NURSING CLINICAL TRANSITION

1. PERSONAL CLINICAL GOALS

a) Student Goals

b) Evaluation of Goals

MATH QUIZ

Objectives

MATH QUIZ

Objectives

CLINICAL TRANSITION

November 2008

SUNDAY	MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY	SATURDAY
						1
2	3	4	5	6	7	8
9	10	11	12 8-10 CHA 2 Final 1030-1200: Orientation to course, clinical math quiz 1330-1430 – Preceptor Orientation	13 8-12 or 12-4 pm Skill Lab Hours Retake Math quiz	14 8-12 pm Skill Lab Hours Retake Math quiz	15
16	17 Clinical Transition Hours Begin	18 8-10 Transitions Discussion 10-12 NMPC	19	20	21	22
23	24	25 Senior Seminar	26	27 Holiday	28 Holiday	29
30

**The lead instructor reserves the right to make any changes in the syllabus and calendar at any time.

**The Senior Mentor Reception has yet to be scheduled

Each shift must be initialed by preceptor when completed. Student signature

Turn in calendar at wrap-up. Student phone no.#

Preceptor signature

Facility

Unit

Phone

November 2008

SUNDAY	MONDAY	TUESDAY	WEDNESDAY	THURSDAY	FRIDAY	SATURDAY
						1
2	3	4	5	6	7	8
9	10	11	12 8-10 CHA 2 Final 1030-1200: Orientation to course, clinical math quiz 1330-1430 – Preceptor Orientation	13 8-12 or 12-4 pm Skill Lab Hours Retake Math quiz	14 8-12 pm Skill Lab Hours Retake Math quiz	15
16	17 Clinical Transition Hours Begin	18 8-10 Transitions Discussion 10-12 NMPC	19	20	21	22
23	24	25 Senior Seminar	26	27 Holiday	28 Holiday	29
30

Each shift must be initialed by preceptor when completed. Student signature

Turn in calendar at wrap-up. Student phone no.#

Preceptor signature

Facility

Unit

Phone

December 2008

Nursing Clinical Transition

Course Outcome Summary

Information

*Course Number*	10-543-116
*Credits*	2
*Instructional Area*	Nursing
*Instructional Level*	Associate Degree

Description

This clinical experience prepares the student to assume the role of graduate nurse. The course promotes clinical decision-making, delegation, and collaboration to achieve client and organizational outcomes. Continued professional development is fostered.

Prerequisites

1.	Pre/Co: Nursing Advanced Clinical Practice
2.	Pre/Co: Nursing Management Concepts
3.	Pre/Co: Nursing Complex Health Alterations II

Competencies

1.	Adapt communication style based on analysis of the situation *Performance Standards* You will demonstrate your competence: o in a clinical experience with guidance from an experienced registered nurse Your performance will be successful when: o you determine the best methods to communicate relevant accurate and complete information in a concise and clear manner o you report and document assessments, interventions, teaching, and evaluations effectively o you protect confidential information o you create a climate of mutual trust and partnership with clients and families o you communicate a sense of "being present" with clients that provides empathy and support o you preserve the dignity and autonomy of clients by respecting their right to make health care decisions o you give meaningful verbal and written summary reports to other members of the health care team o you maintain effective communication with staff o you demonstrate skill in the use of communication technology available within agencies o reflection describes areas of strength and opportunities for growth related to communication o reflection presents a realistic picture of the learner's current level of communication skills o reflection includes specific strategies for continued improvement o your personal evaluation is validated by another (i.e. preceptor, teacher) *Learning objectives* What you will learn as you master the competency: a. Assess own communication style b. Implement a communication style/strategy appropriate to clinical situation c. Effectivel communicates in the clinical experience d. Validatea effectiveness of communication skills within the clinical setting e. Comply with standards regarding protected information f. Document data according to agency guidelines
2.	Assess the needs of clients, families, and groups within the community *Performance Standards* You will demonstrate your competence: o in a clinical experience with guidance from an experienced registered nurse o by reflecting on your use of the skills in an oral discussion or written summary Your performance will be successful when: o you complete a holistic assessment o you incorporate concepts of development, culture, socioeconomics, spirituality, and community in the assessment o you assess environmental factors that promote safety and wellness o you assess and anticipate the needs of the family *Learning objectives* What you will learn as you master the competency: a. Utilize holistic approcah to assess client needs b. Incorporate clients/families/groups unique needs within assessment
3.	Make relatively independent clinical decisions *Performance Standards* You will demonstrate your competence: o in a clinical experience with guidance from an experienced registered nurse o by reflecting on your use of the skills in an oral discussion or written summary Your performance will be successful when: o you anticipate problems o you use critical thinking when analyzing clinical decisions o you apply concepts from the sciences and nursing in formulating decisions o you create alternative solutions to clinical problems o you compare diverse viewpoints in the interpretation of data and drawing conclusions o you use verifiable information and clinical judgement in choosing among alternative solutions o you confer with an experienced nurse when encountering a new situation o you recognize and reflect on problems that must be referred o you use appropriate resources to address problems related to client care *Learning objectives* What you will learn as you master the competency: a. Incorporate critical thinking into decision making b. Validate clinical judgement with guidance c. Determine issues requiring referral
4.	Accept accountability for care *Performance Standards* You will demonstrate your competence: o in a clinical experience with guidance from an experienced registered nurse o by reflecting on your use of the skills in an oral discussion or written summary Your performance will be successful when: o you adhere to the nursing code of ethics o you develop a method of resolving conflicts among theoretical, personal, and agency values o you practice within legal parameters o you accept accountability for personal and delegated actions o you seek assistance from peers and other members of the health care team in situations that require higher level of knowledge/skill o you maintain organization and client confidentiality o you serve as a positive role model within the health care setting o you advocate for client rights *Learning objectives* What you will learn as you master the competency: a. Provide nursing care within ethical and legal standards b. Accept responsibility for own and delegated nursing actions c. Determine limits of capabilities when higher skills required
5.	Manage multiple priorities *Performance Standards* You will demonstrate your competence: o in a clinical experience with guidance from an experienced registered nurse o by reflecting on your use of the skills in an oral discussion or written summary Your performance will be successful when: o you establish priorities for organizing nursing care among multiple clients o you use a systematic approach for setting priorities o you apply principles of organizing and managing resources o you demonstrate flexibility in adapting to changing situations o you balance human, fiscal, and material resources to achieve quality health care outcomes o you locate community resources to facilitate optional wellness of clients in their communities *Learning objectives* What you will learn as you master the competency: a. Organize nursing care based on priorities and resources b. Utilize resources to achieve quality outcomes c. Adapt to changing situations
6.	Work collaboratively to achieve client and organizational outcomes *Performance Standards* You will demonstrate your competence: o in a clinical experience with guidance from an experienced registered nurse o by reflecting on your use of the skills in an oral discussion or written summary Your performance will be successful when: o you establish and maintain effective working relationships o you work interdependently with others o you initiate referrals when necessary to promote coordination and continuity of care o you initiate interactions with members of the health care team to resolve problems and provide continuity of actions o you serve as an integral member of the healthcare team o you convey mutual respect, trust, support and appreciation for other members of the healthcare team o you collaborate to bring about fair solutions that balance differing needs, values, and motivations for the purpose of achieving positive client outcomes o you facilitate continuity of care within and across healthcare settings o you provide individuals, families, and groups with the information they need to consider available alternatives and make informed choices *Learning objectives* What you will learn as you master the competency: a. Initiate effective working relationships b. Demonstrate respect, trust, and support for team members c. Collaborate to achieve organizational outcomes d. Facilitate continuity of care
7.	Delegate nursing care *Performance Standards* You will demonstrate your competence: o in a clinical experience with guidance from an experienced registered nurse o by reflecting on your use of the skills in an oral discussion or written summary Your performance will be successful when: o you provide direction for other members of the health care team as appropriate o you apply appropriate management concepts in assigning and/or delegating nursing care o you supervise other health care personnel when necessary o you determine success of delegated acts based on outcomes o you delegate commensurate with education and experience *Learning objectives* What you will learn as you master the competency: a. Delegate care specific to client situation b. Evaluate effectiveness of delegated care
8.	Provide safe and effective care that considers the uniqueness of the client *Performance Standards* You will demonstrate your competence: o in a clinical experience with guidance from an experienced registered nurse o by reflecting on your use of the skills in an oral discussion or written summary Your performance will be successful when: o you perform technical skills competently o you teach the client and significant support persons the information and skills needed to achieve optimal health o you provide individuals, families, and groups with the information they need to consider available alternatives and make informed choices o you incorporate cultural, spiritual, developmental, and socioeconomic client factors into the plan of care o you contribute to the functions of utilization review and continuous quality improvement o you provide caring interventions o you evaluate care based on pre-established criteria o you modify care based on evaluation o you implement the prescribed care regimen within the legal, ethical, and regulatory framework of nursing practice *Learning objectives* What you will learn as you master the competency: a. Implement care specific to the unique needs of client b. Provide care within nursing practice framework c. Modify care based upon nursing evaluation
9.	Assume responsibility for professional development *Performance Standards* You will demonstrate your competence: o in a written or oral presentation Your performance will be successful when: o presentation includes learning goals for this transition experience o presentation includes a self-evaluation of your attainment of the program outcomes o self-evaluation incorporates feedback from clients, families, staff, preceptor, and faculty o presentation includes how you have used the feedback throughout the transition experience to improve your personal nursing practice o presentation includes a plan for continuing education o presentation includes a personal philosophy of nursing *Learning objectives* What you will learn as you master the competency: a. Explain personal philosophy of nursing b. Summarize self-evaluation and nursing goals related to transition from student to registered nurse role c. Incorporate feedback into professional development plan

Textbooks

1. Blackhawk Technical College. Associate Degree Nursing Student Handbook. Required

2. Cox et al., Clinical Applications of Nursing Diagnosis, 4^th Edition, Publisher: Davis. Required

3. Lewis et al., Medical-Surgical Nursing, 7^th Edition, Publisher: Mosby. Required

4. Luz Martinez de Castillo, S., Strategies, Techniques & Approaches to Thinking, 2^nd. Edition, Publisher: Saunders. Required

5. Pagana, K. & Pagana, T., Mosby’s Manual of Diagnostic and Laboratory Tests, 2^nd. Edition, Publisher: Mosby. Required

6. Perry, A. & Potter, P., Clinical Nursing Skills & Techniques, 5^th Edition, Publisher: Mosby. Required

7. Potter, P. & Perry, A., Fundamentals of Nursing, 6^th Edition, Publisher: Mosby. Required

8. Skidmore-Roth, L., Mosby’s Drug Guide for Nurses (2004), 6^th Edition, Publisher: Mosby. Required

9. Stuart, G.W., Principles and Practice of Psychiatric Nursing, 8^th Edition, Publisher: Elsevier Mosby. Required

10. McKinney E., James, S., Murray, S., Ashwill, J., Maternal-Child Nursing, 2^nd Edition, Publisher: Elsevier Saunders. Required

11. Whitehead et al., Essentials of Nursing Leadership and Management, 4^th Edition, Publisher: DavisPlus

Supplies

1. Stethoscope. Required.

2. Watch with a second hand. Required.

3. Protective eye wear. Required.

4. White uniform with BTC patch on arm. Required.

5. White lab coat with BTC patch on arm. Required.

6. Name pin. Required.

7. Scissors. Required.

8. Penlight. Recommended.

ATI TESTs - Policy Statement

The ATI Comprehensive Assessment and Review Program (CARP) prepares students for the NCLEX by systematically strengthening their knowledge base throughout their nursing education. The program is designed to increase pass rates on the NCLEX and to lower program attrition rates by early identification of students at risk.

CARP includes review material and assessments directed toward orientation/assessment, content mastery aligned with each course and NCLEX preparation the final semester.

Proctored exams must be passed at a:

Level 1 – Maternal-Newborn

(semester 2) Nursing Care of Children

Level 2 - All other proctored exams

If a proctored exam is not met as outlined above, it is strongly recommended that you review and re-mediate on your own in order to successfully pass the second practice test at a performance level of 85 %. This second practice test should not take more than four attempts and there should be a minimum of 3 days between testing. After successfully meeting this benchmark, you need to print off your transcript at the completion of the test and submit to your instructor. This transcript in turn will be placed within your file.

Scoring:

Proctored tests

For all except the Comprehensive predictor:

Achieve the status of Level 2: grade will increase 1%

Achieve the status of Level 3: grade will increase 2%

For the Comprehensive predictor: (in 4^th semester)

96% probability of passing NCLEX grade will increase 1%

98% probability of passing NCLEX grade will increase 2%

Senior Mentor Reception

It is a requirement of the course that students attend the Senior Mentor Reception.

Clinical Transition Wrap-Up

It is a requirement of the course that students attend the Clinical Transition Wrap-Up.

MATH QUIZ

ADN students are expected to come to this program with necessary math skills as outlined in the ADN Handbook. A math calculation exam will be administered during the first week of Nursing Clinical Transition. In order to pass the exam, students must achieve 100%. If a student does not pass the Math Exam, s/he may not take another math test for 24 hours.

If a student is unable to successfully pass the Math Exam after two (2) attempts, the student will be referred to the Learning Resources Lab to review math skills. This must be done before the student will be allowed to take another Math Exam. A Learning Resources Math Referral Form must be obtained and brought to the Learning Resources Lab with the student, dated and with the student’s name. The Math Referral Form must be signed and dated by a Learning Resources personnel after the student has successfully reviewed math skills. The signed and dated referral form must be presented to the person proctoring the next math retake exam before the student will be allowed to take the exam. Two (2) retakes will be allowed.

The student is solely responsible for math retakes. Students must pass the math test within two (2) weeks of taking the first math test. If a student does not pass the math test within the required two (2) week period or three attempts, the result will be a course failure.

Students will be expected to satisfactorily (100%) complete a math calculation exam prior to their first clinical day.

Objectives for math calculations:

Demonstrate ability to calculate the following:

1. IV drip rate from medications ordered in units

2. Dosages from medications available to dosage desired using decimals and fractions

3. Dosages based on kilograms per body weight

4. Basic math problems: addition, subtraction, multiplication, division of whole numbers, fractions, decimals

5. Calculate IV drip rates for both gravity infusion and IV pump administration.

6. Calculate maximum dosages for medications that have defined ranges.

Skills Review

Four hours of skills review in the lab are required of each student in the Nursing Clinical Transition course. Each student is expected to complete skills review of specific skills and a brief simulation then hand in the completed skills checklist and signed critical elements before his/her first clinical day. The student may not attend clinical without having completed the skills review. The student must sign in to the skills lab in order to verify his/her times in lab. The skills review must be completed with the critical elements pages with the students name and signed by the evaluator and handed in to the instructor before the students first clinical day. When the skills review is completed and completed critical elements are handed in the student will receive 25 points toward the course grade. In addition, students are encouraged to review other skills in the lab outside of the required skills and lab hours.

Volunteer Hours

Four hours of volunteer work is required of each student in the Nursing Clinical Transition Course. These hours will be completed outside of your scheduled clinical hours. Each student must identify his/her volunteer site, contact the agency to make the arrangements, and provide documentation signed by agency personnel with dates and times the student volunteered to the instructor. The volunteer work each students wishes to do must be approved by the instructor prior to beginning the volunteer hours. Suggestions include: volunteering at Health net, Red Cross Blood Mobile, blood pressure screenings at senior apartments, senior mentor reception, pinning, etc.

NOTE:

If there is any reason that would interfere with your ability to complete the requirements of this course or to participate in the activities described in this syllabus, please contact the Dean of Health, Human and Protective Services. Reasonable requests for appropriate academic adjustments and reasonable modifications to policies and practices will be granted. Requests must be received prior to the third class section.

Volunteer Hours

Student Name:

Proposed Volunteer Work (Be specific – include agency, site & type of volunteer work.)

Approved: Instructor :

4 hours of volunteer work have been completed by

(student)

(dates & times)

Signature:

(Agency personnel)

Grading Policies

Requirements:

1. ATI tests. See guidelines in the syllabus.

2. Attend course orientation/preceptor meeting.

3. Math quiz. See guidelines in the syllabus.

4. Complete four (4) hours of skills review.

5. Satisfactory in discussion sessions. See guidelines in the syllabus.

6. Course evaluations completed and turned in during last small group discussion.

7. Complete four (4) hours of volunteer work. See guidelines in the syllabus.

8. Attend Senior Mentor Reception.

9. Successful completion of 56 hours in the clinical setting with assigned preceptor (plus volunteer hours and skills lab review session).

10. Attend course wrap up.

Final grades will be as follows:

Grading Scale

94-100% A

91-93% B+

87-90% B

84-86% C+

80-83% C

73-79% D

Students are responsible for knowing their own academic status. It is also their responsibility to contact their instructor, the AND Coordinator or the Program Counselor if in jeopardy of failing the course.

Grading

Successful Completion of Clinical experience 100 points

Skills Review 25 points

Discussion Sessions (total) 50 points

Four Volunteer Hours 20 points

Successful (100%) first attempt Math exam 5 points

Total 200 points

Students must complete 56 hours in the clinical setting with the assigned preceptor.

Reminder: In your portfolios, continue to save copies of required papers that you submit in this course. Upon completion of this course, students will be asked to turn in completed portfolios which contain assignments saved throughout the program.

CLINICAL:

Students must pass the 64 hr clinical experience portion of this course in order to pass the course. (56 hours with clinical mentors + 4 Skills Lab hours + 4 Volunteer hours= 64 hours). The clinical experience will be graded as either satisfactory or unsatisfactory. Upon successful completion of the clinical experience portion of the course, the student will receive points towards his/her course grade.

Safety in the Clinical Setting

A student will fail clinical if a safety issue arises deeming the student unsafe to continue in the course.

Professional Behaviors in the Clinical Setting

A student may fail clinical if he/she does not meet the professional behaviors that have been expectations in previous courses.

BLACKHAWK TECHNICAL COLLEGE

NURSING CLINICAL TRANSTION

10-543-116

CLINICAL EVALUATION TOOL

Student Name

Section Number

Fall 2008

CLINICAL EVALUATION TOOL

1. Communication Style

Scoring Standard

1 – Able to perform with confidence

2 – Able to perform with some assistance

3 – Unable to perform without assistance

*Criteria*	*Ratings*
1. You determine the best methods to communicate relevant accurate and complete information in a concise and clear manner.	1 2 3
2. You report and document assessments, interventions, teaching, and evaluations effectively..	1 2 3
3. You protect confidential information	1 2 3
4. You create a climate of mutual trust and partnership with clients and families.	1 2 3
5. You communicate a sense of “being present” with clients that provides empathy and support.	1 2 3
6. You preserve the dignity and autonomy of clients by respecting their right to make health care decisions.	1 2 3
7. You give meaningful verbal and written summary reports to other members of the health care team.	1 2 3
8. You maintain effective communication with staff.	1 2 3
9. You demonstrate skill in the use of communication technology available within agencies.	1 2 3

Comments:

2. Needs of Clients, Families and Groups

Scoring Standard

1 - Able to perform with confidence

2 - Able to perform with some assistance

3 - Unable to perform without assistance

*Criteria*	*Ratings*
1. You complete a holistic assessment.	1 2 3
2. You incorporate concepts of development, culture, socioeconomics, spirituality, and community in the assessment.	1 2 3
3. You assess environmental factors that promote safety and wellness.	1 2 3
4. You assess and anticipate the needs of the family.	1 2 3

Comments:

Self-Assessment of Learning Needs

Target Competencies

1. Adapt communication style based on analysis of the situation.

2. Assess the needs of clients, families, and groups within the community.

3. Make relatively independent clinical decisions.

4. Accept accountability for care.

5. Management multiple priorities.

6. Work collaboratively to achieve client and organizational outcomes.

7. Delegate nursing care.

8. Provide safe and effective care that considers the uniqueness of the client.

Directions

Follow these steps to complete this performance assessment task:

1. Indicate your level of proficiency in each area on Scoring Guides 1 through 8 of the Self-Assessment of Learning Needs.

2. Write a report in which you provide clinical examples to validate all ratings of “1”.

3. Use the results of your self-assessment to write Personal Clinical Goals for this clinical experience using the form provided.

4. Submit a copy of your self-assessment, your clinical examples, and your Personal Clinical Goals to your discussion group instructor at your first scheduled discussion session.

5. Share the Scoring Guides 1 through 8 of the Self Assessment of Learning Needs and your Personal Clinical Goals with your Preceptor your first clinical day.

Self-Assessment of Learning Needs

1. Communication Style

Scoring Standard

1 – Able to perform with confidence

2 – Able to perform with some assistance

3 – Unable to perform without assistance

*Criteria*	*Ratings*
1. You determine the best methods to communicate relevant accurate and complete information in a concise and clear manner.	1 2 3
2. You report and document assessments, interventions, teaching, and evaluations effectively..	1 2 3
3. You protect confidential information	1 2 3
4. You create a climate of mutual trust and partnership with clients and families.	1 2 3
5. You communicate a sense of “being present” with clients that provides empathy and support.	1 2 3
6. You preserve the dignity and autonomy of clients by respecting their right to make health care decisions.	1 2 3
7. You give meaningful verbal and written summary reports to other members of the health care team.	1 2 3
8. You maintain effective communication with staff.	1 2 3
9. You demonstrate skill in the use of communication technology available within agencies.	1 2 3

Name: Date:

Comments:

SUNDAY

MONDAY

TUESDAY

WEDNESDAY

THURSDAY

FRIDAY

SATURDAY

2

9-11 Turn in NMPC assignments.

Transitions: Discussion

9

9-12 ATI Testing:

Med-Surg Test

Transitions Discussion

15

Last day for volunteer & clinical hours

16

8-12 ATI Testing

Comprehensive Predictor

Transitions Discussion

1-2:30 pm

Clinical Transitions Wrap-up:

Completed Clinical Evaluation tool due.

Completed personal clinical goals due.

Completed Clinical Calendars due.

Course evaluation due.

Program exit surveys (2)

18

Graduation

*Criteria*	*Ratings*
1. You anticipate problems.	1 2 3
2. You use critical thinking when analyzing clinical decisions.	1 2 3
3. You apply concepts from the sciences and nursing in formulating decisions.	1 2 3
4. You create alternative solutions to clinical problems.	1 2 3
5. You compare diverse viewpoints in the interpretation of data and drawing conclusions.	1 2 3
6. You use verifiable information and clinical judgement in choosing among alternative solutions.	1 2 3
7. You confer with an experienced nurse when encountering a new situation.	1 2 3
8. You recognize and reflect on problems that must be referred.	1 2 3
9. You use appropriate resources to address problems related to client care.	1 2 3

*Criteria*	*Ratings*
1. You adhere to the nurse code of ethics.	1 2 3
2. You develop a method of resolving conflicts among theoretical, personal, and agency values.	1 2 3
3. You practice within legal parameters.	1 2 3
4. You accept accountability for personal and delegated actions.	1 2 3
5. You seek assistance from peers and other members of the health care team in situations that require higher level of knowledge/skill.	1 2 3
6. You maintain organization and client confidentiality.	1 2 3
7. You serve as a positive role model within the health care setting.	1 2 3
8. You advocate for client rights.	1 2 3

*Criteria*	*Ratings*
1. You establish priorities for organizing nursing care among multiple clients.	1 2 3
2. You use a systematic approach for setting priorities.	1 2 3
3. You apply principles of organizing and managing resources.	1 2 3
4. You demonstrate flexibility in adapting to changing situations.	1 2 3
5. You balance human, fiscal, and material resources to achieve quality health care outcomes.	1 2 3
6. You locate community resources to facilitate optional wellness of clients in their communities.	1 2 3

*Criteria*	*Ratings*
1. You establish and maintain effective working relationships.	1 2 3
2. You work independently with others.	1 2 3
3. You initiate referrals when necessary to promote coordination and continuity of care.	1 2 3
4. You initiate interactions with members of the health care team to resolve problems and provide continuity of actions.	1 2 3
5. You serve as an integral member of the health care team.	1 2 3
6. You convey mutual respect, trust, support and appreciation for other members of the health care team.	1 2 3
7. You collaborate to bring about fair solutions that balance differing needs, value, and motivations for the purpose of achieving positive client outcomes.	1 2 3
8. You facilitate continuity of care within and across health care settings.	1 2 3
9. You provide individuals, families, and groups with the information they need to consider available alternatives and make informed choices.	1 2 3

*Criteria*	*Ratings*
1. You provide direction for other members of the health care team as appropriate.	1 2 3
2. You apply appropriate management concepts in assigning and/or delegating nursing care.	1 2 3
3. You supervise other health care personnel when necessary.	1 2 3
4. You determine success of delegated acts.	1 2 3
5. You delegate commensurate with education and experience.	1 2 3

*Criteria*	*Ratings*
1. You perform technical skills competently.	1 2 3
2. You teach the client and significant support persons the information and skills needed to achieve optimal health.	1 2 3
3. You provide individuals, families, and groups with the information they need to consider available alternatives and make informed choices.	1 2 3
4. You incorporate cultural, spiritual, developmental, and socioeconomic client factors into the plan of care.	1 2 3
5. You contribute to the functions of utilization review and continuous quality improvement.	1 2 3
6. You provide caring interventions.	1 2 3
7. You evaluate care based on pre-established criteria.	1 2 3
8. You modify care based on evaluation.	1 2 3
9. You implement the prescribed care regiment within the legal, ethical, and regulatory framework of nursing practice.	1 2 3