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Clinical Decision-making

Course Details

Course Number
NURS 4613_4612
Section Number
NURS 4613_4612
Spring 2014
Bridwell Hall
Classroom Number
Days & Times

Every other Monday, Wednesday and Friday from 1700 to 1850.

Dr. Robin Lockhart (view Profile)


Concepts for Nursing Practice
Course Objectives



AACN Essentials

DEC Competencies

1.  Apply the theories and concepts learned throughout the program to clinical situations.



I: A,B,C,D




2.  Utilize problem-solving approaches in recognizing and meeting patient care needs.


I: B,C,D



3.  Apply clinical judgment skills in the coordination of patient care.


I: A,B



4.  Implement the nursing role of coordinator of care.


I: B




5.  Integrate effective communication, research, and teaching-learning principles in coordinating patient care.


I: B




6.  Evaluate effective and non-effective nursing interventions in providing care to patients.


I: B,D




7.  Examine the legal, ethical, cultural, economic, and spiritual issues related to the care of patients.


I: A



Course Expectations

Clinical Content


1.         Each student will be required to complete 60 clinical hours with a preceptor, 10 clinical hours in the simulation lab, 12 hours in leadership areas, and 8 hours of patient care write-ups.

2.         The student will select clinical rotations from the offered areas. Absences may be rescheduled based on availability, if there is no longer available rotations, students will not be successful in completing the clinical hours. Therefore it is in the student’s best interest to arrange with a classmate to switch clinical rotations once the student realizes he or she is unable to attend the scheduled rotation.

3.         The student is to complete an evaluation of the preceptor following each clinical experience and attach it within one week to the dropbox in Desire 2 Learn.

4.         Clinical instructors will periodically visit the student and his/her preceptors.

5.         Students are to complete a clinical documentation form following each experience and attach it within one week to the dropbox in Desire 2 Learn.


Clinical Simulation Lab


1.         Students will complete three clinical simulations at the Regional Simulation Center for a total of 10 hours.

2.         Students will sign up for three separate visits to the simulation center.

3.         Students are expected to bring equipment needed to provide patient care and to have the resources they would normally use during a clinical experience.      

4.         Students who are late to the simulation lab will be considered absent. Absences may be rescheduled depending on space availability. If it is not possible to reschedule a simulation experience, the student may elect to complete additional (12 hours) patient care experiences to obtain clinical hours if available.


Clinical Failure:


1.         Clinical failures are awarded students who fail to meet the objectives of the clinical experience, students who fail to uphold the ANA Practice Standards and the ANA Code of ethics, students who fail to maintain patient safety, and students who fail to complete all of their clinical hours.



Infractions constituting clinical failure:




Failure of the clinical component of the course occurs when the student receives an unsatisfactory rating in any area of the evaluation tool or does not complete 90 hours of clinical. Absences will be rescheduled at the discretion of the course coordinator. 


Certain behaviors result in an unsatisfactory rating in the professional behavior section of the evaluation rubric.


Three incidents of infractions to the standard of professional behavior to include but not limited to:


  • Arriving to a clinical experience without completing the pre-clinical assignment even if allowed to stay in the clinical
  • Not conforming to the dress code even if allowed to stay in the clinical
  • Not bringing appropriate supplies to the clinical experience even if allowed to stay in the clinical
  • Unprofessional/inappropriate language or gestures
  • Unprofessional/inappropriate behavior such as disrespectful behavior, chewing gum, using tobacco products in non-smoking areas, disruptive behavior, or failure to comply with a written or verbal instruction including reminders to update immunizations and other clinical requirements
  • Arriving late to any clinical site even if allowed to stay in the clinical
  • Non-compliance with the policy to notify the instructor and the agency of a clinical absence prior to the absence or as soon as possible if immediate notification is not possible
  • Non-compliance with the policy to receive written prior approval before attending the clinical and/or the policy to notify the clinical instructor of absences prior to attending the clinical or as soon as the student realizes he/she must leave the clinical experience.
  • Leaving the premises without permission from the clinical instructor
  • Failure to complete assignments by the due dates
  • Failure to return from meals or breaks at the assigned time
  • Use of a cell phone for calling, texting, e-mailing or receiving calls, texts or e-mails in the clinical area unless given permission by the clinical instructor


Two incidents of infractions to the standard of professional behavior to include but not limited to:


  • Disregarding patient confidentiality without malice or intent to disclose
  • Patient negligence that does not result in patient injury
  • An error in care that does not harm a patient
  • Committing two infractions from the list above as well as one in this list


Infractions to the standard of professional behavior that results in immediate failure of the clinical component of the course to include by not limited to:


  • Administering medications without the direct supervision of a faculty member or preceptor
  • Failing to check two patient identifiers prior to administering medications.
  • The smell of alcohol on the breath
  • Testing positive for illicit drugs or alcohol
  • An error in care or patient negligence that harms a patient
  • Falsification, omissions, and/or lying
  • Intentionally revealing confidential information
  • Placing self, staff or patient at risk of harm due to abandonment of duties and/or sleeping during clinical experiences
  • Cheating, collusion, plagiarism, or stealing. Cheating/collusion/plagiarism – cheating means intentionally using or attempting to use unauthorized materials, information, or study aids in any academic exercise; collusion means the unauthorized collaboration with another person in preparing work offered for credit; plagiarism means intentionally representing the words or ideas of another as one’s own in any academic exercise.
  • Performing in an unsafe manner.
  • Failure to report a patient care error or incident.
  • Physical or verbal abuse of patients, patient’s family members, faculty or staff


Grading Standards

Grading Scale:










64- and below



Evaluation Methods:


Dosage calculation quizzes (Average of 10 highest)


Weekly Content Quizzes (Average of 4 highest)


Midterm Evolve Exit

30 %

Final Evolve Exit




Course Content:


Dosage Calculation Quizzes:


1.         Dosage calculation quizzes will be given over the semester as indicated on the course calendar.

2.         Dosage calculation quizzes may only be taken during class at the time of administration. There will be no “make up” quizzes.

3.         The average of the 10 highest scores will be calculated into the overall course score.

4.         Each quiz will consist of 10 dosage calculation problems and the student will have 20 minutes to complete it

5.         Dosage calculation quizzes are to reflect the student’s individual effort, therefore collaboration , talking during the quiz, or having any physical or digital materials or equipment other than a four function calculator during the quiz will be considered academic dishonesty.

6.         The student must score at least a 90% average on the 10 dosage calculation quizzes to successfully complete the course.


Weekly Content Quizzes


1.         Six quizzes will be given on the Fridays without Evolve exams over the content covered previously in the course.

2.         Quizzes may only be taken during class at the time of administration. There will be no “make-up” quizzes.

3.         Quizzes will consist of 25 multiple choice questions and students will have 50 minutes to complete them.

4.         The average of the 4 highest scores will be calculated into the overall course score.

5.         Students are to bring 5 Nursing Parscore Scantrons without any marks on them by Wednesday, January 29th.

6.         Quizzes are to reflect the student’s individual effort, therefore collaboration, talking during the quiz, or having any physical or digiteal materials or equipment other than a four function calculator during the quiz will be considered academic dishonesty.


Evolve Exit Exam:


1.         The Evolve Exit Exam will be administered twice over the semester and the student will have four hours to complete them and review the rationales for the questions missed.

2.         Conversion scores for each administration will be used in the calculation of the course grade as indicated under the section for Evaluation Methods.

3.         Case Studies, Patient Reviews and Practice tests are available through the Curriculum Test Code for students to prepare for this exam.

4.         Exams are to reflect the student’s individual effort, therefore collaboration , talking during the exam, or having any physical or digital materials or equipment during the exam will be considered academic dishonesty.


Submission Format Policy Note: You may not submit a paper for a grade in this class that already has been (or will be) submitted for a grade in another course, unless you obtain the explicit written permission of me and the other instructor involved in advance.
Plagiarism Policy

Plagiarism is the use of someone else's thoughts, words, ideas, or lines of argument in your own work without appropriate documentation (a parenthetical citation at the end and a listing in "Works Cited")-whether you use that material in a quote, paraphrase, or summary. It is a theft of intellectual property and will not be tolerated, whether intentional or not.

Student Honor Creed

As an MSU Student, I pledge not to lie, cheat, steal, or help anyone else do so."

As students at MSU, we recognize that any great society must be composed of empowered, responsible citizens. We also recognize universities play an important role in helping mold these responsible citizens. We believe students themselves play an important part in developing responsible citizenship by maintaining a community where integrity and honorable character are the norm, not the exception.

Thus, We, the Students of Midwestern State University, resolve to uphold the honor of the University by affirming our commitment to complete academic honesty. We resolve not only to be honest but also to hold our peers accountable for complete honesty in all university matters.

We consider it dishonest to ask for, give, or receive help in examinations or quizzes, to use any unauthorized material in examinations, or to present, as one's own, work or ideas which are not entirely one's own. We recognize that any instructor has the right to expect that all student work is honest, original work. We accept and acknowledge that responsibility for lying, cheating, stealing, plagiarism, and other forms of academic dishonesty fundamentally rests within each individual student.

We expect of ourselves academic integrity, personal professionalism, and ethical character. We appreciate steps taken by University officials to protect the honor of the University against any who would disgrace the MSU student body by violating the spirit of this creed.

Written and adopted by the 2002-2003 MSU Student Senate.

Students with Disabilities

The Americans with Disabilities Act (ADA) is a federal anti-discrimination statute that provides comprehensive civil rights protection for persons with disabilities. Among other things, this legislation requires that all students with disabilities be guaranteed a learning environment that provides for reasonable accommodation of their disabilities. If you believe you have a disability requiring an accommodation, please contact the Disability Support Services in Room 168 of the Clark Student Center, (940) 397-4140.

Safe Zones Statement

The professor considers this classroom to be a place where you will be treated with respect as a human being - regardless of gender, race, ethnicity, national origin, religious affiliation, sexual orientation, political beliefs, age, or ability. Additionally, diversity of thought is appreciated and encouraged, provided you can agree to disagree. It is the professor's expectation that ALL students consider the classroom a safe environment.

Contacting your Instructor

All instructors in the Department have voicemail in their offices and MWSU e-mail addresses. Make sure you add your instructor's phone number and e-mail address to both email and cell phone lists of contacts.

Other Policies


Additional Course Requirements:


1.         Students must maintain satisfactory health as determined by the total faculty consensus.


2.         Clinical performance, campus and/or clinical laboratory, are evaluated. Students are expected to pass both clinical and classroom components of the course. Failure in either one will constitute failure in the course. A course average of at least 74% is required to successfully complete this course.


3.         Students must maintain a current immunization record on file at the Vinson Health Clinic plus proof of a current CPR card, validated Health Insurance and paid Liability Insurance on file with the Wilson School of Nursing secretary during the entire semester. In order to attend class or clinical experiences, each student MUST comply with each of these requirements. 


4.         Four function calculators are allowed during exams. The use of programmable calculators, statistical or graphing calculators and calculators stored on personal data assistant devices are NOT allowed. In addition, sharing a calculator with another student is NOT allowed. Calculators may not make a discernable noise during use.


5.         Faculty reserve the right to make changes at anytime to this syllabus.


6.         Students will be held accountable for all communications sent by faculty via the course’s Desire 2 Learn site; therefore, you will be expected to check the site for announcements, assignments, messages, etc. daily. Faculty asks that students use the discussion board or clinical group sites as a means to make a specific request, ask for content clarification, to submit clinical dates…and so forth…rather than using our school/work email addresses.






Writing Proficiency Requirement

All students seeking a Bachelor's degree from Midwestern State University must satisfy a writing proficiency requirement once they've 1) passed the 6 hours of Communication Core and and 2) earned 60 hours. You may meet this requirement by passing either the Writing Proficiency Exam or English 2113. Please keep in mind that, once you've earned over 90 hours, you lose the opportunity to take the $25 exam and have no option but to enroll in the three-credit hour course. If you have any questions about the exam, visit the Writing Proficiency Office website at, or call 397-4131.

Campus Carry

Senate Bill 11 passed by the 84th Texas Legislature allows licensed handgun holders to carry concealed handguns on campus, effective August 1, 2016. Areas excluded from concealed carry are appropriately marked, in accordance with state law. For more information regarding campus carry, please refer to the University’s webpage at

If you have questions or concerns, please contact MSU Chief of Police Patrick Coggins at