NURS 3315 Holistic Health Assessment

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Submit quiz and assignments by 2359 Saturday of the week in which Module 5 is covered.

Complete the last discussion board posting following the instructions given, initial post must be by Wednesday at 2359 and replies by Saturday night at 2359.

Overview: Ecomap and Final SBAR. You will do the subjective assignment of the family environment using the ecomap. Finally, you will complete a final SBAR of an urgent hypothetical problem, different than any SBARs you have previously submitted. Instructions and rubrics for both of these assignments follow:

 You will read about the reproductive system this week, but you will not be doing an assessment of it. Your reproductive system knowledge will be evaluated by the quiz rather than by assessment forms.

 Family context assessment: The ecomap.

In the ecomap, you will depict the family which you are assessing (it can be your own or that of someone else). In the center are the nuclear family members. Around the large circle containing the family, you will display the top 2 – 4 attachments which exist outside the nuclear family for each member, such as school, work, or other social attachments (like church groups or clubs). (If the family is so large that there is not enough space, limit the family members displayed to 5 – 6 members.) Show the strength of attachment, the amount of stress caused by each attachment, and the direction of the relationship, using Figure 33-4 in your textbook as a guide. Note that this exercise does not depict relationships between family members, but relationships that each family member has with those outside the family.

Another example of an ecomap is given in the ecomap section of the assignment directions on Blackboard, and a template form is provided which you can use to make your ecomap. The provided template is in Microsoft Word and you can add or delete circles (females), squares (males), lines (attachments) and arrows (direction of the relationship). In Word, go to INSERT on the top menu and you will see an option, “Shapes” where you can select the things you wish to insert into the document.

If you like PowerPoint and can use it without a huge time investment, you may prefer to use it—any format is fine as long as the finished product is similar to the example in the textbook. It is acceptable to draw the Ecomap freehand on a sheet of paper and simply

Module 5 Assignment: Ecomap and Final SBAR

NURS 3315 Holistic Health Assessment

©2014 UTA School of Nursing Page 2 of 5

scan it and upload it as your assignment.

Make sure to include the elements of:

 the family—in a family circle with the gender depicted correctly,

 the elements in their lives (work, school, etc.),

 the attachment symbols showing how strong (number of attachment lines), which directions (arrows), and how stressful their attachments are (cross-hashes).

 See the rubric for scoring.

Levels of Achievement

Criteria Expert Competent Needs work Inadequate

info Missing

Ecomap: Members of the nuclear family

30 points Members of the nuclear family depicted as circles (females) or squares (males) by initials, in a circle representing the family.

0 points Members are not depicted correctly

Ecomap: Elements to which family members are attached (such as school, church, social

clubs, etc.)

20 points At least 2 attachment elements are depicted for each family member

0 points One element is shown for at least one member, done incorrectly.

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A final SBAR (realistic—see directions below) is to be done this week along with the family assessment items.

 Select a new realistic but hypothetical or potential problem, which you have not addressed in a previous SBAR and demonstrate your mastery of the SBAR model of team communication. You may select a serious hypothetical problem—a “fake situation” as one of my students has called it, and work out the scenario in SBAR format. I recommend using a situation that could happen in your workplace since that is what you know the best—again, to avoid HIPAA violations don’t use a real patient, just use a “true to life” scenario. (Notice the patient name on the form is to be either John or Jane Doe—just as a reminder.) The reason for having SBARs in the class is because

Ecomap: Strength of Attachment is shown

20 points Strength of attachment is shown, with the number of lines showing the strength of attachment. (Even if the relationship is unhappy, some attachment is present.)

0 points Strength of attachment is not correctly shown.

Ecomap: Stress of attachments are shown

20 points Amount of stress for attachments are shown as hash marks across the relationship lines.

0 points Stress of relationships not depicted

Ecomap: One-way or two-way relationship?

10 points Arrows are shown depicting the direction of the relationship: One arrow, two arrows or a double-headed arrow for each party in the relationship.

0 points No directional arrows shown to represent one or two-way relationships.

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employers asked us to include it because so many new nurses have a hard time calling physicians about patient needs. This will give you the benefit of problem-solving before the pressure is on. Of course, many of you have vast experience and use SBAR or something like it every day—you can think of something that happened in your experience, embellish it to make it different than what actually happened, and use it for your SBAR situation.

Remember, SBARs can be directed to diabetic nurse educators or to dietitians or any member of the health care team, not only to physicians. DO make sure the problem is about a patient rather than, for instance, staffing or some unit-wide infection control issue—this is an assessment class, so the SBARs need to reflect something from an individual’s physical or mental assessment. (Note the content above in bold print—in every session, some students try to re-use an old SBAR—we catch it because our anti- plagiarism software shows that the problem was used already by the student in the session. Since it is their own, they don’t hear from Student Conduct about plagiarism, but they do get a 0 on the assignment. You must have a new realistic or potential problem for the Final SBAR.) If you work with a population you were not able to assess in this class because of the class requirements, such as a child or infant, you can still do the Final SBAR on them. We want your SBAR to show that you can apply the concept in a situation that corresponds to your work. If you are a pedi nurse, you can do the SBAR on a child.

See the rubric below:

NURS 3315 Holistic Health Assessment

©2014 UTA School of Nursing Page 5 of 5

Performance Objectives:

Collect subjective data to include present health concerns, past health history, family history and lifestyle/health practices related to:

 Family assessment, specifically the ecomap.

 Do the final SBAR, demonstrating mastery of this model.

Levels of Achievement

Criteria Expert Competent Needs work Inadequate

info Missing

SBAR Situation

20 Points Situation or

current problem –

the reason why

this problem is

important, how

severe, when it

started.

15 Points Situation is too

wordy or too

brief, not as

clearly identified

as it should be.

10 Points The problem is

stated too

briefly or

clumsily to be

clear.

5 points

Situation is

not

synthesized

correctly and

conclusion is

erroneous.

0 Points Missing

SBAR Background

30 Points Health history

relating to this

problem, what is

being done, and

what assessment

findings are most

important now.

25 Points Background too

wordy or too

brief, but

captures pertinent

data.

15 Points Information

given is vague

or some

pertinent data

is missing,

some relevant

data present.

10 Points Few relevant

data are given

or format not

followed.

0 Points Missing

altogether or

poorly executed

so that

background

cannot be

understood.

SBAR Assessment

30 Points Assessment

names the trouble

in a word or

phrase that briefly

captures the

problem and rates

the urgency.

25 Points Too wordy and

cites things that

belong in

situation or

background, in

addition to

capturing the

problem.

15 Points The problem is

stated too

briefly to be

clear.

10 Points Problem is not

synthesized

correctly.

0 Points Missing or

incorrect.

SBAR Recommendation

20 Points What needs to

happen next?

Recommendation

is appropriate for

the situation.

15 Points Recommendation

has merit but is

not the best

choice for this

situation or is not

stated well.

10 Points Recommendati

on has minimal

merit and is not

appropriately

stated.

5 Points Recommendat

ion is present

but is patently

incorrect.

0 Points Missing