NRS 420 Care of the Complex Client

Spring 2017

3.0 units     Wednesdays 0900-1150 am     Broome Library 2330

Course Description

This course focuses on principles of nursing care delivery for patients experiencing more complex medical-surgical, multisystem alterations in health. Enhancement of knowledge in managing the care of patients in the acute care setting and/or in the community in order to maintain maximum levels of function, manage systems, analyze nurse sensitive indicators, and increase quality of life. Focus on care planning for the complex patient utilizing the nursing process and Neuman Systems Model. Emphasis is placed on nursing case management models, roles and strategies used for managing high-risk vulnerable populations, provided comprehensive care coordination within the interdisciplinary team, leadership roles, patient-centered care, patient education, informatics, quality improvement, discharge planning, patient/family advocacy, and inter-professional interventions for the complex patient.

Student Learning Outcomes

1. Explore contemporary issues in professional practice including social, political, organizational, and professional issues (e.g. Joint Commission Standards, Medicare and Medi-cal, Private-Pay Insurance, CMS Hospital Inpatient Value-Based Purchasing Program, Core Measures Sets)

2. Define specific vulnerable populations in the acute care and community-based settings.

3. Identify issues of access to care, case management, and utilization of health services, cost and quality.

4. Examine the major nursing organizations, roles of non-nursing healthcare professionals, and their interrelated roles in collaboration with nursing.

5. Integrate knowledge of pharmacology, pathophysiology, nutrition, established evidence-based practices, and concepts from previous nursing courses when planning care for adult patients with multisystem alterations in health.

6. Use technology to evaluate healthcare apps, resources, and health information available to the patient/family/community and healthcare professionals.

7. Integrate evidence-based knowledge in the management of care to patients with multisystem alterations in health.

8. Analyze healthcare facility policies and related challenges for nursing practice to compare and contrast with evidence based practice for patient centered care.

9. Analyze the scope of nursing practice and related competencies as articulated in ethical, legal, and professional documents (e.g. Scope and Standards of Nursing Practice, Nursing Codes of Ethics, Nurse Practice Acts, QSEN Competencies, NLN Competencies, and BSN Essentials).

Welcome to NRS 420

Instructor Contact Information:

Jaime Hannans, Ph.D., RN, CNE

Office Location: Solano Hall 1172

Phone: (805) 437 - 3308

Email: jaime.hannans@csuci.edu


Office Hours: Wednesdays 12 pm - 1 pm or by appointment

Course Access

This course and course materials will be available on the course website and open on the web. Your grades will still be protected within CI Learn.

Course Materials


There are no required materials or textbook for this course. Aligning with the CSU Affordable Learning Solutions initiatives, and campus efforts, openCI, required readings for this course will be provided through course eReserves, websites, library readings, and multimedia materials.


Recommended resources from prior nursing courses:


Neuman, B. and Fawcett, J. (2001). The Neuman Systems Model (5th Ed.). Philadelphia: J.B. Lippincott Co. Smeltzer et al. (2010)


Brunner Suddarth’s Textbook of Medical Surgical Nursing (12th Ed.). Lippincott Williams and Wilkins (or other med-surg/patho resource of choice)

Course Content Outline

• Introduction to Critical Care Nursing

• Vulnerable Populations and Case Management

• Pulmonary System

• Cardiovascular System

• Hemodynamic Monitoring

• Endocrine Complications

• Care of the Burn Patient

• Hematological and Immune Disorders

• Renal Disease and Failure

• Sepsis and Sepsis Protocols

• MODS and End of Life

• Trauma Care and Disaster Preparation

• Neurological System

• Role of the Graduating Nurse

Commitment to Integrity

As a student in this course (and in this nursing program, at this university), you are expected to maintain high degrees of professionalism, commitment to active learning and participation in this class. You are also expected to maintain integrity in your behavior in and out of the classroom.


CSU Channel Islands Mission Statement

Placing students at the center of the educational experience, California State University Channel Islands provides undergraduate and graduate education that facilitates learning within and across disciplines through integrative approaches, emphasizes experiential and service learning, and graduates students with multicultural and international perspectives.

Course Assignments

Technology is an essential part of our modern culture. Nursing is a blend of art and science, with change and advancements occurring constantly to improve patient outcomes. In this course you will be expected to expand your horizons, taking on new challenges, and create of your own digital identity through the use of CI Keys and development of your ePortfolio as you prepare to graduate. You will be expected to regularly access our course site to follow our schedule, access the assigned materials each week, complete your weekly assignments, and read announcements. To complete the VoiceThread activities for this course, access copyright protected materials, or review grades you will at times also log-in to myCI though CI Learn when instructed. It is my hope, and the goal of this course, that you leave this program with increased knowledge, skills, and attitudes you can apply in nursing practice as you continue to grow.


Key Course Assignments:

These assignments are described further on the course site and/or linked to further instructions and details from this page

ATI Proctored Exam

This course includes a Proctored ATI Exam. The points obtained will be based upon the overall score. Please review the student handbook for the complete ATI policy and remediation plan.


An ATI proctored exam is worth up to 5% of the total course points. The following delineates how the points are determined. Formula for course points for ATI Proctored Exam Assigned by Proficiency Level and/or Need for Remediation is as follows:


Proficiency Level/ Points Earned

These levels are based upon the levels set by ATI

Level 3 (>85%) = 20 points

Level 2 (76 - 85 %)= 17 points

Level 1 and below (< 76%)= 15 points with successful remediation

0 points if remediation plan is not completed


Rationale: ATI defines level 1 proficiency as one who is expected to just meet NCLEX-RN® standards in the content area that has been tested, demonstrating the minimum level of knowledge in this content area required to support academic readiness for subsequent curricular content, and meeting the absolute minimum expectations for performance in this content area. The rationale for the Nursing Program setting the ATI proficiency at level 2 and above, as the standard, is to assure the student achieves a sound foundation for practice.

Course Outline and Readings


Click above to access the course outline, week-by-week schedule, and assigned readings. These are additionally available from your course home page.

Grading Criteria

Letter Grades are as follows:

(See Student Nurse Handbook)

A 95-100%

A- 90-94.9%

B 85-89.9%

B- 80-84.9%

C 76-79.9%

D 65-75.9%

F 64.9 and below


On a +/- grading scale C- is not considered passing the bottom of the scale is set at C 76% with no C- grades. There are no B+ or C+ grades.

Student Expectations

  • Assigned readings, discussions and challenges are to be completed in a timely manner prior to the due date/time.
  • Students should attend all class sessions (unless there is an excused absence based on university policy).
  • Students are expected to follow the Nursing Student Handbook guidelines and have reviewed the updated policies
  • Students are also expected to follow the
    University Student Code of Conduct.
  • We expect students to submit original work and adhere to the CSU Channel Islands Academic Dishonesty policy. Please review the policy and guidelines.
  • It is expected that you communicate with your instructor, especially if you have a concern, as early as possible.
  • The learning environment should be a safe and comfortable place, with respect among peers. Please review the community ground rules for this course.

Tech Requirements

  • Regular access to a computer (not a mobile device)
  • Regular access to the internet
  • A recently upgraded web browser
  • Access to a computer with a microphone or webcam OR a smartphone (iOS or Android)
  • Get more help through CI Technology and Communication Services

ATI has technology requirements as well. Please be sure to investigate the requirements for use prior to assignment due dates. You can find more information at the ATI website where there are also student tutorials under "How To"


If you run into technical problems in this course, you should do the following:

  1. Clear your browser’s cache
  2. Try a different browser (Internet Explorer, Firefox, Safari or Chrome)
  3. Shut down and restart your computer


Disability Resources

CSU Channel Islands is committed to equal educational opportunities for qualified students with disabilities in compliance with Section 504 of the Federal Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA) of 1990. The mission of Disability Resource Programs is to assist students with disabilities to realize their academic and personal potential. Students with physical, learning, or other disabilities are encouraged to contact Disability Resource Programs at (805) 437-3331 for personal assistance and accommodations.


If you are a student with a documented disability who will require accommodations in this course, please register with Disability Resource Programs located in the Educational Access Center, Bell Tower 1541, or call (805) 437-3331 for assistance with developing a plan to address your academic needs. Faculty, students and Disability Resource Programs will work together regarding classroom accommodations. Please discuss approved accommodations with faculty.

Campus Resources

In addition to admissions and advising services, there are a variety of additional student resources. The university offers additional student support through the University Writing and Multi-literacy Center and Learning Resource Center. Counseling and Psychological Services provides student support, wellness information, stress management, and other resources. The Career Center provides support for students related to resume building, mock interviews, and will be hosting a career fair.

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