading. Reach Out and Read trains doctors and nurses to advise parents about the importance
of reading aloud and to give books to children at pediatric check-ups from six months to five years of age. A
special focus is placed on children growing up in poverty. By building on the unique relationship between parents
and medical providers, Reach Out and Read helps families and communities cultivate early literacy skills so that
children enter school prepared to succeed at reading.

*History
In 1989, Reach Out and Read was founded at Boston City Hospital (now Boston Medical Center) through
collaboration between pediatricians, family physicians, nurses and early childhood educators. As a result of their
work, physicians and educators realized that pediatricians and nurse practitioners were in a unique position to
promote early literacy for two reasons:
Pediatricians, family physicians and nurses regularly interact with young children and their parents at well-child
checkups.
Parents trust and respect the guidance that they receive from pediatricians, family physicians and nurses. When
doctors and nurses discuss the importance of reading in an exam-room setting, parents realize the significance of
the message.
Reach Out and Read was originally based on a simple but powerful premise: encourage parents to read regularly
to their children and give them the tools (the books) to do so. *

*Organization
ROR National Center
The Reach Out and Read National Center is affiliated with the Boston University School of Medicine, the Boston
Medical Center Department of Pediatrics, and the Boston Medical Center Department of Family Medicine.

50

Topic: Community Service

Reach Out and Read

Sign In Sheet
Please have Rosemary Hanson or other assigned staff sign your
log in/out form:

Student Name:_________________________________________
ROR Program Director or Nurse:________________________

Sign In/Out

Date

Time

ROR Staff Signature

In
Out
In
Out

**Return the completed form to Judy Bazzell during class. Three hours reading time are required. If you do
not want to select three books to donate, you should repeat an additional three hours (total=6 hours)
You may split the time.
**NEW book donation: Select three childrens books appropriate for ages 6 months -6 years. These books
will be given to a child during a well child check-up to promote learning and literacy. Books must be new and
of good quality. Write a brief description of the book, appropriate age group, and why you selected the book
on an index card and place inside the book for credit.
Required: 3 hours and 3 new books (or 6 hours reading time)
Deadline: OCTOBER 30

51

Topic: Community Service/Health Assessment

A. Kid Check Clinical Assignment
Student Learning Outcomes: same as hospital and school health clinical
Location: Pike County Schools
Number of Students: 400 - 800 students
Date: TBA Must attend Kid Check Rotation(s) all day
What is the Kid Check Program?
Overview:
We are extremely pleased to announce the adoption of the "Kid Check" program, a new statewide
program under the Alabama Rural Action Commission. As we all know, there is an important link
between a child's health and his/her academic performance. This initiative will result in comprehensive
head to toe health screenings in school systems who want to adopt this program. We are working to
expand on the success that the Alabama Power Foundation and the Alabama Child Caring Foundation
of Blue Cross Blue Shield of Alabama are having in public schools in several counties of our state.
This is a model program that is the result of partnerships between the local school systems and BC-BS,
Alabama Power, many Schools of Nursing, and other organizations in the state. The schools select a
day to have the health screenings and the school gymnasium is divided into areas for different types of
screenings. Nursing students, under the guidance of their supervisors, screen the kids. This is a
win/win situation that provides the nursing students with valuable experience while providing a
tremendous benefit to our school kids. Children who fail screenings are referred for follow-up care
either through public or private insurance. Those who are uninsured and are not eligible for Medicaid
or All Kids can be covered through the Alabama Child Caring Foundation.
B. Lets Pretend Hospital (Spring Semester only)
Student Learning Objectives: same as hospital and school health
Location: Montgomery
Number of Students: 200-300 daily
Date: TBA- Required attendance (add day rotation)
Overview:
The student provide information to K-1 grade students from the surrounding area to provide
information about various hospital departments. Requires role playing and interacting with 5-7 year old
children.

52

53

Topic: Clinical Evaluation Tool

Troy University School of Nursing Summative Clinical Evaluation Tool
NSG 4404 Child Health Practicum
Student Name ___________________________________
At the end of the semester, the faculty will complete the Summative Clinical Evaluation Tool. This tool lists the clinical competencies using the
program and course objectives as the framework.
Each competency has feedback in the form of 3, 2, 1, or 0 points. There are some clinical competencies denoted by an asterisk (*) that will be scored
with a P (pass) or F (fail) and will not count toward the total number of points earned. The student must meet the standard of these critical
competencies by the end of the clinical rotation. In non-safe patterns of behavior develop; either the agency or the instructor may decline to allow the
student to continue the clinical experience. This constitutes failure of the course.
During this clinical rotation the student:
3 pts.

Came to clinical well prepared for all aspects of clinical experiences;

Performed accurately and efficiently without supportive cues from preceptor/instructor;
Handled stressful situations well consistently;
Applied theoretical knowledge/principles in the provision of therapeutic nursing interventions each time

2 pts.

Came to clinical well prepared for most aspects of clinical experiences;

Performed accurately and efficiently with occasional supportive cues from preceptor/instructor;
Handled stressful situations well most of the time;
Applied theoretical knowledge/principles in the provision of therapeutic nursing interventions accurately with occasional cues;
Demonstrated effective use of problem-solving, creativity, and decision-making in critical thinking skills with occasional
direction and support;
Demonstrated effective verbal and nonverbal communication abilities in most situations;
Demonstrated confidence most of the time during delivery of nursing care;
Focused on patient most of the time while giving care.

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1 pt.

Came to clinical prepared for most aspects of clinical experiences;

Performed accurately but not always efficiently; requires frequent supervision;
Demonstrated occasional anxiety;
Identified theoretical knowledge/principles for therapeutic nursing interventions but needs occasional direction to identify
application;
Demonstrated effective use of problem-solving and decision-making in critical thinking skills with frequent directions and
support;
Demonstrated effective verbal and nonverbal communication abilities in predictable situations;
Demonstrated confidence in the delivery of nursing care but only in predictable situations;
Focused on patient initially; as complexity increases, focused on task or own behavior.

0 pts.

Performed under supervision, but not always accurately or efficiently; required continuous direction and support;
Demonstrated frequent anxiety;
Unable to identify theoretical knowledge and principles for therapeutic nursing interventions or apply them most of the time;
Failed to demonstrate evidence of problem-solving, creativity, or decision-making in critical thinking skills in spite of direction and support in
most situations;
Demonstrated ineffective verbal and nonverbal communication abilities frequently;
Demonstrated lack of confidence in the delivery of nursing care in most situations;
Focused primarily on tasks or own behavior, not on patient.
To pass the course the student must achieve a total rating of 66 (minimum) or 198 (maximum) on the items evaluated. Numerically rated
competencies must have a rating of 1 or better. Refer to the grading rubric for the final grade.
Each of the critical competencies must be met with a pass (p).
Faculty Signature/Date ____________________________________________
Student Signature/Date ___________________________________

BSN School of Nursing Competencies

Score

Comments

Program Student Learning Outcome 1

Synthesize theoretical and empirical knowledge form nursing, scientific, community, and humanistic disciplines within the practice of nursing.
Course Student Learning Outcome 1
Analyze theoretical and empirical knowledge from nursing, scientific, community, and humanistic disciplines in the nursing care of children experiencing alterations in
health states.
1. Applies theoretical and empirical knowledge in the provision of care to children and their families.
2. Utilize knowledge from natural and human sciences in the provision of nursing care to children.
Program Student Learning Outcome 2
Demonstrate nursing roles designed to meet health needs in a socially and culturally diverse global society.
Course Student Learning Outcome 2
Engage in nursing roles designed to meet developmental and health needs of children, using socially and culturally appropriate approaches.

1. Analyzes the impact of cultural values on the health care needs of children and their families.
2. Participates in the interactions of the healthcare team in provision of patient care.
3. Acts as an advocate for the clients.
4. Educates the client and/or family members regarding procedures and conditions, medications, and
evaluates learning.
5. Implements therapeutic nursing interventions which are consistent with cultural needs of children
and family members.
6. Seeks learning opportunities with patients who represent all aspects of human diversity.
Program Student Learning Outcome 3
Provide professional nursing care for all ages, which includes health promotion and clinical prevention.
Course Student Learning Outcome 3
Provide safe, evidence-based nursing care of children, including health promotion and clinical prevention.
1. Provides therapeutic nursing interventions consistent with the developmental stage of children and
its influence on their health promotion needs.
2. Makes clinical judgments about childrens health status based on available resources, desired
outcomes, and principles of growth and development

Program Student Learning Outcome 4

Utilize evidence-based clinical decisions in the application of the nursing process to provide therapeutic nursing interventions for human responses to
internal and external environmental dimensions.
Course Student Learning Outcome 4
Demonstrate evidence-based clinical decisions in the application of the nursing process for children with alterations in health states.
1. Assessment
a. Performs accurate health and developmental assessments.
b. Collects and analyzes significant diagnostic data for children.
c. Prioritizes collection of data based on client needs.
2. Analysis
a. Analyzes the physiological, psychosocial, and developmental causes for
alteration in health states for children.
b. Analyzes the impact of changes in health states on the child and the family.
c. Formulates nursing diagnoses based on analysis of assessment findings.
d. Prioritizes the nursing diagnoses.

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Additional Comments: