CLINICAL TEACHING PLAN
Prepared by:
ABANDO, JHONABELLE L.
Student Nurse
PHILOSOPHY, VISION, MISSION, GOALS AND PROGRAM OUTCOMES
PHILOSOPHY Total human development with appropriate competencies
VISION A globally competitive university
MISSION Provides high quality instruction, research and extension
GOAL To lead in transforming human resources into productive self-reliant citizens and responsible leaders
Graduate Professionally competent, Committed and responsible leader, Effective communicator and collaborator, Critical thinker
Attributes and innovator, Reflective lifelong learner, and Responsible environment steward
Core Values SERVICE: Service to our stakeholders
PRODUCTIVITY: Productivity with passion for work
EXCELLENCE: Excellence in our programs through scholarly undertakings
COMMITMENT: Commitment in delivering our mandates
INNOVATIVENESS: Innovation towards attaining operative systems, breakthroughs, and milestone
ADVOCACY: Advocacy in transforming lives
LEADERSHIP: Leadership for transformation, Empowerment, and sustainable development
Program 1. Apply acquired knowledge in physical, social, natural and health sciences, and humanities in the practice of nursing.
Outcomes 2. Practice safe, appropriate and holistic care to individuals, families, population groups, and community utilizing
nursing process.
3. Utilize evidence-based approach in the delivery of care in accordance with the guidelines and principles of nursing
and other existing laws, legal, ethical, and moral principles.
4. Work in collaboration with inter-, intra-, and multi-disciplinary and multi-cultural teams through effective modes of
communication across groups of patients.
5. Document and report up-to-date client care management comprehensively.
6. Demonstrate efficiency in performing management and leadership skills in the delivery of care using applicable
systems approach.
7. Conduct research and other knowledge-creation endeavours necessary for the furtherance of the profession.
8. Engage in lifelong learning and other professional growth and development to keep abreast with the latest trends in
the profession.
9. Demonstrate responsible citizenship and pride in being a Filipino by effectively managing socio-environment problems.
10. Apply techno-intelligent care systems and processes in health care delivery.
11. Manifest the DMMMSUnian and nursing core values in the practice of the profession
12. Show entrepreneurial skills in the delivery of nursing care.
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MS Concepts
AGENCY: Naguilian District Hospital
AREA: ER
SHIFT: 7:00 AM – 3:00 PM
YEAR: BSN IV
SY: 2024-2025
Objectives:
Within 4 days of clinical exposure, students will be able to:
a. Demonstrate understanding and adherence to hospital policies, emergency room protocols, and collaborative practices with multidisciplinary teams.
b. Exhibit confidence and professionalism in applying the nursing process to provide holistic and patient-centered care in emergency situations.
c. Perform accurate and efficient documentation of patient care activities and nursing interventions while maintaining confidentiality and ethical
standards.
d. Develop skills in emergency nursing interventions, such as triage prioritization, medication administration, and life-saving procedures, under
supervision.
e. Reflect on and evaluate their clinical experiences to identify areas for improvement, enhance critical thinking, and apply evidence-based nursing
practices in the emergency room setting.
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Activities Course Content
Day 1
*Orientation to ER set-up and ward staff and hospital personnel.
6:45 am-7:00 am
Pre Conference First Aid for Sprains (RICE Protocol)
● Attendance, uniform, and
paraphernalia check Importance:
● Orientation to the emergency room Immediate and correct management of sprains using the RICE protocol reduces pain, swelling, and long-term joint
environment, staff roles, and damage. Early intervention is key to effective healing and preventing further injury.
protocols
● Discussion of weekly requirements Step-by-Step Procedure:
● Assignment of students to specific
cases or areas (triage,
1. Rest:
resuscitation, observation, etc.)
Avoid using the injured joint.
7:00 am -8:00 am Rationale: Rest helps prevent additional strain and damage to the ligaments.
● Attend endorsement from the 2. Ice:
previous shift Apply cold packs for 15-20 minutes every 1-2 hours during the first 24-48 hours.
Rationale: Ice helps reduce swelling and numbs the pain, providing relief.
8:00 am -10:30 am 3. Compression:
Hands-On Nursing Activities
Wrap the joint with an elastic bandage, ensuring it’s not too tight.
● Monitor and assess incoming
patients in triage Rationale: Compression helps control swelling and provides support to the injured area.
● Assist in taking vital signs, patient 4. Elevation:
history, and documentation Keep the limb above heart level.
● Observe and assist with emergency Rationale: Elevation reduces blood flow to the injured area, helping decrease swelling.
procedures (e.g., wound care, IV
insertion, CPR) Example Scenario:
● Orientation to crash carts, You assist a basketball player who sprained his ankle by explaining and guiding him through the RICE protocol.
emergency medications, and
After applying the steps, the swelling is noticeably reduced.
equipment
● Carrying out doctor’s orders under
supervision First Aid for Stroke (FAST Protocol)
10:30 am -10:45 am
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Activities Course Content
(1st batch break) Importance:
The FAST protocol helps quickly identify the signs of a stroke, ensuring that the patient receives timely medical
10:45 am -11:00 am attention. Early treatment can minimize brain damage and improve patient outcomes.
(2nd batch break)
Step-by-Step Procedure:
11:00 am -12:00 pm
● Continue supervising the co-
1. Face:
students on nursing process or
Clinical Activities Ask the patient to smile and check for drooping.
Rationale: Facial drooping is a key indicator of stroke and suggests possible nerve involvement.
12:00 pm -12:30 pm 2. Arms:
(1st batch lunch break) Ask the patient to raise both arms and observe if one arm drifts downward.
Rationale: Weakness in one arm is a common sign of stroke.
12:30 pm -1:00 pm 3. Speech:
(2nd batch lunch break)
Ask the patient to repeat a simple sentence. Look for slurred speech or trouble speaking clearly.
1:00 pm -2:00 pm Rationale: Speech difficulty is another hallmark of stroke.
● Continue monitoring and 4. Time:
documenting patient conditions Note when symptoms started and call emergency services immediately.
● Prepare and administer afternoon Rationale: Time is critical for stroke treatment, as early intervention can prevent further damage.
medications
Example Scenario: Patient Pedro suddenly develops slurred speech and arm weakness. You perform the FAST
2:00 pm -3:00 pm assessment, document the onset of symptoms, and immediately call emergency services to ensure he receives
Post conference:
prompt treatment.
Topic Discussion:
● FIRST AID OF INJURY AND STROKE
● Evaluation of Nursing Process
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Activities Course Content
Day 2
ECG Placement
6:45 AM - 7:00 AM: Pre-Conference
Importance:
● Attendance, uniform, and Proper ECG placement is crucial for accurate monitoring of the heart’s electrical activity. Correct electrode
paraphernalia check.
placement ensures reliable heart rhythm readings, essential for diagnosing conditions like arrhythmias, myocardial
● Review of Day 1 experiences and
key takeaways. infarctions, and other cardiac irregularities.
● Assignment of new cases or roles
(triage, observation, Step-by-Step Procedure:
resuscitation).
● Orientation to the day’s 1. Clean the patient’s skin where electrodes will be placed.
objectives. Rationale: Cleaning the skin removes oils and debris that could interfere with the electrode’s conductivity,
ensuring clear and accurate readings.
7:00 AM - 8:00 AM 2. Attach Limb Leads:
● RA (Right Arm): Inner aspect of the right wrist or shoulder.
● Attend shift endorsement and
updates on patient progress. ● LA (Left Arm): Inner aspect of the left wrist or shoulder.
● Familiarize co-students with new ● RL (Right Leg): Inner aspect of the right ankle or thigh.
patient cases. ● LL (Left Leg): Inner aspect of the left ankle or thigh.
● Rationale: Limb leads serve as the baseline for the ECG signal.
8:00 AM - 10:30 AM: Hands-On Nursing
Activities
● Assist in monitoring patients in 3. Attach Chest Leads (Precordial):
triage or observation areas.
● Perform nursing interventions
● V1: 4th intercostal space, right of sternum.
(e.g., wound care, medication
administration, vital signs ● V2: 4th intercostal space, left of sternum.
monitoring). ● V3: Midway between V2 and V4.
● Assist with emergency procedures. ● V4: 5th intercostal space at the midclavicular line.
● V5: Horizontally aligned with V4, at the anterior axillary line.
● V6: Horizontally aligned with V4 and V5, at the midaxillary line.
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Activities Course Content
● Carry out doctor’s orders and ● Rationale: Chest leads monitor the electrical activity of specific areas of the heart (anterior, lateral, and
update documentation under septal walls).
supervision.
4. Check Lead Placement:
10:30 AM - 10:45 AM: 1st Batch Break
10:45 AM - 11:00 AM: 2nd Batch Break ● Ensure electrodes are secure, and confirm the correct positioning of all leads before starting the ECG
11:00 AM - 12:00 PM: Clinical Activities recording.
● Rationale: Prevents artifacts and ensures clear waveforms on the ECG.
● Supervise co-students in assessing
and documenting patient care.
● Continue hands-on practice and
observation in resuscitation or
observation units.
12:00 PM - 12:30 PM: 1st Batch Lunch
Break
12:30 PM - 1:00 PM: 2nd Batch Lunch
Break
1:00 PM - 2:00 PM: Afternoon Clinical
Activities
● Administer afternoon medications.
● Monitor and update documentation
for assigned patients.
● Assist in patient education (e.g.,
discharge instructions).
2:00 PM - 3:00 PM: Post-Conference
Topic Discussion:
● ECG PLACEMENT
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Activities Course Content
● Evaluation of students’
understanding and application of
the nursing process.
Day 3
Breathing Techniques and Coughing
6:45 AM - 7:00 AM: Pre-Conference
Coughing
● Attendance, uniform, and
paraphernalia check. Importance:
● Recap of Day 2 experiences and
Coughing is vital for facilitating the removal of secretions, preventing infections such as pneumonia, and ensuring
learnings.
● Assignment of students to new the lungs remain clear. It is an essential technique for postoperative patients, particularly those who have
roles or specific patients. undergone abdominal, thoracic, or any major surgeries that can restrict normal lung expansion.
7:00 AM - 8:00 AM Step-by-Step Procedure:
● Receive shift endorsements and 1. Splint the incision (if any) with a pillow or folded towel.
updates on ongoing patient cases. Rationale: Provides comfort and reduces pain, especially in postoperative patients when coughing. It helps
prevent strain on the surgical site.
8:00 AM - 10:30 AM: Hands-On Nursing
Activities 2. Ask the patient to take a deep breath, hold it for 3 seconds, then cough deeply two or three times.
Rationale: Deep breathing expands the lungs, while multiple coughs are more effective at mobilizing
● Monitor and assess incoming secretions than a single cough. This method promotes better secretion clearance.
patients in triage 3. Perform this every 2 to 3 hours postoperatively.
● Assist in taking vital signs, patient Rationale: Regular coughing helps prevent mucus accumulation and lung collapse (atelectasis), reducing
history, and documentation
the risk of postoperative pneumonia.
● Assist in monitoring patients in
triage or observation areas.
● Carrying out doctor’s orders under
supervision Deep Breathing
Importance:
Deep breathing exercises improve lung ventilation, enhance oxygen exchange, and help to mobilize secretions.
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Activities Course Content
This technique is essential for preventing atelectasis, a condition where parts of the lungs collapse due to lack of
10:30 AM - 10:45 AM: 1st Batch Break expansion, especially after surgery or during immobility.
10:45 AM - 11:00 AM: 2nd Batch Break
Step-by-Step Procedure:
11:00 AM - 12:00 PM: Clinical Activities
1. Position the patient in Fowler’s or sitting position.
● Continue monitoring patients.
● Perform supervised interventions Rationale: This position allows for full lung expansion and alleviates pressure on the diaphragm, enabling
and update nursing deeper and more effective breaths.
documentation. 2. Ask the patient to place their hands along the lower rib cage to feel diaphragm movement.
Rationale: This encourages the patient to focus on their diaphragm and ensures that they are engaging the
12:00 PM - 12:30 PM: 1st Batch Lunch correct muscles for effective breathing.
Break
3. Instruct the patient to inhale fully through the nose, hold for 2-3 seconds, then exhale slowly through
12:30 PM - 1:00 PM: 2nd Batch Lunch
Break the mouth.
Rationale: Nasal breathing filters, warms, and humidifies the air, while slow exhalation prevents
1:00 PM - 2:00 PM: Afternoon Clinical hyperventilation, reduces the risk of dizziness, and promotes better secretion mobilization.
Activities
● Administer medications under Pursed-Lip Breathing
supervision.
● Monitor and update documentation Importance:
for assigned patients.
Pursed-lip breathing slows down exhalation and helps prevent airway collapse, especially in patients with chronic
● Assist in patient education (e.g.,
discharge instructions). obstructive pulmonary disease (COPD). This technique also reduces shortness of breath and helps to manage
conditions that cause air trapping, such as emphysema or asthma.
2:00 PM - 3:00 PM: Post-Conference
Step-by-Step Procedure:
Post conference:
Topic Discussion: 1. Ask the patient to take a deep breath through the nose.
● BREATHING TECHNIQUES (e.g., Rationale: Promotes full lung expansion.
diaphragmatic breathing, 2. Hold the breath momentarily.
pursed-lip breathing).
Rationale: Allows time for the alveoli to expand fully.
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Activities Course Content
● Evaluation of students’ ability to 3. Exhale slowly through pursed lips, as though blowing out a candle.
apply the nursing process Rationale: This creates a backward pressure that keeps airways open during exhalation, preventing air
effectively. trapping and promoting more efficient gas exchange.
Day 4
Basic Wound Care
6:45 AM - 7:00 AM: Pre-Conference
Importance:
● Attendance, uniform, and Proper wound care prevents infection, promotes healing, and reduces complications like wound dehiscence or
paraphernalia check.
abscess formation. It is essential for ensuring that surgical or traumatic wounds heal properly without
● Reflection on Day 3 experiences
and key takeaways. complications.
● Assignment of students to new
roles or specific patients (triage, Step-by-Step Procedure:
resuscitation, observation, etc.)..
1. Prepare for the Procedure:
7:00 AM - 8:00 AM ● Wash hands thoroughly and gather all necessary supplies (sterile gloves, saline, gauze, dressing, and
adhesive materials).
● Receive endorsements and updates ● Rationale: Ensures aseptic technique and reduces contamination.
on ongoing patient cases. 2. Assess the Wound:
● Familiarize students with patient ● Inspect the wound for signs of infection, such as redness, swelling, discharge, or odor.
progress and specific treatments. ● Measure the wound size if required.
● Rationale: Assessing the wound helps in determining the appropriate dressing and identifying potential
8:00 AM - 10:30 AM: Hands-On Clinical complications early.
Activities 3. Clean the Wound:
● Using sterile gloves, clean the wound gently from the center outward with saline-soaked gauze. Avoid
● Monitor and assess incoming scrubbing or applying pressure.
patients in triage or observation ● Rationale: Cleaning from the center outward prevents spreading contaminants into the wound. Saline
areas. solution is non-irritating and promotes a conducive environment for healing.
● Provide nursing care such as 4. Debridement (if necessary):
administering medications, taking ● If there is dead tissue (necrosis), gently remove it using sterile tools or consult a physician for advanced
vital signs, or assisting with debridement methods.
procedures. ● Rationale: Removing necrotic tissue prevents infection and facilitates healthy tissue growth.
5. Apply Topical Treatments (if prescribed):
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Activities Course Content
● Assist in emergency procedures ● Apply an antimicrobial ointment or prescribed medication as directed.
(e.g., CPR, oxygen therapy, IV line ● Rationale: Topical treatments can prevent infection and promote tissue repair.
insertion). 6. Cover the Wound:
● Collaborate with the healthcare ● Apply a clean, sterile dressing over the wound. Use an appropriate dressing type based on the wound's
team in managing critical cases. condition (e.g., gauze, hydrocolloid, or foam dressing).
● Carry out doctor’s orders and ● Rationale: A sterile dressing protects the wound from contaminants, absorbs drainage, and maintains a
ensure proper documentation. moist environment conducive to healing.
7. Secure the Dressing:
10:30 AM - 10:45 AM: 1st Batch Break ● Use adhesive tape or bandages to secure the dressing without applying excessive pressure.
10:45 AM - 11:00 AM: 2nd Batch Break ● Rationale: Proper securing ensures the dressing stays in place and does not interfere with circulation or
movement.
11:00 AM - 12:00 PM: Clinical Activities 8. Dispose of Used Materials Safely:
● Discard gloves, gauze, and other materials in a biohazard bag.
● Continue monitoring patients, ● Wash hands thoroughly.
updating charts, and supervising ● Rationale: Proper disposal reduces the risk of spreading infection.
nursing interventions.
● Assist in patient education for
discharge planning or home care
instructions.
12:00 PM - 12:30 PM: 1st Batch Lunch
Break
12:30 PM - 1:00 PM: 2nd Batch Lunch
Break
1:00 PM - 2:00 PM: Afternoon Clinical
Activities
● Administer afternoon medications
and ensure timely interventions.
● Monitor patient conditions and
review changes in status.
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Activities Course Content
● Collaborate with the healthcare
team for any follow-up care or
transfers.
2:00 PM - 3:00 PM: Post-Conference
● Topic Discussion: BASIC WOUND
CARE AND RECALL OF TOPICS
DISCUSS FROM DAY 1-3
● Quiz time
● Evaluation of students’ application
of the nursing process, clinical
skills, and teamwork during the
rotation.
● Reflection on overall ER
experience and feedback for
improvement.
References: 4. National Institutes of Health (NIH). (2022). Breathing techniques for
lung health: Pursed-lip and deep breathing exercises. Retrieved
1. American Heart Association. (2021). Basic ECG interpretation and from https://www.nih.gov
electrode placement. Retrieved from https://www.heart.org 5. Centers for Disease Control and Prevention. (2021). Postoperative
2. National Institute of Neurological Disorders and Stroke. (2023). respiratory care: Techniques for preventing pneumonia. Retrieved
Stroke signs and symptoms: FAST protocol. Retrieved from from https://www.cdc.gov
https://www.ninds.nih.gov 6. World Health Organization (WHO). (2022). Basic wound care and
3. Mayo Clinic. (2023). Sprains and strains: RICE protocol for infection prevention. Retrieved from https://www.who.int
treatment. Retrieved from https://www.mayoclinic.org
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