Adult Gerontology Acute Care NP Clinical Rotation Descriptions

It is a requirement for accreditation that each preceptor working with a student in an APRN concentration have at least 1 year of clinical experience in the population-focused area of practice and role prior to providing clinical supervision (i.e., precepting).  

It is a recommendation that the preceptor-to-student ratio is 1:2 if the preceptor is not seeing his/her own patients and 1:1 if the preceptor is seeing his/her own patients.

Spring Semester

NURS 60120 Adult/Gerontology Primary Care I
NURS 61292 Adult/Gerontology Primary Care I Practicum

NURS 60120 Course Description: Introduction to the Advanced Practice Registered Nurse (APRN) role with adult patients across the lifespan. Identification and examination of evidence-based primary health care problems, needs, and interventions. The course will focus on biological and behavioral parameters at primary, secondary and tertiary levels of prevention.

Course Objectives:

1. Identify positive health maintenance and health surveillance by functioning in the APRN role.
2. Examine appropriate theoretical and evidence-based research to support APRN practice.
   1. Elicit and analyze the primary health care data base, define problems/needs, plan interventions and intervene using relevant theories and research.
   2. Interpret biological and behavioral parameters at primary, secondary and tertiary levels of prevention.
3. Identify needs, teach and support appropriate behaviors for effective management and prevention of actual and potential disorders.

NURS 61292 Course Description: Practicum for the concepts introduced in Primary Care I: Across the Lifespan.

Course Objectives:

1. Apply appropriate theoretical and evidence-based research to clinical practice.
2. Demonstrate clinical reasoning in approach to management of common patient health/illness states.
3. Manage, advise, teach and counsel regarding potential and identified risks, disorders and problems while addressing health related priorities according to evidence-based practice.
4. Integrate knowledge of relevant standards of care into APRN practice.
5. Consult and collaborate within a multidisciplinary approach to maximize the effectiveness of health care systems and community services.

Ideal Clinical Practice Site (150 hours): The student should be seeking experience with a Nurse Practitioner or Physician in an outpatient setting. Inpatient settings are not recommended for this practicum. Outpatient settings in: Internal Medicine, Primary Care, Outpatient Clinics, Express Care Clinics or Skilled Nursing/Long-term Care.

Summer Semester

NURS 61392 Adult Gerontology ACNP Role Practicum

Course Description: This practicum introduces the student to the concepts of working with multi-disciplinary teams and follows the content taught in NURS 60130 Adult Gerontology Acute Care Nurse Practitioner Role. 150 hours of practicum. 

Course Objectives:

1. Integrate and understand current and historic landmark literature on the role and practice of advanced practice nursing.
2. Continue to develop comprehensive clinical assessment skills, including cultural implications and management skills related to common problems and conditions in the acute care setting.
3. Identify and evaluate patient interventions and outcomes in the acute care setting.
4. Integrate inpatient management of the patient in the acute care setting, demonstrating meaningful and succinct verbal and written communication.
5. The student will be able to evaluate, manage and communicate an appropriate plan of care using evidence-based practice and research based criteria in caring for the patient in the acute care setting.
6. The student will be able to verbalize and demonstrate a basic knowledge of procedural and diagnostics skills to care for the patient in the acute care setting

Ideal Clinical Practice Site (150 hours):

The student should be looking for an acute care setting or hospital based setting with a CNP, MD or DO. Students should focus on incorporating a rotation with critical care this semester. AGACNP students have 16-20 hours minimum per week in clinical setting. The clinical days must be congruent unless you are working in a setting that you will not see the same patient in consecutive days.

Fall Semester

NURS 62392 Adult Gerontology ACNP I Practicum

Course Description: The student will apply techniques for evaluation and treatment of the adult-gerontology patient in the acute care setting. The course includes approaches to pharmacotherapeutic and non-pharmacotherapeutic treatment for acute, acute on chronic and chronic illness. 150 hours of practicum.

Course Objectives:

1. Assess the complex acute, critical and chronically ill patient for urgent and emergent conditions, using both physiologically and technologically derived data, to evaluate for physiologic and potential life-threatening conditions.
2. Distinguish between normal and abnormal developmental and age related physiologic and behavioral changes in complex acute, critical and chronic illness.
3. Assess for multiple interactive and synergistic effects of pharmacological agents, including over the counter preparations and alternative and complementary therapies, in patients with complex acute, critical and chronic illness.
4. Determine physiologic risk, including, but not limited to, immobility impaired nutrition and immunocompetence, fluid and electrolyte imbalance, invasive interventions, therapeutic modalities and diagnostics.
5. Determine health care system risks associated with care of complex patients, including but not limited to multiple caregivers, continuity of care, and coordination of the plan of care, polypharmacy and communication with family or between multiple care providers
6. Prioritize data collection according to the patient’s immediate condition or needs as a continuous process in acknowledgement of the dynamic nature of complex acute, critical and chronic illness.
7. Diagnose acute and chronic conditions that may result in rapid physiologic deterioration or life-threatening instability through the management of diagnostic testing: ordering, interpretation, performance of diagnostic procedures to confirm or rule out health problems.
8. Diagnose complications of complex acute, critical and chronic illness considering multi-system health problems.
9. Reformulates diagnosis by priority based on new or additional assessment data and the dynamic nature of complex acute, critical and chronic illness.
10. Formulates differential diagnosis by priority considering multiple potential mechanisms and formulating a plan of care to address complex acute, critical and chronic health care needs.
    1. Integrates knowledge of rapidly changing pathophysiology of acute and critical illness in the planning of care and implementation of treatment.
    2. Prescribes appropriate pharmacologic and non-pharmacologic treatment modalities.
    3. Utilizes evidence base practice implementing care.
11. Implement interventions to support the patient with a rapidly deteriorating physiologic condition, including the application of basic and advanced life support and other invasive interventions or procedures to regain physiologic stability.
12. Utilize specialty based technical skills in the performance of diagnostic procedures to confirm or rule out health problems and perform therapeutic interventions to stabilize acute and critical health problems such as suturing, wound debridement, line and tube insertion and lumbar puncture.
13. Analyze the indication, risk of complication, and cost benefits of therapeutic interventions.

Ideal Clinical Practice Site (150 hours):

The student should be looking for an acute care setting or hospital based setting with a CNP, MD or DO. Students should focus on incorporating a rotation with critical care this semester. AGACNP students have 16-20 hours minimum per week in clinical setting. The clinical days must be congruent unless you are working in a setting that you will not see the same patient in consecutive days.

Spring Semester

NURS 63392 Adult Gerontology ACNP II Practicum

Course Description: The student applies therapeutic measures for patients with specialty needs as it relates to acute,
acute on chronic and chronic illness. Demonstrates competency in direct acute care of patients across the adult lifespan and demonstrate professional, compassionate care to patients and their significant others. 150 hours of practicum.

Course Objectives:

1. Describe the utility and pharmacodynamic of selected pharmacologic, biological, nutritional, and hematological agents used by AGACNP.
2. Implement evidence based selected therapies for acute & decompensated chronic health conditions.
3. Select appropriate strategies to treat common problems in the hospitalized patient.
4. Recognize and correct nutritional, fluid and electrolyte disorders in the elderly and hospitalized patient.
5. Implement effective, safe and evidence based therapies for patients who are being treated for medical and surgical problems.
6. Implement an appropriate plan of care and discharge for patient in the medical and surgical ICU and hospital setting.

Ideal Clinical Practice Site (150 hours):

The student should be looking for an acute care setting or hospital based setting with a CNP, MD or DO and focusing on a specialty area that they do not have much experience or comfort in, such as working with an infectious disease, endocrine, renal, cardiovascular specialty. Students are encouraged to work with 2-3 different specialties this semester to strengthen areas that need clinical improvement with a minimum of 50 hours for each specialty. AGACNP students have 16-20 hours minimum per week in clinical setting. The clinical days must be congruent unless you are working in a setting that you will not see the same patient in consecutive days.