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Acute Care Rotations for AGNP Students

Rotation schedules for students in the Adult Gerontology Nurse Practitioner (AGNP) programs are determined by the preceptor’s schedule. In general, acute care students will work 2-3 days consecutively to enhance the learning experience. Locations of care are primarily hospitals and may include sub-acute care facilities and specialty clinics.

  • AGNP Master of Nursing students complete four direct-care clinical rotations.
  • AGNP Certificate Students are nurse practitioners and complete three direct-care clinical rotations (no Introduction to Practice Rotation).

Course Objectives and Competencies

The following courses correspond with each rotation. Please review the course descriptions and targeted clinical competencies for each rotation.

Introduction to Practice Rotation (NURS 535)

Rotation provides an introduction to advanced nursing practice emphasizing integration of assessment data to generate differential diagnoses and apply diagnostic reasoning skills. Located in an Urgent Care setting, or site that provides a wide overview of patient care.

NURS 535: Diagnosis & Management of Adult/Geriatric Health & Illness Clinical
Required For: AGNP Master of Nursing Students
Course Description: Integrates theory with therapeutic decision making for adult populations across the lifespan with common health conditions within acute or primary health care settings.

Course Objectives:

  • Display and document comprehensive problem-focused assessments correctly including a complete health history and physical examination, for adults from diverse populations across the lifespan.
  • Use critical inquiry, and clinical decision-making skills safely and efficiently to determine current health status and potential health problems.
  • Select appropriate differential diagnoses in the clinical setting.
  • Utilize theories, evidence, and scientific principles to categorize appropriate diagnostic strategies and outline effective patient centered plans of care to address common adult health issues, promote health, and/or prevent disease and injury.
  • Outline safe, effective, high quality, evidence-based, patient centered plans of care across a spectrum of health care settings.
  • Demonstrate partnerships with the patient or designee that enable patient-centered education, counseling, and care that recognizes and respects individual patient, family, and/or caregiver needs, preferences, values, and beliefs.
  • Display the role of the advanced practice nurse practitioner and participate in collaborative relationships with inter-professional team members using communication, mutual respect, and shared decision-making to contribute to quality patient care.

Clinical Competencies: All rotations require hands on, direct patient interaction. Observation only time should be very minimal. Student should acquire the following skills/competencies during this rotation:

  • Taking appropriately comprehensive complete and focused health histories.
  • Reconciliation of health information and medications.
  • Performing appropriately comprehensive complete and focused physical examinations.
  • Selecting and interpreting appropriate diagnostic testing as indicated by the clinical presentation.
  • Developing and prioritizing appropriate differential diagnoses with evidence-based rationale.
  • Identification of risk factors.
  • Patient education / counseling / health promotion and protection.
  • Documentation of a SOAP note. For educational purposes, students are expected to develop a traditional written note in the SOAP format. It is preferred that students document and review notes with their preceptor using this format rather than documenting in the EMR. The SOAP note format is better suited to developing and demonstrating skills of diagnostic reasoning than is an EMR template).

Note:  No procedures at this stage and limited expectation for developing a management plan since students have not yet had Procedures and Diagnostic

Basic Health Management Rotation (NURS 537)

Rotation builds upon Rotation 1 to include development and evaluation of an evidence based management plan of care. Placed with a Hospitalist.

NURS 537: Acute Care Management of Adult/Geriatric Health and Illness
Required for: Masters of Nursing and Certificate Students
Course Description: Fosters development and application of expanded therapeutic and interventional skills to assess, diagnose, and manage care for adult-geriatric populations with complex acute, critical, and chronic health conditions in the acute care setting.

Course Objectives:

  • Demonstrate and document comprehensive problem-focused assessments correctly, including a complete health history and physical examination and plan of care, for adults from diverse populations, across the lifespan, in the acute care setting.
  • Assemble theories, scientific principles, patient data, critical inquiry, and clinical decision-making to accurately determine current health status and potential health problems, including acute, chronic and life threating issues.
  • Prioritize appropriate differential diagnoses in the clinical setting.
  • Examine theories, evidence, and scientific principles to analyze appropriate diagnostic strategies and determine effective patient centered plans of care to manage the acutely ill adult-geriatric populations with unstable, chronic, and episodic illness and/or injury.
  • Determine safe, effective, high quality, evidence-based, patient centered plans of care across a spectrum of health care settings.
  • Synthesize partnerships with the patient or designee to select patient-centered education, counseling, and care that recognizes and respects individual patient, family, and/or caregiver needs, preferences, values, and beliefs.
  • Demonstrate competency in the role of the advanced practice nurse practitioner and application of collaboration, communication, mutual respect, and shared decision-making skills as an inter-professional team member.

Clinical Competencies: All rotations require hands on, direct patient interaction. Observation only time should be very minimal. Student should acquire the following skills/competencies during this rotation:

  • Taking appropriately comprehensive complete and focused health histories.
  • Reconciliation of health histories and medication.
  • Performing appropriately comprehensive complete and focused physical examinations.
  • Selecting and interpreting appropriate diagnostic testing as indicated by the clinical presentation.
  • Identification of risk factors.
  • Developing appropriate differential diagnoses with evidence based rationale.
  • Arriving at final working diagnosis with evidence based rationale.
  • Development of a management plan with preceptor guidance.
  • Patient education / counseling / health promotion and protection.
  • Evaluation of management plans with preceptor guidance.
  • May perform scope specific procedures under direct preceptor supervision.
  • Documentation of a SOAP note. For educational purposes students are expected to develop a traditional written note in the SOAP format. It is preferred that students document and review notes with their preceptor using this format rather than documenting in the EMR. The SOAP note format is better suited to developing and demonstrating skills of diagnostic reasoning than is an EMR template.

Intermediate Health Management Rotation (NURS 539)

Builds upon Rotations 1 & 2 in the management of patients with higher acuity care needs. Placed with an Intensivist.

NURS 539: Acute Care Management of Adult- Geriatric Health and Illness 2 Clinical
Required for: Masters of Nursing and Certificate Students
Course Description: Synthesis and application of advanced therapeutic and interventional skills to assess, diagnose, and manage care for adult-geriatric populations with complex acute, critical, and chronic health conditions in the acute care setting.

Course Objectives

  • Proficiently demonstrate and document comprehensive problem-focused assessments correctly and efficiently including a complete health history and physical examination and plan of care, for adults from diverse populations across the lifespan in the acute care setting.
  • Synthesize theories, scientific principles, patient data, critical inquiry, and clinical decision-making to correctly determine current health status and potential health problems.
  • Evaluate appropriate differential diagnoses in the clinical setting.
  • Summarizes theories, evidence, and scientific principles to construct appropriate diagnostic strategies and formulate effective patient centered plans of care to manage adult-geriatric populations with unstable chronic and acute episodic illness and injury in the acute care setting.
  • Consistently construct safe, effective, high quality, evidence-based, patient centered plans of care in the acute care setting.
  • Value partnerships with the patient or designee that create patient-centered education, counseling, and care that recognizes and respects individual patient, family, and/or caregiver needs, preferences, values, and beliefs.
  • Demonstrate advanced competency in the role of the advanced practice nurse practitioner and application of advanced collaboration, communication, mutual respect, and shared decision-making skills as an inter-professional team member.
  • Evaluate the legal and ethical factors influencing the care of the adult-geriatric population in the acute care setting.

Clinical Competencies: All rotations require hands on, direct patient interaction. Observation only time should be very minimal. Student should acquire the following skills/competencies during this rotation:

  • Taking appropriately comprehensive complete and focused health histories.
  • Reconciliation of health histories and medication.
  • Performing appropriately comprehensive complete and focused physical examinations.
  • Selecting and interpreting appropriate diagnostic testing as indicated by the clinical presentation.
  • Identification of risk factors.
  • Developing appropriate differential diagnoses with evidence based rationale.
  • Arriving at final working diagnosis with evidence based rationale.
  • Development of a management plan with preceptor guidance- would expect increased independence in diagnostic reasoning and decision making.
  • Patient education / counseling / health promotion and protection.
  • Evaluation of management plans with preceptor guidance.
  • May perform scope specific procedures under direct preceptor supervision.
  • Documentation of a SOAP note. For educational purposes students are expected to develop a traditional written note in the SOAP format. It is preferred that students document and review notes with their preceptor using this format rather than documenting in the EMR. The SOAP note format is better suited to developing and demonstrating skills of diagnostic reasoning than is an EMR template.

Advanced Health Management Rotation/Residency (NURS 541)

The clinical residency rotation integrates, synthesizes and applies diagnostic reasoning and management skills in a comprehensive interdisciplinary, and autonomous manner that reflects the AG-ACNP scope of practice. These hours should be spent in high acuity settings such as internal medicine, cardiology, gastroenterology, nephrology, endocrinology, etc. Optionally, the preceptor facility assists with allowing observational rotation in inter-professional departments such as radiology, pharmacy, dietetics or physical therapy. Observational opportunities augment the students overall learning and understanding, however, these hours do not count toward the required 192 hours.

NURS 541: Acute Care Clinical Residency
Required for: Masters of Nursing and Certificate Students
Course Description: Theoretical, clinical, and scientific principles are synthesized and implemented in acute care setting. Provides comprehensive adult-geriatric health and illness care, therapeutic interventions, and evaluation of patients with complex acute, critical, and chronic illness problems.

Course Objectives:

  • Synthesis, implementation, and evaluation of theoretical, clinical, and scientific principles of AGNP practice.
  • Consistently demonstrate accountability and competency in all aspects of the role of the AGNP in clinical practice providing care for adults across the lifespan, under the supervision of the preceptor, including: advanced skills in advanced practice nursing, communication, documentation, clinical reasoning, decision making, information literacy, evidence-based practice, and self-directed learning.
  • Construction, implementation, and evaluation of safe, appropriate, effective, patient-centered, ethical, and evidence based plans for assessment, diagnosis, and management of health/chronic and acute illness in adult-geriatric patients and their families.
  • Provision of the full spectrum of health care services within the full scope of the adult-geriatric acute care nurse practitioner role, including transitions across the continuum of care settings.
  • Leading creation of mutually respectful, collaborative, effective, trust-based, partnerships with patients, families, and inter-professional team members.
  • Development of an outcomes focused plan of care that prescribes intervention for patients in the primary care setting.
  • Thorough, ongoing evaluation of the patient’s changing condition and response to therapeutic interventions.
  • Synthesis of an inter-professional plan of care to optimize the goals and outcomes of treatment.

Clinical Competencies: All rotations require hands on, direct patient interaction. Observation only time should be very minimal. Student should acquire the following skills/competencies during this rotation:

  • Taking appropriately comprehensive complete and focused health histories.
  • Reconciliation of health histories and medication.
  • Performing appropriately comprehensive complete and focused physical examinations.
  • Selecting and interpreting appropriate diagnostic testing as indicated by the clinical presentation.
  • Identification of risk factors.
  • Developing appropriate differential diagnoses with evidence based rationale.
  • Arriving at final working diagnosis with evidence based rationale.
  • Development of a management plan with preceptor guidance- would expect high level of autonomous diagnostic reasoning and decision making.
  • Patient education / counseling / health promotion and protection.
  • Evaluation of management plans with preceptor guidance.
  • May perform scope specific procedures under direct preceptor supervision.
  • Documentation of a SOAP note. For educational purposes students are expected to develop a traditional written note in the SOAP format. It is preferred that students document and review notes with their preceptor using this format rather than documenting in the EMR. The SOAP note format is better suited to developing and demonstrating skills of diagnostic reasoning than is an EMR template.