UNIVERSITY OF LA SALETTE College of Nursing Santiago City, Philippines

SOUTHERN ISABELA GENERAL HOSPITAL CLINICAL FOCUS The Individual Client with Problems in Oxygenation, Fluid and Electrolyte Balance, Nutrition and Metabolism and Endocrine Function
A. HOSPITAL PROFILE ABOUT SOUTHERN ISABELA GENERAL HOSPITAL Southern Isabela General Hospital is the lone DOH-HOSPITAL in Isabela. In 1986 by virtue of Circular No. 10, the Southern Isabela District Hospital was integrated with the rural health units. The SIDH continued with its operation as a nationally administered entity until 1993. In that year, the SIDH was devolved to the Provincial Government of Isabela by virtue of the Local Government Code. It maintained its status as a district hospital under the direct supervision and fiscal control of the Provincial Government of Isabela. In 1996, Santiago City was chartered as an independent City, altering the official address of the Hospital as SIDH Santiago City. For eight (8) years, the hospital operated under the Provincial Government of Isabela. In August 1997, Republic Act 8338 An Act Upgrading the SIDH to a 50-bed Tertiary Hospital was promulgated. The SIDH was re-named Southern Isabela General Hospital. In January 1, 2002, the SIGH became a DOHRetained Hospital. It boasts of a staff of competent highly qualified and fully trained medical specialist utilizing state of the art technology and equipment. SIGH within the formula 1 framework is aimed at achieving critical reforms with speed, precision and effective coordination directed at improving the quality, efficiency, effectiveness and equality of the Philippine health system in a manner that is felt and appreciated by Filipinos, especially the poor.

B. DESCRIPTION OF LEARNERS

The learners are in Level III specifically the BSN 3-A which are heterogeneous group in terms of their ages, family income and educational background. They will be focusing on complex nursing care of individuals, families and/or groups in various stages of development who are experiencing alterations related to their bio-psychosocial needs. Uses all components of the nursing process with increasing degrees of skill. Includes math computation skills, basic computer instruction related to the delivery of nursing care with patients having fluid & electrolyte imbalance related to inflammatory bowel disease, intestinal obstruction, peptic ulcer disease and cirrhosis; altered regulatory hormonal mechanism related to endocrine disorders; altered inflammatory process. All of them will be rotating in 3 other affiliating areas including Manango Hospital, Cagayan Valley Adventist Hospital and one community health setting which is Gulac Immersion. C. CLINICAL HOURS The clinical practicum hours of BSN level III students are 24 hours a week from 7 to 3 pm. Students are required to complete 96 hours per rotation. Typically, student nurses will work either in an 8-hour shift from 7 to 3PM. 24 hours should be completed in a week so they will be having their duties from Monday to Wednesday. STUDENTS RESPONSIBILITIES: 1. Responsible for practicing at their level of knowledge and experience; perform only those tasks/procedures for which they have had previous instruction. 2. Familiarizes self with policies/procedures of Elliot Hospital and the nursing organization. 3. Participates in direct patient care under the supervision of the clinical instructor in conjunction with the RN assigned to the patient. 4. Documents on patients permanent record after collaborating with the instructor and RN assigned to the patient. Documentation must include the student's name, title, and name of school. 5. Responsible for knowing who the staff nurse assigned to their patient is. 6. Prepares to complete patient assignment and articulate basic, pertinent, theoretical knowledge prior to participating in direct nursing care. 7. Identifies and verbalizes learning needs to instructor or staff nurse. 8. Informs the staff nurse of the hours he/she will be on the unit, including when leaving the unit for break, lunch, or alternate learning experience. 9. Notifies the instructor when unable to report to duty due to illness or other emergency. Provides name, school, unit assigned to and instructor's name. (If a family member is attempting to locate a student, follow the same procedure).

10. Informs the staff nurse of the patient care procedures, medications, documentation, flow sheets, etc., that he/she will or will not be using. 11. Maintains patient confidentiality. 12. Upon identification of any medication variance/occurrence, procedure or treatment error, or patient fall, informs the staff nurse assigned to the patient and reports the variance to the instructor and completes the appropriate documentation. 13. Must be knowledgeable about medications prior to their administration. 14. Notifies instructor when supervision is required prior to tasks/procedures, etc. 15. Communicates location of patient chart to staff nurse prior to taking chart from desk area; chart should be returned to place from where it was removed. 16. Wears ID tag and complete uniform as prescribed. 17. Students are not permitted to: a. Draw arterial or venous blood b. Start IVs c. Hang blood or blood products d. Administer Chemotherapy drugs 18. All IV Medications must be given in the presence of the Instructor knowledgeable of the patient, and in accordance with nursing organization's policies/procedures/protocols.

D. FOCUS OF CLINICAL EXPERIENCE Objectives: At the end of the 4-week rotation at SIGH, the student should be able to: 1. Utilize the nursing process in the care of the individuals and families in the hospital setting such as: a. Assess with clients their condition/health status through interview, physical examination, interpretation of laboratory findings; b. Identify actual and at-risk nursing diagnosis; c. Plan appropriate nursing interventions with clients for identified nursing diagnosis; d. Implement plan of care with clients and families; e. Evaluate the progress of their clients condition and outcomes of care 2. Ensure a well-organized and accurate documentation system. 3. Relate with clients and their families and with the health team appropriately. 4. Observe bioethical concepts/principles, core values and nursing standards in the care of the client 5. Promote personal and professional growth of self and others.

COURSE IN THE WARD Schedule of Activities 6:45 - 7:00 AM Checking of Attendance and paraphernalia Receive change of shift report/ Attend endorsements 7:00 - 11:00 AM Morning Care: Giving Medication Ward Rounds, V/S taking, IVF monitoring Quiz, NPI, Chart Reading and Recording Preparation of Medicines, regulation of IVF 11:00 - 12:00 NN Lunch Break 12:00 - 1:00 Case conference: Checking of Charting, PM Case discussion Charting and Documentation: 1:00 - 3:00 PM Endorsement Afternoon Shift 2:45 - 3:00 PM Summing up. F. GRADING SYSTEM 60% A.K.S. 40% REQUIREMENTS Drug Studies Journals Quizzes NCPs Charting/Progress Notes Individual Case Studies Physical Assessment Checklist

Learning feedback evaluation: learning experience, comments and suggestions to improve/enhance learning. a. Quizes and Post-Test b. Skills: Case Presentation c. Skills: Observation d. Reportings

NOTE: A minimum of 5 quizzes will be given every rotation but may exceed to 1 quiz per duty. In their last week of rotation, probably on the 2nd day, students will be having an evaluation exam to sum up all their learned activities throughout their related learning experience at CGH. On the third day of their fourth week, a case presentation will be held at the university campus to share their knowledge and experience of the case they handled to their classmates. Student checklist should be accomplished and signed by the clinical instructor within the rotation period.

PREPARED BY: MS. SUSAN LOIDA SANTIAGO-SORIANO, MSN CLINICAL INSTRUCTOR

UNIVERSITY OF LA SALETTE COLLEGE OF NURSING

SANTIAGO CITY, PHILIPPINES

1st SEMESTER SY 2012-2013 LEVEL III

CLINICAL FOCUS SOUTHERN ISABELA GENERAL HOSPITAL

SUBMITTED BY: MS. SUSAN LOIDA SANTIAGO-SORIANO, MSN CLINICAL INSTRUCTOR

SUBMITTED TO: MS. MARIA THERESA G. SANTOS, MSN CLINICAL COORDINATOR