Strategy Submission

It is common for students in an acute care clinical to be assigned to a different patient each week. Often this is for one 8-hour shift or at most, two consecutive days with each patient. While this approach is an effective way to teach skills and certain clinical judgments, it is not as effective in showing students how patient needs vary across time and settings or their responsibility for ensuring successful transitions across care settings. This assignment consisted of the initial assessment and plan of care for one adult and one elderly patient in the critical care unit and the student following this same patient throughout the patient’s hospitalization and into a post-acute setting (e.g. rehabilitation, long-term care, and home health). One specific tool was developed by the Gerontological Nursing course instructor to guide students in the steps of the assignment as well as in the specific physiological, functional, and post-discharge needs for equipment and support service for the elderly patient. A similar instructional tool specific to the needs of the young or middle-aged adult patient was developed by the Critical Care course instructor. Students were put into teams of four for completing all components of the assignment. Requirements of this assignment included a written plan of care and a videotape simulating a report to a case manager or to an interdisciplinary patient conference as the patient’s specific situation would warrant. The first plan of care and conference was done as soon as possible after admission to the ICU. The second plan and conference was in consideration of transfer out of the ICU. The third was in anticipation of discharge from the hospital. When possible, a videotaped addendum was added to the third case study discussion for the purpose of analyzing the patient’s progress and status over a one to two-month period of time. Implementation of project Instructors developed three videotaped interdisciplinary patient care conferences which depicted one simulated case study at three different points in time. These videotapes were shown to the students as examples of the videotaped conferences they were to do for the adult and the elderly patient from their critical care clinical. Four students were assigned to care for one adult and one elder in their critical-care clinical. The students met one day per week for three weeks and then one-half day for three weeks for follow-up on their assigned patient. Their Adult Health Critical Care instructor was with them for the first three weeks of their clinical and then both this instructor and the Gerontological Nursing course instructor met with the students for the three weeks of follow-up with each group’s assigned patient. The students met in a conference room at the University’s Center for Scholarship in Teaching and Learning for the taping of the patient care conference. These tapes were not placed on an online server and were provided only to the instructors in order not to risk violation of patient confidentiality. These videotapes were shown to students only in a private classroom setting in which confidentiality of patient information could be ensured.