COMMUNITY COLLEGE OF PHILADELPHIA

DEPARTMENT OF CARDIORESPIRATORY TECHNOLOGIES

RESPIRATORY CARE PROGRAM

RESP 102-- CLINICAL AFFILIATIONS

 

PURPOSE OF COURSE

 

            This clinical course is the first experience in a clinical setting for Respiratory Care students. The student will perform routine respiratory therapy skills and integrate theory taught during the first semester of the program. The student must be familiar with the pre-requisite information from the major and support courses to take full advantage of the educational opportunities afforded at our clinical affiliates.

 

DRESS CODE

 

            The student is expected to present a professional appearance while in the affiliate and should dress and act accordingly. As per guidelines handed out at the end of the Fall semester, all students are expected to be dressed in Navy blue scrubs with a CCP shoulder patch attached. A lab coat will be worn to cover the scrubs outside of the units and will also have a shoulder patch. A nametag clearly identifying you as a student will be worn. All appropriate equipment (stethoscope, scissors, watch, pen, etc.) will be taken to clinical. Personal/oral hygiene must conform to local norms including regular bathing and hair washing. Hair should be short or tied backs so as to minimize patient discomfort and maximize equipment safety. Minimal jewelry may be worn but no large earrings and/or rings and bracelets that may become tangled in equipment and harm the patient. Nails should be clean and trimmed with only conservative polish colors, if any, worn. Perfumes and after-shaves must be only lightly scented, if worn, due to the possible disease states of the patients. Shoes should be chosen which offer good support as you will be on your feet for extended periods of time. Sneakers may be worn if they are leather-topped and conservative in color.

 

EVALUATION

 

            Students will be evaluated two times during the semester using the attached form. The form has multiple statements, which are rated by the clinical instructor. To successfully complete the clinical, all statements must be rated as "ACCEPTABLE" and all clinical objectives must be satisfactorily completed. These should be read BEFORE going to the hospital.

 

 

CLINICAL ASSIGNMENTS -- RESP 102--

 

STUDENT                                           HOSPITAL               HOSPITAL SUPERVISOR

MONDAY:

Pat Rocha                                           Presbyterian                Sally Heuser, RRT

Maureen Wilcox                                   39th and Powelton        Roseanne Rappa, RRT

Sin Tran                                              215-662-9372

Everton Brown

Cynthia Guillard

Frank Hyduk   

 

            Instructor: Lisa Epright, RRT

 

THRUSDAY:

 

            Sydrick Rabusa                        Pennsylvania Hospital   Pat Schmienke, RRT

            Yifrach Anat                            8th and Spruce St.

            Ashley Ernst                            215-829-8495

            Zoraida Rivera

Hoa Nguyen

            Instructor: Levi Clark, RRT

 

THURSDAY:

 

            Christine Kober                       Presbyterian     Sally Heuser, RRT

            Greg Jones                              39th & Powelton Ave.  Roseanne Rappa, RRT

            Diane Hart                               215-662-9372

            Kelly Skahan

            Jamilah Lorrick

                        Instructor: Virgo Kidd, RRT

MONDAY:

 

            Matt Simmons             Albert Einstein Med. Center                             

            Brett Mills                    Old York and Tabor Rds.                     Maureen Jordon, RRT

            Jane Divergilis              215-456-7890

            Kesha Williamson

                Kra Noel

            Steve Rajan

           

 

            Instructor: Kelly Joseph, RRT

 

 

 

COMMUNITY COLLEGE OF PHILADELPHIA

DEPARTMENT OF CARDIORESPIRATORY TECHNOLOGIES

 

 

 

 

POLICY STATEMENT

ABSENCE FROM CLINICAL EXPERIENCE

 

 

 

1. Students may make up due to illness, the total number of hours per semester equal to the number of hours that the course meets weekly.

            (Exception: Summer Session Clinical Rotations employ a different formula. Students may make up One eight-hour shift for ever 160 hours of clinical time.)

 

2. A student who misses an excess of hours (as defined in #l) must arrange a conference with the Clinical Coordinator as soon as possible. Following the conference, one or more of the following decisions will be reached:

                       

                        a.         make up time will be scheduled

                        b.         a conference with the total faculty will be scheduled

                        c.         dismissal from the program

 

3.         Students who miss twice the number of hours above are beyond remedial help and may either be dropped from the program or given permission to repeat depending upon individual circumstances. However, no student may complete, or receive a grade for a clinical practice course in which twice the number of allowed hours have been missed unless the course is repeated.

 

 

4. Students must notify the clinical instructor regarding absence in the clinical area PRIOR to the experience.

 

5. If a student reports to the clinical area more than 30 minutes late, he/she may be directed to leave the area and the time missed will be counted as absentee time.

 

6. Under no circumstances may the student engage in make-up time without being enrolled as a bona fide student.

 

 

 

 

 

 

 

 

 

 

 

 

 

COMMUNITY COLLEGE OF PHILADELPHIA

DEPARTMENT OF CARDIORESPIRATORY TECHNOLOGIES

 

 

 

 

RESP 102 CLINICAL RESEARCH ASSIGNMENT

 

 

 

Because pharmacology is important in the treatment of patients with cardiopulmonary disease, the respiratory care practitioner must possess a thorough knowledge of commonly used medications.

 

This semester a pharmacology course is part of your studies. To ease your integration of this material in the clinical environment, the following drugs should be researched according to the attached format.

 

Any source may be used for the information as long as the cards are complete, up-to-date, and accurate. Cards are to be completed and taken to your clinical assignment during the third week of clinical.

 

                        DRUGS:

                                                Acetylcysteine

                                                Cromolyn Sodium

                                                Ipratroprium Bromide

                                                Albuterol

                                                Flovent

Do a good job on these, as you'll be tested on them in the 102 classroom!

                                               

REFERENCE SOURCES:

            Physician's Desk Reference

            Respiratory Care: A Guide to Clinical Practice

            The Pharmacological Basis of Therapeutics

Respiratory Care Drug Reference

 

 

FRONT SIDE

 

 

 

MEDICATION CARDS

 

YORK HOSPITAL SCHOOL OF RESPIRATORY THERAPY

MEDICATION CARDS

 

MEDICATION Isuprel ( isoproternol hydrochloride )

 

ACTION : one of the most pure beta stimulants, relaxes bronchial spasm, facilitates expectoration of pulmonary secretions. Isuprel's bronchodilator action via aerosol can persist for a time as short as 20 minutes, although it often is effective l90 to 120 minutes.

 

INDICATIONS: the treatment of bronchospasm associated with acute - chronic bronchial asthma, pulmonary emphysema, bronchitis, and bronchiectasis.

CONTRAINDICATIONS: the cardiac stimulant effect of the drug may cause cardiac arrhythmias with tachycardia in patients inclined to these disorders.

 

 

 

REVERSE SIDE

 

Isuprel (isoproterenol hydrochloride)

 

ADVERSE REACTIONS: Tachycardia, palpitation, nervousness, nausea, vomiting; may experience some transient throat irritation attributed to the alcohol content.

 

ADMINISTRATION: Children and adults, 1:200 solutions, 5-15 deep inhalations, up to 5 times daily; adults, 1:100 solutions, 3-7 deep inhalations, administered as an aerosol mist by Mistometer, hand-bulb nebulizer, compressed air or oxygen operated nebulizer, IPPB devices (usual dosage is .25-.5 ml of 1:200 diluted to 5 ml with NSS)

 

HOW SUPPLIED: Mistometer l5 ml (16.8g) complete nebulizing unit; solution 1:200, bottles of 10 and 60 ml. ; solution 1:100, bottles of 10 ml; as tablets, glossets of 1O and 15 mg., bottles of 50

 

 

From Respiratory Care . June 80 Vol. 25 No 6 pg. 661

 

CCP - RESPIRATORY CARE PROGRAM        DAILY CLINICAL LOG

 

NAME __________________________________ COURSE ___________

 

 

DATE          ACTIVITY

 

 

__________    ____________________________________________________________

 

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COMMUNITY COLLEGE OF PHILADELPHIA

DEPARTMENT OF CARDIORESPIRATORY TECHNOLOGIES

RESPIRATORY CARE PROGRAM

 

CLINICAL BEHAVIORAL EVALUATION FORM

 

NAME______________________________________DATE______________

 

COURSE: (circle one)

 

            102                  104                  221     

 

            299 CRITICAL CARE            299 NEO/PEDS                     

 

 

SIGNATURES:_____________________________/HOSPITAL SUPERVISOR

 

                        _____________________________/STUDENT

 

 

Check appropriate column for each statement using the following key:

U = Unacceptable; I = Improvement Necessary; A = Acceptable

 

                                                                                                                         U | I | A

1. Accurately checks patient chart before patient contact                                  

_______________________________________________________________________________|_____|_____

2. Accurately records patient information after patient contact

_______________________________________________________________________________|_____|_____

3. Communicates information to other health care team members clearly and concisely

_______________________________________________________________________________|_____|_____

4. Demonstrates proper care and maintenance of equipment before, during, and after use

_______________________________________________________________________________|_____|_____

5. Demonstrates aseptic technique at all times

_______________________________________________________________________________|_____|_____

6. Demonstrates an ability to appropriately operate equipment and administer therapies required for this clinical rotation.

_______________________________________________________________________________|_____|_____

7. Demonstrates an ability to apply classroom concepts to problem solving in the clinical environment

_______________________________________________________________________________|_____|_____

8. Explains procedures and/or equipment to the patient in understandable terminology

_______________________________________________________________________________|_____|_____

9. Respects the patient/practitioner relationship by varying approach according to individual needs

_______________________________________________________________________________|_____|_____

10. Demonstrates an appreciation of the patient's safety and privacy

_______________________________________________________________________________|_____|_____

 

 

 

 

 

                                                                                                                                                 U | I | A

11. Respects the confidentiality and legality of the patient's records

_______________________________________________________________________________|_____|_____

12. Attendance and punctuality during this rotation

_______________________________________________________________________________|_____|_____

13. Makes good use of time while in clinical

_______________________________________________________________________________|_____|_____

14. Presents to clinical area with appropriate appearance/hygiene

_______________________________________________________________________________|_____|_____

15. Reacts appropriately to emergency and/or pressure situations

_______________________________________________________________________________|_____|_____

16. Reacts appropriately to suggestions, criticism, and guidance

_______________________________________________________________________________|_____|_____

17. Learns independently via keen, accurate observation

_______________________________________________________________________________|_____|_____

18. Overall rating for this rotation

_______________________________________________________________________________|_____|_____

 

 

================================================================================

Use this space for comments by both student and supervisor. All statements graded less than "acceptable" to be explained here. Explanation to be listed by statement number.

 

 

 

COMMUNITY COLLEGE OF PHILADELPHIA

DEPARTMENT OF CARDIORESPIRATORY TECHNOLOGIES

RESPIRATORY CARE PROGRAM

 

CLINICAL BEHAVIORAL EVALUATION FORM

 

NAME______________________________________DATE______________

 

COURSE: (circle one)

 

            102                  104                  221                 

 

            299 CRITICAL CARE            299 NEO/PEDS                     

 

 

SIGNATURES: _____________________________/HOSPITAL SUPERVISOR

 

                        _____________________________/STUDENT

 

 

Check appropriate column for each statement using the following key:

U = Unacceptable; I = Improvement Necessary; A = Acceptable

 

                                                                                                                         U | I | A

1. Accurately checks patient chart before patient contact                                  

_______________________________________________________________________________|_____|_____

2. Accurately records patient information after patient contact

_______________________________________________________________________________|_____|_____

3. Communicates information to other health care team members clearly and concisely

_______________________________________________________________________________|_____|_____

4. Demonstrates proper care and maintenance of equipment before, during, and after use

_______________________________________________________________________________|_____|_____

5. Demonstrates aseptic technique at all times

_______________________________________________________________________________|_____|_____

6. Demonstrates an ability to appropriately operate equipment and administer therapies required for this clinical rotation.

_______________________________________________________________________________|_____|_____

7. Demonstrates an ability to apply classroom concepts to problem solving in the clinical environment

_______________________________________________________________________________|_____|_____

8. Explains procedures and/or equipment to the patient in understandable terminology

_______________________________________________________________________________|_____|_____

9. Respects the patient/practitioner relationship by varying approach according to individual needs

_______________________________________________________________________________|_____|_____

10. Demonstrates an appreciation of the patient's safety and privacy

_______________________________________________________________________________|_____|_____

 

 

 

 

 

                                                                                                                                                 U | I | A

11. Respects the confidentiality and legality of the patient's records

_______________________________________________________________________________|_____|_____

12. Attendance and punctuality during this rotation

_______________________________________________________________________________|_____|_____

13. Makes good use of time while in clinical

_______________________________________________________________________________|_____|_____

14. Presents to clinical area with appropriate appearance/hygiene

_______________________________________________________________________________|_____|_____

15. Reacts appropriately to emergency and/or pressure situations

_______________________________________________________________________________|_____|_____

16. Reacts appropriately to suggestions, criticism, and guidance

_______________________________________________________________________________|_____|_____

17. Learns independently via keen, accurate observation

_______________________________________________________________________________|_____|_____

18. Overall rating for this rotation

_______________________________________________________________________________|_____|_____

 

 

===============================================================================

Use this space for comments by both student and supervisor. All statements graded less than "acceptable" to be explained here. Explanation to be listed by statement number.

 

 

 

 

            The following list of objectives is intended to be a guide only. There may be additional objectives added to this list and some may not be covered depending on the clinical preferences of individual physicians and hospitals.

 

1.         General

 

1.1       The student will become familiar with physical layout of the hospital. A thorough understanding of the accepted policies and procedures specific to the assigned hospital is mandatory.

 

1.2       The student will familiarize himself with the equipment specific to the assigned hospital affiliate to include any appropriate operator manuals, if necessary.

1.3       The student will observe departmental employees during normal workday activities. This will further emphsize the policy and procedure of the hospital and allow the student to get a "feel" what he will be doing.

 

2.         Medical Records

 

2.1       Given any patient chart, the student will identify at least six data related to admission sheet. The data must include patient name, age, sex, and religious affiliation, admitting diagnosis and admitting physician.

2.2       Given any patient chart, the student will identify the history and physical sheet and the standard entries. This must include chief complaint; history of present Illness; past medical history, family history, social history; review of systems; physical exam and impression

2.3       Given any patient chart, the student will identify the laboratory report section and interpret the most recent compete blood count.

2.4       Given any patient chart, the student will identify the radiology report section and those reports dealing with the lungs and thorax.

2.5       Given any patient chart, the student will identify the vital sign record sheet and define the markings used to record the temperature; pulse; respiration and blood pressure.

2.6       Given any patient chart, the student will identify the respiratory therapy record sheet and state the items which constitute a complete entry - date, time of procedure, medication name and dosage, patient reaction, signature and title of practitioner.

2.7       Given any patient chart, the student will identify the physician order sheet and state the items which constitute a complete entry - date; name of procedure, frequency of procedure, medication name and dosage, Signature and title of practitioner.

2.8       Given any patient chart, the student will identify if the following exists: drug allergies, possible contagion, and diagnostic studies.

2.9       The student will discuss the ethics involved with chart entries and medico-legal aspects of accurate entries, erasures, falsification and confidentiality of medical history.

2.10     Given any patient chart, the student will record in the appropriate section correct entries regarding respiratory therapy procedures and objective information re: patient response to therapy.

2.11     The student will give "report" of his assigned patient to the oncoming shift. "Report" is defined by the affiliate normal operating procedure.

 

 

 

 

 

 

 

 

3.         Equipment

 

3.1       Medical Gas Cylinders. Given any cylinder of medical gas, the student will:

a.         identify its content by at least two methods

            b.         state the procedure for storage and transportation.

c.         connect a pressure-reducing valve and flowmeter

3.2       Medical Gas Analyzers. Given an oxygen analyzer in working condition, the student will:

            a.         Calibrate the device using two reference concentrations of oxygen

b.         Analyze the FI02 for a patient receiving controlled oxygen concentration from a continuous high flow system +/- 2% compared to the same measurements made by the clinical instructor

3.3       Humidifiers and Nebulizers. Given a humidifier, the student will:

a.         Identify the safety devices of the humidifier

b.         demonstrate the procedure to check the proper operation of the safety devices

c.         demonstrate the filling of humidifier or preparation of pre-filled humidifier using aseptic technique

d.         demonstrate the connection of humidifiers to various oxygen equipment

3.4       Given a Pneumatic Nebulizer, the student Will:

            a.         Identify the safety devices of the nebulizer

            b.         demonstrate the procedure to check the proper operation of the safety device

            c.         demonstrate the filling of nebulizers or preparation of pre-filled nebulizers using aseptic technique

            d.         demonstrate the connection of nebulizers to various types of pneumatic power

3.5       Given an ultrasonic nebulizer, the student will demonstrate the filling of the nebulizers of preparation of pre-filled packs using aseptic technique.

3.6       Bag-Mask Resuscitators. Given a variety of manual bag-mask resuscitators, the student will:

a.         describe operational characteristics to include pressure relief valve (if appropriate), gas inlet port, exhalation port, type of valve and delivered FI02

b.         describe the procedure to modify the bags to deliver a high (>90%) FI02

3.7       Infection Control. The student will demonstrate:

a.         entering/leaving an Isolation area including handwashing, gown, mask and glove use and Disposal, and after care of articles used in area

3.8       The student will demonstrate the procedure to use (according to affiliate policy and procedure):

a.         cold sterilizing liquid agents

b.         gas sterilizing and aeration equipment

c.         sterility indicators in equipment packaging

 

3.9       The student will demonstrate the procedures employed in the routine care of the patient to control cross-contamination by infectious agents including

a.         handwashing technique

b.         disposal of secretions and needles

c.         aseptic insertion of artificial devices within the body

d.         care of apparatus used by more than one patient or apparatus or reused by same patient

e.         dispensing of medication

 

 

4. NON CRITICAL RESPIRATORY CARE

 

4.1       Oxygen therapy. The student will perform "oxygen rounds" according to the standard practice of the clinical affiliate. "Oxygen rounds" are defined as the collection and distribution of oxygen therapy equipment to hospital storage areas and the keeping of accurate record to charge patient for therapy administered.

4.2       The student will state the indication, contraindications, benefits and side effects of oxygen therapy.

4.3       Given a prescription for basic oxygen therapy, the student will administer the therapy to a patient in the clinical setting. (Cannula/Simple/Mask/Venturi Mask /Partial or Non-Rebreathing Mask.)

4.4       Carbon Dioxide Therapy. When appropriate in the clinical setting, the student will demonstrate two methods to achieve an increased FIC0 2, describe physiological effect of an increased FIC0 2, and list clinical situation for this type of therapy.

4.5       Aerosol Therapy. The student will explain the theory of operation of pneumatic, ultrasonic and hydrodynamic nebulizers.

4.6       The student will exp1ain the theory of air-entrainment a it applies to the determination of oxygen percentage and total gas flow administered to the patient.

4.7       The student will state the indications, contraindications, benefits and side effects of aerosol therapy.

    1. Given a prescription for aerosol therapy the student will administer that therapy to a patient in the clinical setting.
    2. Given a prescription for aerosol therapy with supplemental oxygen of a specific concentration, the student will select components, assemble and administer that therapy to a patient in the clinical settling.
    3. Postural Drainage and Chest Physical Therapy. Given a prescription for postural drainage and chest physical therapy, the student will administer that therapy in the clinical settling.

4.11     The student will state indications, contraindications, benefits and side effects of postural drainage and chest physical therapy.

4.12     Intermittent Positive Pressure Breathing (IPPB). The student will state indications, contraindications, benefits and side effects of IPPB therapy. (NB: BiPAP can be substituted for IPPB, if more prevalent in the facility)

4.13     The student will explain the theory of operation of IPPB apparatus specifically the Bird Mark I and Bennett PR-2.

4.14     The student will describe the techniques and precautions of aerosolized medication administration including calculation of dosage, patient monitoring and evaluation of patient response.

4.15     Given a prescription for IPPB therapy, the student will administer that therapy to a patient in the clinical setting.

4.16     Incentive Spirometry. Given a prescription for incentive Spirometry, the student will administer that therapy to a patient in the clinical setting.

 

4.17     Sputum Induction and Collection. Given a prescription for the induction and/or collection of a sputum specimen, the student will:

a.         assemble the necessary equipment and solutions

b.         demonstrate the technique of collecting the sample either by natural airway or by Lukens tube

c.         demonstrate aseptic technique in handling the specimen.

4.18     Given a specimen of sputum, the Student will describe the significance of:

a.         color

b.         quantity

c.         viscosity

d.         odor

e.         ease of clearance

4.19     Mechanical Aspirator. The student will state the indications, contraindications, benefits and side effects of mechanical aspiration.

    1. Given a prescription for mechanical aspiration of a patient's airway, the student will perform the technique on non-intubated and intubated patients both alert and comatose.

4.21     Nursing Skills. Given a patient assignment dealing with common, well-defined health-problems, the student will perform skills related to vital sign assessment. To be rated as acceptable the student must measure patient pulse, measure patient respiration, and measure patient blood pressure within the limits defined in Course Level Objective #3 RESP 100: Introduction to Health Care Delivery.

4.22     Pulmonary Rehabilitation. Given a prescription for "home care", the student will demonstrate instruction to a patient and/or family for the following procedure :

a.         use, operation and maintenance of home IPPB equipment; low flow oxygen equipment (cylinder, liquid, and concentrator humidity and aerosol equipment)

b.         mixing, storing and administering medication

c.         postural drainage and chest physical therapy

d.         breathing retraining exercise including diaphragmatic breathing; relaxation; pursed-lip breathing; ambulating

e.         inhalation of bronchospastic prophylactics

 

 

 

Community College of Philadelphia

Clinical Objective Check Off Form

 

 

 

 

 

Community College of Philadelphia

Department of Cardiorespiratory Technologies

 

Record of Clinical Hours

 

 

Name: _________________________________ Hospital _________________________________________

 

COURSE: (circle one)

 

            102                  104                  221                 

 

            299 CRITICAL CARE            299 NEO/PEDS                     

 

Clinical Supervisor: Fill in the number of hours the student is present each day and sign weekly. Place an "L" in the appropriate block to indicate lateness. A student is considered "LATE" if not present within 10 minutes of the scheduled start time.

 

           

 

Mon

Tues

Wed

Thurs

Fri

Total

Signature

1

 

 

 

 

 

 

 

2

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

4

 

 

 

 

 

 

 

5

 

 

 

 

 

 

 

6

 

 

 

 

 

 

 

7

 

 

 

 

 

 

 

8

 

 

 

 

 

 

 

9

 

 

 

 

 

 

 

10

 

 

 

 

 

 

 

11

 

 

 

 

 

 

 

12

 

 

 

 

 

 

 

13

 

 

 

 

 

 

 

14

 

 

 

 

 

 

 

15

 

 

 

 

 

 

 

 

 

            I attest that this is a true and accurate statement of the times I attended the clinical area during the indicated course. I understand that the penalty for falsification of these records will be a failing grade for this course and immediate dismissal from my program of study.

 

 

            __________________________________________ Student signature

 

 

 

 

Clinical Patient Evaluation Format

 

Each student will be expected to complete four (4) patient evaluations during the clinical rotation. The following outline should be used when writing your evaluations. All evaluation must be typed and will be graded on a 10-point scale. Please hand in the evaluations to your Clinical Instructor. Once he/she grades them, please show them to your 102-classroom instructor as they are part of your grade.

 

Patient evaluation process should include, but need not be limited to, information gathered from the patients medical record as well as from patient interviews and your own assessment results. ~ -

 

Note: proper abbreviations must be used throughout the assessment.

 

1.         Patient information:

Name, age. sex. race.

 

2.         A summary of the patient's chief complaint (CC):

 

3.         An assessment of the patients condition:

                        Vital Signs

                        Work of Breathing

                        Inspection and palpation of the chest

                        Breath Sounds

                        Inspection of the extremities

 

4.         A summary of the patient's history (H&P):

                        Smoking History

                        Related illness

                        Occupational history

 

5.         An explanation of any pertinent lab results:

                        Blood Gas (ABG)

                        PFT

                        CBC, Hb, etc.

                        Chest X-ray results

 

6.         An explanation of the current Plan of Care:

                        Include all medications the patient is receiving and Why?

 

7.         Look for pertinent lab and subjective evaluation notes that will verify that the current plan of care is working. These might include:

                        Improved breath sounds after treatments

                        Improved CXR

                        Improved Peak Flow or PFT results

                        ABG changes