Emergency Nursing

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COPYRIGHTS AND AMENDMENTS

COPYRIGHT AND AMENDMENTS

All rights reserved. © 2016 Saudi Commission for Health Specialties.

This material may not be reproduced, displayed, modified, or distributed without prior written
permission of the copyright holder.

No other use is permitted without prior written permission of the Saudi Commission for Health
Specialties.

For permission, contact the Saudi Commission for Health Specialties, Riyadh, Kingdom of Saudi Arabia.

Any amendment to this document shall be approved by the Specialty Scientific Council and the
Executive Council of the commission and shall be considered effective from the date of updating the
electronic version of this curriculum published on the commission’s website unless a different
implementation date has been mentioned.

P.O. Box: 94656

Postal Code: Riyadh 11614

Contact Center: 92-001-9393

Website: www.scfhs.org.sa

Formatted and Designed by:


Salem M Altamimi (SCFHS)/Manoj Thomas Varghese, CMT (SCFHS)

ii SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


ACKNOWLEDGEMENTS

ACKNOWLEDGEMENTS
Throughout the process of writing this program, several individuals have taken time to provide
feedback, enriching the program and its content. We would like to give a special thanks to the Nursing
Scientific Board Members for actively participating in the feedback and contributions to this program.

We also appreciate the Saudi Commission Continuous Training Committee Members for their feedback
and support throughout the development of the emergency diploma program. We would like to offer
an extra special thanks to Drs. Zubair Amin and Sami Al Shammarri for their guidance on modifying this
program.

Finally, we would like to state to all of those who have contributed to the components of this program,
including Ms. Husna AlNasr, that without their insight and assistance, the development of this program
might have been much more difficult.

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM iii


TABLE OF CONTENTS

TABLE OF CONTENTS
INTRODUCTION 1
GENERAL TRAINING REQUIREMENTS 3
PROGRAM OVERVIEW 4
PROGRAM OBJECTIVES 5
ADMISSION REQUIREMENTS 6
PROGRAM REQUIREMENTS 7
TEACHING AND LEARNING METHODS 8
Methods of teaching 8
Clinical practicum 8
Hospital rotations 9
Methods of evaluation 9
Method of assessment 10
MODULES OF FIRST YEAR TRAINING 11
Module I: Foundation of emergency nursing 11
Module II: Foundations of emergency nursing practicum I 12
Module III: Pharmacological management of emergencies 13
Module IV: Pathophysiological changes in emergency nursing 14
Module V: Management of behavioral problems and psychosocial concepts 15
Module VI: Ethics in nursing and dimension of care 16
Module VII: Epidemiology 17
Module VIII: Biostatistics 17
MODULES OF SECOND YEAR TRAINING 19
Module IX: Introduction to research and evidence based practice 19
Module X: Trauma assessment and nursing consideration 19
Module XI: Major trauma and surgical emergencies 20
Module XII: Clinical practicum in emergency nursing II 22
Module XIII: Clinical practicum in emergency nursing III 23
Module XIV: Nursing informatics 23
Module XV: Leadership and management 24
Module XVI: Professional performance 25
ASSESSMENT 26
Continuous evaluation 26
Centralized examinations 26
Promotion examination 26
Final (End-of-program) examinations 27
Certification 27
REFERENCES 28
APPENDICES 30
iv SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM
TABLE OF CONTENTS

Appendix A 30
Appendix B 31
Appendix C 32
Appendix D 34
Appendix E 36
Appendix F 37
Appendix G 38
Appendix H 39
Appendix I 40
Appendix J 41
Appendix K 42
Appendix L 42

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM v


INTRODUCTION

INTRODUCTION

Emergency care deals with human responses to any trauma or sudden illness that requires immediate
intervention to prevent imminent severe damage or death. Care is provided in any setting to persons
of all ages with actual or perceived alterations in physical or emotional health. Initially, patients may
not have a medical diagnosis. Care is episodic when patients return frequently, primary when it is the
initial option for health or preventive care, or acute when patients need immediate and additional
interventions.

Emergency care is typically sought for serious injuries and acute medical conditions (i.e., heart attack
or stroke). However, excessive delays and overcrowding of emergency departments (EDs) have
become serious problems, thus, causing concern about compromised care.

Time is truly an important factor in the care of emergency and trauma patients. The acuity and
complexity of nursing practice in diverse settings continue to grow. As a result, emergency and trauma
nurses are faced with challenges of varying degrees from practice issues and healthcare system
delivery complexities that effectively and adequately prepare a confident and competent nurse or
nurse specialist. Essential practice patterns in emergency and trauma integrate clinical and non-clinical
practitioners to deliver appropriate, efficient, and effective care to healthcare consumers.

Emergency Nursing is the provision of immediate nursing care to people who have identified their
problem as an emergency or where nursing intervention may prevent an emergency arising. The
emergency nurse accepts (without prior warning) any person requiring healthcare with
undifferentiated and undiagnosed problems originating from social, psychological, physical, spiritual,
or cultural factors. The emergency nurse must lead, initiate, and coordinate patient care. This includes
rapid patient assessment, prioritizing care, appropriate intervention - based on assessment, ongoing
evaluation, and discharge or referral to other sources including discharge education where indicated.
Emergency nurses play a major role in disaster response and have the knowledge and skills to care for
mass casualties to ensure maximum survivability is achieved. An emergency nurse is a medical
professional who specializes in emergency care. This type of nursing focuses on identifying serious
problems in incoming trauma cases and on stabilizing those patients so that they can receive further
medical treatment.

There are number of arenas in which a trauma nurse can work; employment prospects in this field are
generally very good, as these nurses are constantly in demand globally. One of the most common
places for a trauma nurse to work is in an emergency room, processing incoming patients. Nurses can
also work in critical care units, applying their specialized training to patients who may be prone to
experiencing medical emergencies and various crises.

The key requirement for people in this field is the ability to work under pressure. They may be required
to cope with chaotic environments, stressful situations, and catastrophic trauma cases. These nurses
must often contend with cultural and language barriers and they must be able to coordinate with
doctors, other nurses, and healthcare professionals who work together as a team to provide
patient care.

Therefore, this postgraduate diploma in emergency specialty is designed to assist students to exercise
critical thinking skills to anticipate patients’ immediate needs and demands in the emergent and critical
phases of patients’ clinical courses. Furthermore, this post-graduate diploma program prepares
professional nurses to develop abilities to be competent and safe in providing emergency and disaster
nursing care in a variety of high dependence emergency settings.

1 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


INTRODUCTION

Emergency Care in Saudi Arabia


Saudi Arabia is undergoing rapid population growth; along with improved socioeconomics, many
individuals now own a car or even a number of cars per family, resulting in a greater number of
vehicles on the roads. The reduced focus on public transportation systems and the dependence on cars
for transportation have created many drivers who are unfamiliar with local driving rules and lack basic
skills for safe driving. This is in addition to some young drivers who frequently violate traffic laws and
tend to speed most of the time. This unplanned expansion in road traffic has resulted in more car
accidents, injuries, disabilities, and deaths. Accompanying that is an increased socioeconomic burden,
depletion of human resources, emotional and psychological stress on families, and strain on healthcare
facilities. If this continues without prompt intervention, it will lead to increased insurance premiums
and may become unmanageable.

To minimize this impact, a national or regional multidisciplinary trauma system has to be developed
and implemented. A trauma system is a preplanned, comprehensive, and coordinated regional injury
response network that includes all facilities with the capability to care for the injured. Essential
components of the system include trauma prevention, pre-hospital care, hospital care, rehabilitation,
system administration, trauma care education and training, trauma care evaluation and quality
improvement, and societal participation. Research has documented a significant decrease in morbidity
and mortality from trauma after the implementation of such systems, depending on their efficiency.
The population in Saudi Arabia increased1 from 26 million in 2004 to 29,897,000 million in 2015, with
further growth projected to 45 million by the year 2025. Healthcare facilities are expanding to meet
the demand of the population. This expansion, of course, requires more trained/specialized healthcare
professionals. The Saudi Arabian Red Crescent Society Emergency Medical Services Year-End
Accountability Report (1426 H) indicates the total requests/referrals of critical cases to emergency
rooms in the Eastern Province increased from 1423 H – 1426/1427 H by 46.6%.

Hence, the previous information mandate to develop an emergency program that enables healthcare
professionals and nurses in particular to be trained specifically to care for people in different
emergency situations.

1
Further information can be obtain from Central Department of Statistics and Information via URL:
http://www.cdsi.gov.sa/
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 2
GENERAL TRAINING REQUIREMENTS

GENERAL TRAINING REQUIREMENTS

1) The trainee shall abide by the training regulations and obligations set by the Saudi
Commission for Health Specialties (SCFHS).
2) Training is a full-time commitment. The trainee shall be enrolled in full-time, continuous
training for the entire duration of the program.
3) Training is to be conducted in institutions accredited for nursing training by the Saudi
Commission for Health Specialties.
4) The training will be comprehensive in the specialties of emergency nursing.
5) The trainee shall be actively involved in patient care with gradual progression of responsibility.

3 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


PROGRAM OVERVIEW

PROGRAM OVERVIEW

The Advanced Nursing Practice Diploma in Emergency program is a module-based one that melds a
comprehensive curriculum of emergency nursing theory and clinical practice. These modules provide
the necessary pathophysiology, assessment frameworks, and nursing theory to enable nurses to serve
a multicultural client base presenting a diverse range of illness and injury from a wide age spectrum.

This program is designed to provide an opportunity for professional nurses to develop a specialized
practice and to upgrade knowledge and clinical competence in the area of emergency and disaster
nursing based on international standards. It is constructed in a form that enables the learner to
understand and apply the necessary knowledge, skills, and attitudes about contemporary nursing
issues, theory, and research to emergency and disaster nursing practice. It also focuses on creating
learning opportunities and exemplar case studies that contribute to quality practice environments.

The program aims at facilitating the learner’s personal and professional growth in emergency and
disaster nursing by enhancing critical thinking skills necessary for making rapid, sound nursing
judgments and demonstration of self-direction in providing immediate emergency care in a variety of
high dependency emergency settings such as pre-hospital, emergency department, burn, and trauma
units. Furthermore, this program will synthesize evidence-based data and theoretical knowledge to
deliver immediate, competent, culturally sensitive care, as well as develop expertise in utilizing human
and material resources to support clinical reasoning.

Upon completion of the program, the learner will earn an Advanced Nursing Practice Diploma in
Emergency. This program is offered under the supervision of the Saudi Commission of Health
Specialties.

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 4


PROGRAM OBJECTIVES

PROGRAM OBJECTIVES

Upon completion of the Advanced Nursing Practice Diploma in Adult Emergency Specialty, the learner
will be able to:
1) Provide specialized knowledge and skills to contribute to the development of emergency care.
2) Understand the professional issues influencing emergency nursing and the wider nursing
profession.
3) Apply management principles for acutely ill and traumatized patients, including multiple
casualties in different health settings.
4) Implement a systematic patient assessment.
5) Incorporate advanced life support skills in the management of traumatized ill patients.
6) Understand the implications of hazards and risk potential risk when managing emergencies.
7) Plan for health promotion, prevention of diseases, and recovery from emergency and
disasters.
8) Apply infection control measures when caring for emergency/disaster patients and their
families.
9) Utilize an evidence-based and research-supported approach in evaluating nursing practice
within an emergency department.
10) Manage ethical issues concerning emergency/disaster care of patients and their families in
accordance with Saudi Arabia’s rules and regulations.
11) Apply leadership concepts in emergencies.
12) Apply quality improvement concepts in evaluating emergency nursing care.

5 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


ADMISSION REQUIREMENTS

ADMISSION REQUIREMENTS

To be eligible to enroll in the program, the applicant must conform to the application requirements of
the Saudi Council of Health Specialties, in addition to the following:
1) Be a graduate with a bachelor of nursing (BSN) degree or equivalent.
2) Have completed the internship year
3) Interview successfully.
4) Have a valid nursing license from the SCFHS.
5) Be prepared to study on full-time basis.
6) Provide a letter from employer allowing participation.
7) Being physically fit.

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 6


PROGRAM REQUIREMENTS

PROGRAM REQUIREMENTS

In order to obtain an Advanced Practice Clinical Nursing Diploma in Adult Emergency, the candidate
must fulfil the following requirements:

1) The period for completing this program is two calendar years.


2) The program consists of 44 weeks per calendar year, excluding examination weeks and annual
vacation. A total of 88 weeks must be completed for the entire study period.
3) A total of 48 didactic and clinical hours must be completed each week.
4) Trainees may complete clinical rotations as an 8-hour shift per day, excluding lunchtime, or as
a 12-hour shift to complete a total of no more than 40 hours per week.
5) The language of instruction for the program is English.

Leaves
1) The trainee is entitled to an annual leave of thirty days in addition to an Eid's leave.
2) Sick leaves, maternity leaves, and exceptional ”emergency” leaves for a period not exceeding
ninety days shall be compensated by an equivalent period of days before the trainee is
awarded the Certificate of Training Completion.
3) Leaves 2 that are not utilized in due time within the year shall not be shifted to the coming
year.
4) Trainee may be granted a special leave for scientific purposes nor exceeding seven days per
training year to attend scientific conferences, seminars, or workshop in the same specialty
provided that trainee presents proof of attending such activities.

2
For further information on leaves, refer to article (6) in Rules of Procedure for Training of Saudi Board
Specialties Booklet, 4th edition. 2012 that can be accessed through URL:
http://www.scfhs.org.sa/en/Reglations/Documents/Rules%20of%20Procedure%20for%20Traini
ng%20of%20Saudi%20Board%20Specialties.pdf
7 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM
TEACHING AND LEARNING METHODS

TEACHING AND LEARNING METHODS

Methods of teaching
This includes the following:
1) Interactive lecture and discussion
2) Computer assisted interactive instructional programs
3) Weekly reading assignments and use of SCFHS digital library3
4) Simulations and clinical skills demonstration
5) Presentations
6) Group discussion of case studies
7) Clinical practicum including theory to precede related clinical assignment (as needed), post
clinical debriefing (one to two per week), and the development of nursing plans of care for
selected patients (Appendix K).

The Advanced Practice Clinical Nursing Diploma in Adult Emergency contains sixteen modules
addressing the education and training of nurses who will provide comprehensive emergency care to
clients. Each one of these modules includes specific competencies. The clinical competencies of the
program are adopted from Mosby’s online nursing skills database and some were modified for this
program. Each trainee will be issued a username and a password to access the Mosby’s Nursing
Consult database. The trainee is expected to perform competency online testing. Results of these tests
will be monitored by the assigned clinical instructor. The assigned clinical instructor, based on the
trainee’s score on the online exam, will schedule the trainee for a competency checklist review in the
nursing skills laboratory. The attached checklist is used as a tool to monitor the competency review for
each trainee.

Clinical practicum
1) Theory to precede related clinical assignment (as needed).
2) Post clinical debriefing sessions will be conducted once or twice per week as needed for
presentation of individual work and development of nursing care plans for selected patients.

Case presentation guidelines


Each student will present a case study of a patient treated in the clinical setting. Case presentation is to
include: patient’s past medical/surgical history, diagnosis, treatment, and nursing diagnosis with
appropriate assessment findings with identification of optimal outcomes. Presentations are to be
approximately 15 minutes with the student facilitating the post-presentation discussion. Discussion is
to include a comparison of plans of care with the current Mosby Clinical Skills Adult Emergency Nursing
and any other related evidence-based practice standards for adult emergency practice.

3
SCFHS digital library provides Instructor and trainee with access to diverse electronic learning resources that
provide full-text for evidence-based for best practice such as Ovid Medical Collection, Mosby’s Nursing consult,
LexiComp, PubMed Central Journal and UpTodate. Digital library can be browsed through URL:
http://www.scfhs.org.sa/eservices/ELibrary/Pages/default.aspx
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 8
TEACHING AND LEARNING METHODS

Hospital rotations
A significant proportion of problems are frequently encountered in emergencies. Therefore, to
experience the nurse’s role in emergency and disaster nursing, trainees must have an adequate
specialty experience, enabling them to have confidence and competency in terms of assessment and
overall management of common emergency and disaster problems. At the end of the rotation, the
trainee should acquire knowledge, skills, and attitudes and demonstrate core competencies.

Guidelines
1) Hospital rotations in first two years are considered one block and can be completed in any
sequence. Therefore, any rotation can be taken any time during the first two year after
introductory course.
2) Rotations including inpatient setting should be completed in inpatient and emergency
departments.
3) An outpatient department rotation candidate should perform a minimum of 8 clinics per
week.

Content
The core content of knowledge and skills expected for emergencies and disasters should be attained
during appropriate hospital rotations as described for each rotation.

Learning methods
1) Emergency Department and casualties
2) Clinical rounds case discussion
3) Presentations in continuing professional development activities
4) Chart reviews
5) Clinical and topics presentations
6) Self-directed learning and conferences
7) Simulation and workshops
8) Small group discussions
9) Learning with other healthcare professionals (dietician, educator, etc.)

Methods of evaluation
Attendance
Assignments
Clinical evaluation/OSCE
Quizzes
Final examination/Project

9 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


TEACHING AND LEARNING METHODS

Method of assessment
1) Cognition
 Multiple choice questions (MCQs) and extended matching items
2) Clinical skills/Patient Management
 Portfolio and logbook4
 Case-based discussion

4
Instructor and trainee need to refer to electronic logbook, instructions, and log-ins for users through the following
URL:
http://www.scfhs.org.sa/en/MESPS/TrainingProgs/ElectrobookCases/Pages/default.aspx
http://www.scfhs.org.sa/en/MESPS/TrainingProgs/ElectrobookCases/Pages/Instructions.aspx
To view the video tutorial refer to this URL:www.youtube.com/watch?v=ZncCbDhehns
www.scfhs.info/medical/Bmedical/login.php
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 10
MODULES OF FIRST-YEAR TRAINING

MODULES OF FIRST YEAR TRAINING

(Please see Appendix A)

Module I: Foundation of emergency nursing


Learning Objectives
At the end of this module, the learner will be able to:
1) Demonstrate flexibility and innovation in the application of specialist knowledge and skills
appropriate to the area of practice.
2) Use professional/therapeutic communication techniques in nursing practice.
3) Comprehend the functions and responsibilities of the professional emergency nurse.
4) Differentiate the potential stressors in the emergency care environment and apply strategies
to minimize their effects on the patient and families.
5) Implement the basic principles of time management in the performance of nursing activities
for patients presenting to the Emergency Department.

Content Outline
1) Emergency room nurse
 Scope of practice
 Professionalism and ethics
 Legal responsibility
 Credentialing
 Advanced practice role
 Professional development
2) Stressors in the emergency care environment
 Identifying stressors
 Stress coping
 Emergency room psychosis
3) Time management in the Emergency Department
 Teamwork
 Pattern and routine
 Acuity index
 Triage system5
4) Crisis management
5) Basics of first aid emergency nursing care
6) Stabilization of injuries
7) Pain management and sedation6
8) End-of-life care

Competencies
1) Assessment: Head and Neck

5
The Canadian Triage & Acuity Scale (CTAS) can be accessed through URL:
http://caep.ca/resources/ctas#intro
6
Refer to the universal topic of Medical and Surgical Emergencies for pain management through the
URL:http://www.scfhs.org.sa/en/MESPS/Pages/UniversalTopics.aspx.
11 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM
MODULES OF FIRST-YEAR TRAINING

2) Assessment: Visual Acuity


3) Assessment: Cardiovascular
4) Assessment: Thorax and Lungs
5) Assessment: Respiration
6) Assessment: Musculoskeletal and Neurologic
7) Pelvic Examination
8) Assessment: Abdomen, Genitalia, and Rectum
9) Assessment: Intake and Output
10) Assessment: Nutrition Screening
11) Assessment: Wound
12) Pain Relief
13) Determination of Death: Advanced Practice
14) Life-Sustaining Therapy: Withholding and Withdrawing
15) Symptom Management at End of Life
16) Grief Support for Patients and Family

Module II: Foundations of emergency nursing practicum I


Learning Objectives
At the end of this module, the learner will be able to:
1) Describe steps of the primary and secondary survey to diagnose and manage life-threatening
injuries.
2) Obtains initial subjective and objective data of the trauma patient.
3) Identify the main elements in emergency resuscitation.
4) Describe different therapeutic airway management options.
5) Describe principles of wound and burn management.
6) Explain cardiopulmonary resuscitation techniques.

Content Outline
1) Systematic primary and secondary survey
2) Vascular access monitoring
3) Airway management and ventilation
4) Calculate and administer medications safely for care of patients undergoing invasive
procedures
5) Wound management
6) Burn management
7) Cardiopulmonary resuscitation

Competencies
1) Emergency Primary Assessment
2) Emergency Secondary Assessment
3) Code Management
4) Airway Positioning
5) Airway Foreign Object Removal
6) Esophageal Foreign Body Removal
7) Nasal Foreign Body Removal
8) External Defibrillation

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 12


MODULES OF FIRST-YEAR TRAINING

9) Aspiration Precautions
10) Blood Pressure (Systolic): Palpation
11) Apical Pulse
12) Pulse Oximetry
13) Pulsus Paradoxus Assessment
14) Cardiac Output Measurement
15) Cardiac Monitor Setup and Lead Placement
16) Oxygen Therapy and Oxygen Delivery
17) Nasal Cannula or Oxygen Mask Application
18) Ventilation: Bag Mask
19) Ventilation: Mouth to Mask
20) Electrocardiogram: 12 Lead
21) Oral Airway Insertion
22) Endotracheal Tube Intubation
23) Endotracheal Tube Intubation: Advanced Practice
24) Endotracheal Tube and Tracheostomy Tube: Oxygen Administration
25) Endotracheal Tube: Skin and Oral Care
26) Laryngeal Mask Airway
27) Tracheostomy Tube: Care and Suctioning
28) Intravenous Therapy: Initiation
29) Venous Cut down
30) External Jugular Venous Access
31) Mechanical Ventilation: Volume and Pressure Modes
32) Nasopharyngeal Airway Insertion
33) Nasopharyngeal Suctioning
34) Burn Wound Care
35) Wound Cleansing and Irrigation of Traumatic Wounds
36) Wound Drainage Evacuation
37) Wound Irrigation

Module III: Pharmacological management of emergencies


Learning Objectives
At the end of this module, the learner will be able to:
1) Understand the legal and ethical aspects of drug administration.
2) Identify the drug dosage, prescription reading, and commonly used medical abbreviations.
3) Understand principles of pharmacokinetics, pharmacodynamics, and drug-drug interactions.
4) Discuss clinical pharmacology of anticoagulant and thrombolytic drugs.
5) Describe toxicological emergencies in pre-hospital settings.

Content Outline
1) Introduction to pharmacology and legal and ethical aspects of drug administration
2) Dosage calculation, administration of IV fluids, and drug incompatibilities in addition to
prescription reading
3) Principles of pharmacokinetics and pharmacodynamics
4) Adverse drug reactions and drug interactions
5) Psychological factors affecting drug therapy
6) Toxicological emergencies pre-hospital

13 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


MODULES OF FIRST-YEAR TRAINING

7) Drugs and coagulation (anticoagulants, thrombolytic)


8) Drugs used in treatment of different emergencies:
 Respiratory emergencies
 Cardiovascular emergencies
 Neurological emergencies
 Gastrointestinal emergencies
 Renal emergencies
 Endocrine emergencies
 Obstetrical and Gynecological emergencies
 Behavioral emergencies

Competencies
1) Medication Administration: Oral
2) Medication Administration: Topical
3) Medication Administration: Nasal Instillation
4) Medication Administration: Nebulized
5) Medication Administration: Rectal Suppositories
6) Medication Administration: Local Infiltration and Topical Agents for Wound Anesthesia
7) Medication Administration: Intradermal Injection and Allergy Skin Testing
8) Medication Administration: Continuous Subcutaneous Infusion
9) Medication Administration: Subcutaneous Injection
10) Medication Administration: Intramuscular Injection
11) Medication Administration: Intermittent Infusion Methods
12) Intravenous Therapy: Regulation of Flow Rate
13) Intravenous Therapy: Solution Change
14) Blood Products Administration
15) Medication Administration: Intravenous Bolus
16) Medication Administration: Mixing Medications in One Syringe
17) Gastric Lavage for Removal of Toxic Substances
18) Streptokinase for Acute Myocardial Infarction
19) Seizure Precautions

Module IV: Pathophysiological changes in emergency nursing


Learning Objectives
At the end of this module, the learner will be able to:
1) Recognize physiological changes occurring during life-threatening situations.
2) Understand the pathophysiology of disease processes commonly seen in emergency patients.
3) Understand the inflammatory response and infection process.
4) Discuss the fluid, electrolyte disturbance, and acid base balance imbalance.
5) Explain the pathophysiology of shock.

Content Outline
1) Introduction to pathophysiology adaptations and alteration in cellular function
2) Body defense mechanisms
3) Inflammation and repair
4) Immunity
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 14
MODULES OF FIRST-YEAR TRAINING

5) Fluid, electrolyte, and acid base balance and imbalance


6) Pathophysiology shock
7) System and associated pathophysiological problems:
 Respiratory alteration
 Cardiovascular alteration
 Hematological disorders
 Neurological Disorders
 Gastrointestinal disturbance
 Endocrine Disorders
 Urinary Disorders
 Motor, sensory disturbance
 Immunologic and lymphatic disorders
 Reproductive disorders
8) Toxicological emergencies

Competencies
1) Alteplase for Acute Ischemic Stroke
2) Alteplase for Acute Myocardial Infarction
3) Alteplase for Pulmonary Embolism

Module V: Management of behavioral problems and psychosocial concepts


Learning Objectives
At the end of this module, the learner will be able to:
1) Identify communication and interpersonal relationships in an emergency.
2) Describe the relationship between stress and anxiety.
3) Identify the stages of grieving and describe nursing interventions for each stage.
4) Recognize the emotional implications of transferring a patient from the critical unit and
describe interventions that help the patient cope with changes.
5) Discuss the physical and emotional responses to stress, including local and general adaptation
syndromes, mind-body interaction, anxiety, coping, and defense mechanisms.

Content Outline
1) Assessment and management of mental health emergencies
 Anxiety and panic reaction
 Ineffective coping and situational crisis
 Depression
 Suicidal behavior
2) Therapeutic communication skills
3) Developmental factors in effective coping responses
 Stress
 Anxiety
 Dependency
 Responses to loss
4) General systems theory applied to individual and family coping responses
5) Major coping risks associated with physical and or emotional illness

15 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


MODULES OF FIRST-YEAR TRAINING

 Major developmental issues


 Control
 Loss
 Guilt
6) Psychosocial interventions with ineffectively coping patients and/or families:
7) Interventions with dying client and the family

Competencies
1) Seizure Precautions
2) Communication with Anxious Patients
3) Communication with Depressed Patients
4) Life-Sustaining Therapy: Withholding and Withdrawing
5) Symptom Management at End of Life
6) Grief Support for Patients and Family

Module VI: Ethics in nursing and dimension of care


Learning Objectives
At the end of this module, the learner will be able to:
1) Examine the nature and role of ethical theories in guiding sound ethical decision making in
workplace settings.
2) Discuss the ethical and legal contexts of professional nursing practice.
3) Examine key ethical issues occurring in nursing and related health care contexts.
4) Discuss processes for achieving desired moral outcomes in nursing and healthcare domains.
5) Analyze conflicting duties and rights inherent in moral dilemmas.
6) Discuss the impact of current issues related to healthcare delivery.
7) Use ethical reasoning to synthesize standards of practice, ethical principles, and
legal/regulatory requirements in the resolution of ethical dilemmas.
8) Discuss relevant ethical issues to traumatized patients.

Content Outline
1) Introduction to moral and legal concepts
2) Credentialing and licensing
3) Autonomy and paternalism
4) Life and death
5) Public health
6) Ethical issues related to emergency situations

Competencies
For competencies, refer to (Appendix L)

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 16


MODULES OF FIRST-YEAR TRAINING

Module VII: Epidemiology


Learning Objectives
At the end of this module, the learner will be able to:
1) Describe the mechanisms and dynamics of disease transmission in populations and the risk
factors that determine their distribution.
2) Calculate the measures of morbidity, mortality, incidence, and prevalence.
3) Assess the validity and reliability of diagnostic and screening tests.
4) Explain the different mechanisms used to describe disease prognosis in quantitative terms for
groups of patients.
5) Assess the efficacy of preventive and therapeutic measures via randomized trials.
6) Conduct epidemiological study designs (cohort, cross-sectional, retrospective, and
prospective).
7) Differentiate between association and causation.
8) Identify potential biases, confounders, and interacting factors in an epidemiological study.
9) Explain the role of genetic and environmental factors in disease causation.
10) Apply epidemiologic methods to evaluate screening programs.
11) Identify the sources of information on disease occurrence.
12) Critique medical and health research studies.

Content Outline
1) Definition of epidemiology and health
2) Dynamics of disease transmission
3) Infectious disease epidemiology
4) Measuring the occurrence of disease
5) Assessing the reliability and validity of diagnostic and screening tests
6) Assessing the efficacy of preventive and therapeutic measures through randomized trials
7) Cohort studies
8) Case control and cross-sectional studies
9) Estimating risk determining association
10) Estimating the potential for prevention
11) From association to causation: deriving inferences from epidemiologic studies
12) Bias, confounding, and interaction
13) Roles of genetic and environmental factors in disease causation
14) Ethical and professional issues in epidemiology

Competencies
For competencies, refer to (Appendix L)

Module VIII: Biostatistics


Learning Objectives
At the end of this module, the learner will be able to:
1) Demonstrate familiarity with statistical terminology and the purpose of statistics.
2) Identify ways of organizing data.
3) Recognize measures of central tendency and variability.
4) Demonstrate an understanding of the analysis of statistical data within the research context.

17 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


MODULES OF FIRST-YEAR TRAINING

5) Provide necessary statistical background for analyzing data and drawing inferences from that
analysis.
6) Discuss logic of hypothesis testing.

Content Outline
1) Descriptive statistics, frequencies, shapes, measures of central tendency
2) Univariate descriptive statistics, measures of variability, range standard deviation scores
within a distribution, Z scores standardized distribution
3) Bivariate descriptive statistics
4) Inferential statistics, probability, sampling distribution, hypothesis testing
5) Power analysis, Types 1 and II errors, level of significance/critical regions, confidence interval,
one-tailed and two-tailed tests, and parametric tests
6) Bivariate inferential statistics, t tests for independent groups, paired t tests (dependent
groups)
7) ANOVA, between versus within groups, nonparametric tests, Chi square test for
independence, bivariate inferential statistics, Pearson r as inferential testing.

Competencies
For competencies, refer to (Appendix L).

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 18


MODULES OF SECOND-YEAR TRAINING

MODULES OF SECOND YEAR TRAINING

(Appendix B)

Module IX: Introduction to research and evidence based practice


Learning Objectives
At the end of this module, the learner will be able to:
1) Define the basic concepts of research methodology.
2) Describe the different research designs.
3) Describe the scientific process and its use in nursing research.
4) Design a research proposal project.
5) Explain the steps of the research process in the proposal and/or conduct of a circumscribed
nursing research project.
6) Identify research problems and literature review process related to nursing practice.
7) Compare and contrast research designs.
8) Discuss appropriate statistical techniques in analysis of data.
9) Critique current studies of nursing practice.
10) Describe the utilization of research findings.
11) Define the historical perspective of evidence based practice.
12) Define and apply evidence based nursing practice principles identified through nursing
research.

Please refer to (Appendix C) for Nursing Research Project Guidelines

Content Outline
1) Overview of nursing research
2) Research methodology and process
3) Research designs
4) Data collection and analyses
5) Evidence based research and application

Competencies
For competencies, refer to (Appendix L)

Module X: Trauma assessment and nursing consideration


Learning Objectives
At the end of this module, the learner will be able to:
1) Demonstrate knowledge of health assessment skills.
2) Comprehend the various components of comprehensive health assessment.
3) Determine the four basic assessment techniques of physical examination and their mnemonic
sequences.
4) Integrate the knowledge gained from pathophysiologic effects of disease in conducting the
health assessment for different body systems.
5) Describe the primary and secondary survey for diagnosis and management of life –threatening
injuries.

19 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


MODULES OF SECOND-YEAR TRAINING

Content Outline
1) Patient history
2) General approaches to physical examination
3) Assessment of treatment modalities’ side effects
4) Assessment of nutritional states, spiritual and behavior changes
5) Pain assessment
6) Comprehensive system assessment (head-to-toe assessment)
7) Adapting assessment to special populations (child, infant, adult…)
8) Document quality of care issues associated with the trauma patient.

Competencies
1) Nurse-Patient Relationship
2) Assessment: General Survey
3) Emergency Primary Assessment
4) Emergency Secondary Assessment
5) Assessment: Orthostatic Vital Signs
6) Assessment: Nutrition Screening
7) Arterial Catheter Radial Insertion: Advanced Practice
8) Arterial Catheter: Blood Sampling
9) Arterial Puncture: Arterial Blood Gas Sampling
10) Arterial Catheter Radial Insertion: Advanced Practice
11) Nursing Report

Module XI: Major trauma and surgical emergencies


Learning Objectives
At the end of this module, the learner will be able to:
1) Understand the phases of a disaster and nursing’s role during each phase.
2) Describe phases of initial assessment and related care of the trauma patient.
3) Identify appropriate nursing diagnosis, interventions, and expected outcomes for the trauma
patient.
4) Understand of the management of disasters/mass casualty incidents.
5) Describe the complications of different types of trauma and their clinical manifestations and
nursing management.

Content Outline
1) Disasters and disaster nursing
2) Characteristics of disaster nursing
3) Phases of a disaster and nursing’s role during each phase
4) Basis of trauma and management
5) Head trauma and management
6) Spinal trauma and management
7) Thoracic trauma and management
8) Gastrointestinal trauma and management
9) Renal and genitourinary trauma and management
10) Orthopedic and neurovascular trauma and management
11) Burns and management
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 20
MODULES OF SECOND-YEAR TRAINING

12) Maxillofacial trauma and management


13) Pediatric trauma and management
14) Elder Trauma and management
15) Obstetric trauma and management

7
Refer to Universal Topics/SCFHS Module (4) Medical and Surgical Emergencies.
1) Management of acute chest pain
2) Management of acute breathlessness
3) Management of altered sensorium
4) Management of hypotension and hypertension
5) Management of upper GI bleeding
6) Management of lower GI bleeding

Competencies
1) Ambulation Aids: Measuring and Fitting
2) Automated External Defibrillator (AED)
3) Chest Physiotherapy: Postural Drainage
4) Ear Irrigations
5) Ophthalmic Foreign Body Immobilization
6) Epistaxis: Anterior Packing
7) Epistaxis: Insertion of Balloon Catheters
8) Epistaxis: Posterior Packing
9) Immobilization Devices
10) Lumbar Puncture
11) Ophthalmic Foreign Body Immobilization
12) Spinal Immobilization: Cervical Collar, Backboard, and Vacuum Mattress
13) Cervical Collar: Management
14) Cervical Tongs and Halo Pins: Site Care
15) Cervical Traction Maintenance
16) Skin Traction
17) Splinting: General Principles
18) Splinting: Traction Splints
19) Splinting: Vacuum Splints
20) Restraint Application and Monitoring
21) Thoracentesis
22) Emergency Needle Thoracentesis
23) Chest Tube Insertion
24) Chest Tube Removal
25) Chest Tube: Closed Drainage Systems
26) Paracentesis
27) Preoperative Care

7
Refer to the universal topic of Module (4) Medical and Surgical Emergencies through the
URL:http://www.scfhs.org.sa/en/MESPS/Pages/UniversalTopics.aspx.
21 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM
MODULES OF SECOND-YEAR TRAINING

Module XII: Clinical practicum in emergency nursing II


Learning Objectives
At the end of this module, the learner will be able to:
1) Understand the principles of electrocardiogram (ECG) and 12 Leads ECG.
2) Discuss the measures used to control esophageal bleeding.
3) Discuss enteral and parenteral nutrition.
4) Describe the route for blood glucose monitoring technique and self-injection of insulin.
5) Explain urinary bladder catheterization and the management of patients undergoing supra
pubic bladder drainage.

Content Outline
1) The principles of electrocardiogram (ECG) and 12 Leads ECG
2) Nasogastric tube intubation and removal
3) Esophageal bleeding
4) Enteral and parenteral nutrition
5) Blood glucose monitoring technique and self-injection of insulin
6) Catheterization of the urinary bladder
7) Management of patient undergoing supra pubic bladder drainage
8) Application and removal of a cast
9) Glasgow Coma Scale measurement

Competencies
1) Electrocardiogram: 12 Lead
2) Electrocardiogram: Right Precordial and Left Posterior Leads
3) Esophagogastric Tamponade Tube: Insertion and Care
4) Feeding Tube: Verification of Placement
5) Feeding Tubes: PEG, Gastrostomy, and Jejunostomy Care
6) Gastric Lavage for Removal of Toxic Substances
7) Feeding Tube: Medication Administration
8) Fecal Impaction Removal
9) Massive Transfusion
10) Blood Glucose Monitoring
11) Peritoneal Lavage: Diagnostic: Advanced Practice
12) Specimen Collection: Timed Urine Specimen
13) Specimen Collection: Urine from Indwelling Catheter
14) Specimen Collection: Urine Screening for Glucose, Ketones, Protein, Blood, pH, and Specific
Gravity
15) Urinary Catheter: Closed Continuous Irrigation
16) Urinary Catheter: Indwelling Catheter Care
17) Urinary Catheter: Indwelling Catheter Removal
18) Urinary Catheter: Straight and Indwelling Catheter Insertion (Female)
19) Urinary Catheter: Straight and Indwelling Catheter Insertion (Male)
20) Urinary Catheter: Suprapubic Catheter Care
21) Restraint Application and Monitoring

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 22


MODULES OF SECOND-YEAR TRAINING

Module XIII: Clinical practicum in emergency nursing III


Learning Objectives
At the end of this module, the learner will be able to:
1) Explain the approaches to acute abdominal and ectopic pregnancy.
2) Describe the therapy for sepsis during pregnancy and postpartum hemorrhages.
3) Explain different trauma and cardiopulmonary resuscitation in pregnancy.
4) Discuss the triage process for the pediatric patient and the difference between emergent and
urgent pediatric illness and/or injury.
5) Discuss the top ten pediatric emergencies.

Content Outline
1) Approach to the acute abdomen in pregnancy
2) Management of ectopic pregnancy
3) Postpartum hemorrhage
4) Sepsis during pregnancy
5) Thromboembolism in pregnancy
6) Diabetic ketoacidosis in pregnancy
7) Amniotic fluid embolism
8) Trauma in pregnancy
9) Cardiopulmonary resuscitation in pregnancy
10) Pediatric medical emergency
11) Pediatric resuscitation
12) Pediatric orthopedics
13) Pediatric surgical emergencies
14) Pediatric toxicology
15) Pediatric trauma

Competencies
1) Emergency Primary Assessment
2) Emergency Secondary Assessment
3) Code Management
4) Airway Positioning
5) Airway Foreign Object Removal
6) Esophageal Foreign Body Removal
7) Nasal Foreign Body Removal
8) External Defibrillation
9) Aspiration Precautions

Module XIV: Nursing informatics


Learning Objectives
At the end of this module, the learner will be able to:
1) Describe the foundation of nursing informatics as an emerging field in the nursing profession.
2) Identify key factors and legislative organizations that help shape nursing informatics.
3) Discuss evolving models and theories of nursing informatics that define roles and
competencies.

23 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


MODULES OF SECOND-YEAR TRAINING

4) Explain the implications of nursing informatics for nursing practice, administration, education,
and research.
5) Demonstrate skills in the acquisition and retrieval of nursing information using health
information systems within the institution and through the Internet and varied electronic
resources.
6) Apply approaches that safeguard data and information integrity while maintaining privacy and
confidentiality

Content Outline
1) Introduction of nursing informatics and overview
2) Nursing informatics goals, standards, and scope of practice
3) Nursing informatics competencies (i.e., computer literacy skills, informatics literacy skills, etc.)
4) Models and theories of informatics
5) Internet, search engines, and electronic databases and resources
6) Selection of health care information systems
7) System implementation, maintenance, and development
8) Data integrity, security, and confidentiality
9) Intranet, extranet, and network integration
10) Information technology in patient education
11) Integrating computers and information technology in nursing education and practice

Competencies
For competencies, refer to (Appendix L)

Module XV: Leadership and management


Learning Objectives
At the end of this module, the learner will be able to:
1) Analyze the components of organizational structure and culture.
2) Apply theories of effective leadership and management within selected healthcare arenas.
3) Utilize the skills of nursing process, critical thinking, ethical decision-making, communication,
and therapeutic nursing intervention in managing culturally competent, cost-effective care of
groups of clients across the wellness/illness continuum.
4) Collaborate with multidisciplinary healthcare team members in prioritizing and coordinating
quality/cost-effective healthcare.
5) Demonstrate leadership and management of a care-giving team comprised of individuals with
varied cultural backgrounds and varied levels of clinical knowledge and competencies.
6) Utilize skills of inquiry and research as a means to enhance knowledge base, facilitate change,
and improve quality of care.
7) Demonstrate professional accountability for effective leadership in nursing practice.
8) Contribute to organizational strategic planning and its implementation at different levels
within healthcare organizations.

Content Outlines
1) Organizational structure and culture
2) Application of leadership and management theories
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 24
MODULES OF SECOND-YEAR TRAINING

3) Organizational and personal mission, vision, and goals


4) Critical thinking, problem solving, and effective decision making
5) Quality and risk management
6) Budgeting, cost, care delivery models, and staffing
7) Communication, motivation, and team building
8) Change and conflict management
9) Role transition and delegation
10) Strategic planning and strategic management
11) Career planning

Competencies
For competencies, refer to (Appendix L)

Module XVI: Professional performance


Learning Objectives
At the end of this module, the learner will be able to:
1) Assume responsibility for personal professional development.
2) Initiate independent learning activities.
3) Provide care in an inter-professional environment
4) Advocate for the health and safety of patients.
5) Differentiate between effective versus ineffective communication.
6) Discuss the meaning of active listening.
7) Identify three skills necessary for active listening.
8) Describe ways patients and coworkers benefit when nurses communicate effectively.
9) Discuss the difference between “I” and “You” statements.
10) Identify skills required for therapeutic communication.

Content Outline
1) Sources of data for evidence-based practice
2) Education process (teaching and learning principles)
3) Legal issues
4) Ethical issues
5) Patient advocacy
6) Quality assurance
7) Professional development
8) Multidisciplinary collaboration
9) Effective communication

Competencies
For competencies, refer to (Appendix L)

25 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


ASSESSMENT

ASSESSMENT

Overall, evaluation and assessment of trainees is performed according to the Saudi Commission
training and examination rules and regulations. Assessment is divided into two parts:
1) Continuous evaluation process
2) Centralized examinations

Continuous evaluation
The main aim of the continuous evaluation process is to evaluate every aspect of the trainees’
performance during their presence at the training center. This process provides objective feedback
obtained from those who are involved in the training process (i.e., preceptors). This process also
involves evaluation of interactive training activities such as case studies and seminars. The following
are the continuous evaluation process components:
1) Feedback from the assigned clinical instructor: this feedback should be obtained and
documented every month and as needed (Appendix D).
2) Feedback from the assigned preceptor: this feedback should be obtained and documented
every month and as needed (Appendix E).
3) Feedback from the assigned head nurse/nurse manager: this feedback should be obtained
every month and as needed (Appendix E).
4) Seminar evaluation: one group seminar will be conducted each training year. Seminar topics
should be selected by the trainee and approved by the assigned clinical instructor and the
program director (Appendix F).
5) Case study evaluation: case study of a patient treated in the clinical setting. Case presentation
is to include: patient’s past medical/surgical history, diagnosis/treatment history, current
medical/surgical diagnosis and nursing diagnosis with appropriate assessment findings, and
current medical/nursing plans of care with identification of optimal outcomes. Presentations
are to be approximately 15 minutes with the trainee facilitating the post-presentation
discussion. The case study evaluation form has to be completed and signed by the clinical
instructor and the trainee (Appendix G).

Centralized examinations
This assessment component includes examinations conducted centrally by the Saudi Commission for
Health Specialties, which are:
1) Promotion Examinations
2) Final Examinations

Promotion examination
This examination is held at the end of first year of the program. Successful completion of the
examination will enable the trainee to enter the second training year of the program. The promotion
examination will consist of a written test. The main objective of this exam is to assess the theoretical
knowledge as well as the critical thinking skills of the trainees regarding the topics and clinical
experiences covered in the first training year. The examination format including number of items,
eligibility, and passing scores will be according to the Saudi Commission Examination Rules and
Regulations available on the Saudi Commission Website; www.scfhs.org.sa.

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 26


ASSESSMENT

Final (End-of-program) examinations


The end-of-program examinations are comprehensive. The trainees would be awarded their diploma
certificate once they successfully complete these examinations.

Final Written Examination


This exam assesses the theoretical knowledge as well as the critical thinking skills of the trainees
regarding the topics and clinical experiences covered in the entire program. The examination format
including number of items, eligibility, and passing scores will be according to the Saudi Commission
Examination Rules and Regulations (available on the Saudi Commission Website, www.scfhs.org.sa;.

Final Clinical Examination


An objective structured clinical examination exam will be conducted to assess the trainees’ clinical
skills, including data gathering, patient management, communication, and counseling skills. This
examination will include a specific number of stations designed to achieve the training objectives. The
examination format including number of items, eligibility, and passing scores will be according to the
Saudi Commission Examination Rules and Regulations (available on the Saudi Commission website,
www.scfhs.org.sa.

Certification
Certificate of training completion will only be issued upon the trainee’s successful completion of all
program requirements. Successful completion of all program requirements (including examinations,
competencies, etc.) would result in awarding the trainees the “Emergency Nursing Diploma”

27 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


APPENDICES

REFERENCES

1) Blanchard, L., 2010. Pathophysiology for Nurses. Delmar, Australia M. Shaw (latest edition).
2) Lippincott Williams & Wilkins. 2005. Pathophysiology: A 2-in-1 reference for nurses.
Philadelphia: Springhouse Publishing.
3) Emergency Nurses Association, 2008. Emergency Nursing Core Curriculum (6th ed.). New York:
Elsevier Saunders.
4) Emergency Nurses Association, 2011. Emergency Nurses Pediatric Course (4th ed.). Emergency
Nurses Association. Available at https://www.ena.org/education/ENPC-
TNCC/enpc/Pages/aboutcourse.aspx. Cited 5/24/16.
5) Emergency Nurses Association and Hammond, B. 2013. Sheehy's Manual of Emergency Care
(7th ed.). St. Louis, MO: Elsevier Mosby.
6) Emergency Nurses Association, Howard, P. K., and Steinmann, R. A., 2010. Sheehy’s
Emergency Nursing Principles and Practices (6th ed.). St. Louis MO: Mosby Elsevier.
7) Estes, M. E. Z., 2013. Health Assessment and Physical Examination (5th ed.). Clifton Park, NY:
Delmar Cengage Learning.
8) Godwin, L., Johnson, M., Potter, P. A., Perry, A. G., and Sorrentino, S. A., 2002. Mosby's
Nursing Skills: Intermediate. St. Louis, Mo: Mosby.
9) Gordis, L., 2014. Epidemiology (5th ed.). New York: W.B. Saunders Co.
10) Gravetter, F., and Wallnau, L., 2010. Essentials of Statistics for the Behavioral Sciences (8th
ed.). Belmont, CA: Thomson Wadsworth.
11) Gregory, J., 1996. Psychosocial Education of Nurses: The Interpersonal Dimension. Aldershot
UK: Avebury.
12) Guido, G.W., 2010. Legal & Ethical Issues in Nursing (4th ed.). Upper Saddle River, NJ: Pearson.
13) Jarvis, C., 2016. Physical Examination and Health Assessment (7th ed.). St. Louis, MO: Elsevier.
14) Cavanaugh, B. M., 2003. Nurse’s Manual of Laboratory and Diagnostic Tests (4th ed.).
Philadelphia: F. A. Davis Co.
15) Kellar, S. P., and Kelvin, E. A. 2012. Munro’s Statistical Methods for Health Care Research (6th
ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
16) McQuillan, K. A., Makic, M. B. F., and Whalen, E., 2009. Trauma Nursing from Resuscitation
through Rehabilitation, (4th ed.). St. Louis MO: Elsevier Saunders.
17) Petrie, A and Sabin, C., 2009. Medical Statistics at a Glance, (3rd ed.). London: Wiley-Blackwell.
18) Barry, P. D., 1996. Psychosocial Nursing: Care of Physically Ill Patients & Their Families, (3rd
ed.). Philadelphia: Lippincott Williams & Wilkins.
19) Polit, D. F. and Beck, C. T., 2005. Study Guide to Accompany Essentials of Nursing Research:
Methods, Appraisal, and Utilization, (6th ed.). Philadelphia: Lippincott Williams & Wilkins.

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 28


APPENDICES

20) Saudi Commission on Health Specialties, 2016. Saudi Board Family Medicine Curriculum.
Available at
http://www.scfhs.org.sa/MESPS/TrainingProgs/TrainingProgsStatement/Family/Documents/%
D9%83%D8%AA%D9%8A%D8%A8%20%D8%A7%D9%84%D8%A8%D8%B1%D9%86%D8%A7%
D9%85%D8%AC%20-
%20%D8%B7%D8%A8%20%D8%A7%D9%84%D8%A7%D8%B3%D8%B1%D8%A9.pdf. Cited
5/26/16.
21) Saudi Commission on Health Specialties, 1436/2015. Licensing Examinations. Available at
http://www.scfhs.org.sa/en/registration/exams/Pages/default.aspx. Cited 5/26/16.
22) Saudi Commission on Health Specialties, 1436/2015. Oncology Nursing Diploma. Available at:
http://www.scfhs.org.sa/en/MESPS/TrainingProgs/TrainingProgsStatement/OncologyNursing/
Documents/Program%20Booklet.pdf. Cited 05/24/16.
23) Veenema, T. G. (ed.), 2012. Disaster Nursing and Emergency Preparedness for Chemical,
Biological and Radiological Terrorism and Other Hazards. New York: Springer Publishing
Company, Inc.

29 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


APPENDICES

APPENDICES

Appendix A
st
Didactic and Clinical Rotations (1 Year)
First Year
Courses Duration Theoretical Clinical
384 Hours
Module I: Foundation of 96 Hours (4 days per week)
12 Weeks
Emergency Nursing * (1 day per week) Simulation and workshop, including
ACLS
Module II: Foundation of 384 Hours
96 Hours
Emergency Nursing 12 weeks (4 days per week)
(1 day per week)
Practicum I ER & Casualty
Module III:
48 Hours
Pharmacological 32 Hours
2 Weeks (3 days per week)
Management of (2 days per week)
ER & Casualty
Emergencies *
Module IV:
128 Hours
Pathophysiological 32 Hours
4 weeks (4 days per week)
Management of (1 day per week)
ER & Casualty
Emergencies
Module V: Emergency
128 Hours
Management of Behavioral 32 Hours
4 Weeks (4 days per week)
Problems and (1 day per week)
ER & Casualty
Psychosocial Concepts *
192 Hours
Modules VI: Ethics in
48 Hours (4 days per week)
Nursing & Dimensions of 6 Weeks
(1 day per week) Application of foundations of emergency
Care *
nursing in ER & Casualty
80 Hours
Module VII: Epidemiology * 2 Weeks Application in computer lab and library
(5 days per week)
80 Hours
Module VIII: Biostatistics * 2 Weeks Application in computer lab and library
(5 days per week)
Total 44 Weeks 496 Hours 1,264 Hours
*These modules are didactic modules.

30 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


APPENDICES

Appendix B
nd
Didactic and Clinical Rotations (2 Year)
Second Year
Courses Duration Theoretical Clinical
96 Hours
Module IX: Introduction (3 days per week)
to Research and 64 Hours Consolidate rotation in the research area of
4 Weeks
Evidence Based (2 days per week) interest and in areas that provide resources
Practice * for nursing research (e.g., nursing
researchers, biostatisticians, librarians, etc.…)
Module X: Trauma 192 Hours
48 hours
Assessment and 6 Weeks (4 days per week)
(1 day per week)
Nursing Consideration ER & Casualty
Module XI: Major 256 Hours
64 Hours
Trauma and Surgical 8 Weeks (4 days per week)
(1 day per week)
Emergencies ER and OR
Module XII: Clinical 256 Hours
64 Hours
Practicum in 8 Weeks (4 days per week)
(1 day per week)
Emergency Nursing II ER and Casualty
Module XIII: Clinical 256 Hours
64 Hours
Practicum in 8 Weeks (4 days per week)
(1 day per week)
Emergency Nursing III ER and Casualty
96 Hours
Module XIV: Nursing 64 Hours (3 days per week)
4 Weeks
Informatics* (2 days per week) Rotations with nursing informatics staff, and/or
working with healthcare informatics systems
128 Hours
Module XV: Leadership 32 Hours
4 Weeks (4 days per week)
and Management* (1 day per week)
Rotations with Nurse Managers
48 Hours
Module XVI:
32 Hours (3 days per week)
Professional 2 Week
(2 days per week) Rotation in the oncology specialty area of
Performance*
interest
Total 44 Weeks 432 Hours 1,328 Hours
*These modules are didactic modules.

31 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


APPENDICES

Appendix C
Nursing Research Project Guidelines8
Under the guidance of the advisor, the student takes three credit hours for a research project and
submits it to the adviser. A clinical research project, under the supervision of a faculty member,
employs the scientific process in analyzing a clinical problem or issues related to advanced nursing
practice. Emphasis is on a project that has tangible application to the practice setting.

Learning Objectives
At the end of this module, the learner will be able to:
1) Demonstrate ability to collect, analyze, synthesize, and evaluate information.
2) Formulate research questions on problems of clinical significance on advanced nursing
practice.
3) Critically analyze and apply studies pertinent to client care.
4) Interpret research findings and recommendations to clients, agencies, and health care
professionals.
5) Write a scholarly paper in a formal suitable for professional publication.

Clinical Research Project Guidelines


Utilization Studies
A student may create a research utilization project relevant to nursing. Examples include design of
clinical protocols for implementation of previous research findings.

Pilot Studies
A student may wish to conduct a small-scale study that provides a foundation for future research. This
might include a pilot study (based on a smaller sample or refined methodology), a descriptive survey of
a group targeted for later study, intervention studies, or studies that establish or extend tool reliability
and validity.

Replicated Studies
A student may conduct an exact or approximate (under similar conditions) replication of a study to
extend findings of previous research.

Advisor
For each research project, one faculty member will function as an advisor. This person gives final
approval for the student to register for the course, advises the student during project implementation,
verifies that all requirements for the project and written report have been met, and submits the final
course grade. Graduate faculty will assign faculty members to the role of advisor or readers.

Preliminary approval (prior to registration for project module)

8
Nursing Research Project Guidelines are adopted from the McNeese State University College of Nursing
Graduate Program 2012-2013 through URL:http://www.mcneese.edu/
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 32
APPENDICES

1) Choose an advisor for the project who has expertise or interest in the area of your proposed
clinical research
2) Provide a description of the project, including the following:
 Problem statement;
 Purpose and objectives of the project; and
 Significance of the project.

Enrollment in project module


1) Register for project module assigned to advisor.
2) Attend conferences with the advisor as recommended or requested. Submission of working
drafts of research report to faculty advisor is suggested.
3) Submit copies of written research report to the advisor.

Evaluation
1) Written Research Report
2) Completion of the clinical research project, as outlined

Grading Criteria
The maximum score for this paper is 100 points. Each item is weighted for its importance in fulfilling
the purposes of the project.

33 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


APPENDICES

Appendix D
SCFHS Mentor Guidelines
Goals
1) Guide residents towards personal and professional development through continuous
monitoring of progress.
2) Early identification of struggling residents as well as high achievers.
3) Early detection of residents who are at risk of emotional and psychological disturbances.
4) Provide career guidance.

Roles of the Mentor


The primary role of the mentor is to nurture a long-term professional relationship with the assigned
residents. The mentor is expected to provide an “academic home” for the residents so that they can
feel comfortable in sharing their experiences, expressing their concerns, and clarifying issues in a non-
threatening environment. The mentor is expected to keep sensitive information about the residents in
confidence.

Mentors are also expected to make appropriate and early referral to the Program Director or
Department Head if they discover a problem that would require expertise or resources beyond their
capacity. Examples of such referral might include:
1) Serious academic problems;
2) Progressive deterioration of academic performance;
3) Potential mental or psychological issues;
4) Personal problems interfering with academic duties;
5) Professional misconduct, etc.

However, the following are NOT expected roles of a mentor:


1) Provide extra tutorials, lectures, or clinical sessions;
2) Provide counseling for serious mental and psychological problems;
3) Being involved in residents’ personal matters;
4) Provide financial or other material supports.

Roles of the trainee


1) Submits resume at the start of the relationship.
2) Provide mentor with short (1 year) and longer term (2 years) goal.
3) Takes primary responsibility in maintaining the relationship.
4) Schedule monthly meeting with mentor in a timely manner; do not request ad hoc meetings
except in emergency.
5) Recognize self-learning as an essential element of specialty training.
6) Report any major events to the mentor in a timely manner.

Who can be mentor?


Any faculty member consultant grade and above within the specialty program can be a mentor. There
is no special training required.

Number of trainees per mentor

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 34


APPENDICES

As a guideline, each mentor should not have more than 4–6 trainees. As much as possible, the trainees
should come from the first and second years of training. This will create an opportunity for the senior
trainees to work as a guide for the junior trainees.

Frequency and duration of engagement


The recommended minimum frequency is once every four weeks. Each meeting might take 30 minutes
to an hour. It is also expected that once assigned, the mentor should continue with the same trainee
preferably for the entire duration of the training program (i.e., two years).

Tasks during the meeting


Following are suggested tasks to be completed during the meeting:
1) Discuss overall clinical experience of the trainee with particular attention to any concerns
raised;
2) Review logbook or portfolio with the trainee to determine whether the trainee is on target of
meeting the training goals;
3) Revisit earlier concerns or unresolved issues, if any;
4) Explore any non-academic factors seriously interfering with training;
5) Document excerpts of the interaction in the logbook.

Mandatory Reporting to Program Director or Department Head


1) Consecutive absence from three scheduled meetings without any valid reasons;
2) Unprofessional behavior;
3) Consistent underperformance in spite of counseling;
4) Serious psychological, emotional, or health problems that may potentially cause unsafe
patient care;
5) Any other serious concerns by the mentor.

35 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


APPENDICES

Appendix E
Advanced Practice Clinical Nursing Diploma in Emergency
Performance Assessment of the Trainee
(To be completed by the Preceptor 9 on completion of the clinical hours required monthly in the
specialty)

Trainee Name:………………………………………………………………………………………………….ID Number:…………………

Evaluation for the Period From:………………………………………………..…….To:……………………………………………….


Performance Indicators: Weak: 1 Fair: 2 Good: 3 Very good: 4 Excellent: 5
Skill Assessment Criteria 1 2 3 4 5
Demonstrates the ability to effectively assess, diagnose, plan, implement, and
evaluate patient care.
Plans patient-specific care and uses the care maps or clinical pathways (if
appropriate) for the clinical setting.
Implements nursing interventions and makes individualized therapeutic decisions
related to patient health condition and planned outcomes.
Demonstrates safe medication administration practices at all times.
Participates in formal and informal teaching/training.
Maintains professional behavior at all times.
Maintains complete documentation according to hospital policies.
Works collaboratively with the multidisciplinary team (preceptor, manager,
physicians, etc.) to achieve training goals.
Requests assistance, support, and supervision appropriately as needed.
Shares goals/objectives with preceptor for each clinical day.
Shows initiative in identifying and articulating training needs.
Completes all responsibilities for care associated with designated patients each
clinical day.
Demonstrates effective time management, organization in planning, and
appropriate performance in nursing responsibilities.
Displays punctuality, and provides appropriate absence notification based on
hospital policy.
Displays professional behavior and appearance (uniform and ID).
Demonstrates accountability and responsibility for own practice.
Accepts constructive feedback.
Adheres to the code of ethics.
Maintains patient confidentiality at all times.
Demonstrates respect for cultural differences.
Total /20
Comments: Preceptor:
________________________________________________________________________________________________

Preceptor Name: ____________________________________________________________________

Signature: _________________________________ Date: ___________________________________

Trainee Name: ____________________________________________________________________

Signature: ________________________________ Date: __________________________________

9
Appendix E, F and G are adopted from Advanced Practice Clinical Nursing Diploma in Oncology 2014.
SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 36
APPENDICES

Appendix F
Advanced Practice Clinical Nursing Diploma in Emergency
Performance Assessment of the Trainee
(To be completed by the Clinical Instructor on completion of the clinical hours required monthly in the
specialty)

Trainee Name:…………………………………………………………………………………………………………………………………..

ID Number:……………………………………. Evaluation for the Period From:……………………….To:…………………..

Performance Indicators: Weak: 1 Fair: 2 Good: 3 Very good: 4 Excellent: 5


Skill Assessment Criteria 1 2 3 4 5
Collects relevant patient information to form a comprehensive care plan.
Conducts a thorough physical assessment and documents findings in the patient’s medical
record according to organizational policies.
Identifies, based on assessment findings, appropriate patient outcomes.
Develops a comprehensive plan of care that would ensure continuity of care in
collaboration with patients and their families.
Provides appropriate interventions based on the patient’s plan of care.
Adheres to safety standards/protocols as outlined in hospital policies and procedures.
Communicates with patients and families using therapeutic communication skills.
Evaluates patient’s progress based on planned outcomes and revises plan of care
accordingly.
Is self-directing; assumes initiative and responsibility for own practice.
Develops plan of care for specific patient population as needed.
Accepts constructive criticism and uses suggestions for improvement.
Demonstrates punctuality and reports absence or sickness through the correct channels
according to hospital policies.
Participates in staff and trainee education.
Turns in completed written assignments on time.
Cooperates with and supports other members of the healthcare team.
Adheres to code of ethics.
Maintains patient confidentiality and privacy at all times.
Communicates effectively with the multidisciplinary team members.
Synthesizes appropriate research findings and incorporates them in practice.
Utilizes evidence-based practice in developing the patient’s plan of care.
Total / 20
Comments: Clinical Instructor:
____________________________________________________________________________________

Clinical Instructor Name: _______________________________________________________________

Signature:_______________________________________Date:________________________________

Trainee Name: _______________________________________________________________________

Signature: _______________________________________Date: _______________________________

37 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


APPENDICES

Appendix G
Advanced Practice Clinical Nursing Diploma in Emergency
Performance Assessment of the Trainee
(To be completed by the Nurse Manager on completion of the clinical hours required monthly in the
specialty)

Trainee Name:…………………………………………………………………………………...ID Number:……………………………….

Evaluation for the Period From:…………………………….……………………...To:………………..…………………….………..

Performance Indicators: Weak: 1 Fair: 2 Good: 3 Very good: 4 Excellent: 5


Skill Assessment Criteria 1 2 3 4 5
Actively participates in departmental activities (meetings, education, etc.).
Assists with development, updating, and implementation of clinical guidelines.
Proactively intervenes in challenging situations within the clinical setting.
Attends and actively participates in hospital committees as needed.
Adheres to relevant standards of care and follows hospital policies at all times.
Coordinates with other departments within the hospital to promote optimal
continuity of care.
Serves as patient advocate in exploring other plans of care in collaboration with
the multidisciplinary team members.
Accepts constructive criticism and uses suggestions for improvement.
Demonstrates punctuality and reports absence or sickness through the correct
channels according to hospital policies.
Participates in staff and trainee education.
Turns in completed written assignments on time.
Cooperates with and supports other members of the healthcare team.
Adheres to the code of ethics.
Maintains patient confidentiality and privacy at all times.
Communicates effectively with the multidisciplinary team members.
Utilizes evidence-based practice in developing the patient’s plan of care.
Total / 16
Comments: Nurse Manager:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

Nurse Manager Name: _________________________________________________________________

Signature: ____________________________________Date: _________________________________

Trainee Name: _______________________________________________________________________

Signature:___________________________________________Date:___________________________

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 38


APPENDICES

Appendix H

Case Based Discussion (CBD)

Trainee Name: ……………………………………………………………………………………Year1 Year 2

Assessor name:…………………………………………………………………………………………………………

Date: ………………………………………..…. Location: …..……..…….…………………………………….…

In-patient Follow-up

Reason for clinical encounter: …………………………………………………………………………………..


Focus of clinical encounter:
Clinical assessment Management Record keeping Professionalism

Complexity of case: Low Average High

Please rate the trainee against what you would expect of a trainee in that year of training

Theme Unsatisfactory Satisfactory Superior Not Observed

1. Medical record keeping 1 2 3 4 5 6 7 8 9 n/o


2. History taking 1 2 3 4 5 6 7 8 9 n/o
3. Clinical findings and interpretation 1 2 3 4 5 6 7 8 9 n/o
4. Management plan 1 2 3 4 5 6 7 8 9 n/o
5. Follow-up and future planning 1 2 3 4 5 6 7 8 9 n/o
6. Professional qualities 1 2 3 4 5 6 7 8 9 n/o
7. Overall clinical judgment 1 2 3 4 5 6 7 8 9 n/o
Strengths:

Suggestions for development:

Time taken for discussion: ……………………min Time taken for feedback………………………….....min

Trainee to complete the reflection of this CBD using Gibbs framework for reflection

Assessor satisfaction using CBD LOW 1 2 3 4 5 6 7 8 9HIGH


Trainee satisfaction using CBD LOW 1 2 3 4 5 6 7 8 9HIGH

Assessor’s Signature:_____________________________________________________________________________________

Trainee’s Signature:______________________________________________________________________________________

39 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


APPENDICES

Appendix I
Direct Observation Procedure (DOP) Evaluation Form

Trainee Name: …………………………….………………………..………… Year 1 Year 2

Assessor name: ………………………………………….……………………………………………………………

Date: ………………………………………………………..….………. Location: ……………...……..…….….

In- Follow-up

Reason for clinical encounter: ----------------------------------------------------------------------------------


Focus of clinical encounter:
Management Record keeping Professionalism

Complexity of case: Low Average High

Please rate the trainee against what you would expect of a trainee in that year of training
Theme Unsatisfactory Satisfactory Superior Not Observed
1. Understanding indications, relative
1 2 3 4 5 6 7 8 9 n/o
anatomy, and technique
2. Obtain informed consent 1 2 3 4 5 6 7 8 9 n/o
3. Pre-procedure preparation 1 2 3 4 5 6 7 8 9 n/o
4. Patient safety 1 2 3 4 5 6 7 8 9 n/o
5. Antiseptic technique 1 2 3 4 5 6 7 8 9 n/o
6. Technical ability 1 2 3 4 5 6 7 8 9 n/o
7. Seek help where appropriate 1 2 3 4 5 6 7 8 9 n/o
8. Post-procedure management 1 2 3 4 5 6 7 8 9 n/o
9. Communication skills 1 2 3 4 5 6 7 8 9 n/o
10. Professionalism 1 2 3 4 5 6 7 8 9 n/o
11. Overall clinical judgment 1 2 3 4 5 6 7 8 9 n/o
Strengths:

Suggestions for development:

Time taken for discussion: ……………………min Time taken for feedback………………………….....min

Trainee to complete the reflection of this DOPS on the back of this form using Gibbs framework for reflection

Assessor satisfaction using DOPS LOW 1 2 3 4 5 6 7 8 9HIGH


Trainee satisfaction using DOPS LOW 1 2 3 4 5 6 7 8 9HIGH

Assessor’s Signature:_____________________________________________________________________________________

Trainee’s Signature:______________________________________________________________________________________

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 40


APPENDICES

Appendix J

Trainee Reflection Form


Description of the event:

Feelings and Thoughts (Self-awareness):

Evaluation and Analysis:

Conclusion:

Action Plan:

41 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


APPENDICES

Appendix K
Logbook

NAME:______________________________________________________________________________

YEAR/MODULE: _____________________________________________________________________

Date Patient Data Clinical Problem Management Learning Points

Appendix L

Competency List

1) Airway Foreign Object Removal

2) Airway Positioning
3) Alteplase for Acute Ischemic Stroke

4) Alteplase for Acute Myocardial Infarction

5) Alteplase for Pulmonary Embolism


6) Ambulation Aids: Measuring and Fitting

7) Apical Pulse
8) Arterial Catheter Insertion (Assisting), Care, and Removal
9) Arterial Catheter Radial Insertion: Advanced Practice

10) Arterial Catheter: Blood Sampling


11) Arterial Puncture: Arterial Blood Gas Sampling

12) Aspiration Precautions

13) Assessment: Abdomen, Genitalia, and Rectum

14) Assessment: Cardiovascular

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 42


APPENDICES

Competency List

15) Assessment: Head and Neck


16) Assessment: Intake and Output

17) Assessment: Musculoskeletal and Neurologic

18) Assessment: Nutrition Screening


19) Assessment: Orthostatic Vital Signs

20) Assessment: Respirations


21) Assessment: Thorax and Lungs
22) Assessment: Wound

23) Automated External Defibrillator (AED)

24) Blood Glucose Monitoring


25) Blood Pressure (Systolic): Palpation

26) Blood Pressure: Upper Extremity

27) Blood Products Administration

28) Blood Specimen Collection: Blood Cultures


29) Blood Specimen Collection: Venipuncture Syringe Method

30) Blood Specimen Collection: Venipuncture Vacuum-Extraction Method

31) Burn Wound Care


32) Caps, Masks, and Eye Protection

33) Cardiac Monitor Setup and Lead Placement

34) Cardiac Output Measurement


35) Central Venous Catheter Insertion
36) Central Venous Catheter: Blood Sampling

37) Cervical Collar: Management


38) Cervical Traction Maintenance
39) Chest Physiotherapy: Postural Drainage

40) Chest Tube Insertion


41) Chest Tube Removal
42) Chest Tube: Closed Drainage Systems

43) Code Management

43 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


APPENDICES

Competency List

44) Continuous ST-Segment Monitoring


45) Determination of Death: Advanced Practice

46) Diagnostic Peritoneal Aspiration and Lavage

47) Ear Irrigations


48) Electrocardiogram: 12 Lead

49) Electrocardiogram: Right Precordial and Left Posterior Leads


50) Emergency Needle Thoracentesis
51) Emergency Primary Assessment

52) Emergency Secondary Assessment

53) Emergency Thoracotomy and Internal Defibrillation


54) End-Tidal Carbon Dioxide Monitoring

55) Endotracheal and Tracheostomy Tube Cuff Care

56) Endotracheal Tube and Tracheostomy Tube: Oxygen Administration

57) Endotracheal Tube Extubation and Tracheostomy Tube Decannulation


58) Endotracheal Tube Intubation

59) Endotracheal Tube Intubation: Advanced Practice

60) Endotracheal Tube: Skin and Oral Care


61) Epistaxis: Anterior Packing

62) Epistaxis: Insertion of Balloon Catheters

63) Epistaxis: Posterior Packing


64) Epistaxis: Topical Agents
65) Esophageal Foreign Body Removal

66) Esophageal Tracheal Double-Lumen Airway (Combitube)


67) Esophagogastric Tamponade Tube: Insertion and Care
68) External Defibrillation

69) External Jugular Venous Access


70) Fecal Impaction Removal
71) Feeding Tube: Medication Administration

72) Feeding Tube: Verification of Placement

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 44


APPENDICES

Competency List

73) Feeding Tubes: PEG, Gastrostomy, and Jejunostomy Care


74) Gastric Lavage for Gastrointestinal Bleeding

75) Gastric Lavage for Removal of Toxic Substances

76) Gauze and Elastic Bandages


77) Grief Support for Patients and Family

78) Hyperthermia Measures


79) Hypothermia Measures
80) Immobilization Devices

81) Intraabdominal Pressure Monitoring

82) Intravenous Therapy: Discontinuation


83) Intravenous Therapy: Dose and Flow Rate Calculation

84) Intravenous Therapy: Dressing Change

85) Intravenous Therapy: Initiation

86) Intravenous Therapy: Regulation of Flow Rate


87) Intravenous Therapy: Solution Change

88) Laryngeal Mask Airway

89) Life-Sustaining Therapy: Withholding and Withdrawing


90) Lumbar Puncture

91) Massive Transfusion

92) Mechanical Ventilation: Volume and Pressure Modes


93) Medication Administration: Continuous Subcutaneous Infusion
94) Medication Administration: Intermittent Infusion Methods

95) Medication Administration: Intradermal Injection and Allergy Skin Testing


96) Medication Administration: Intramuscular Injection
97) Medication Administration: Intravenous Bolus

98) Medication Administration: Local Infiltration and Topical Agents for Wound Anesthesia
99) Medication Administration: Mixing Medications in One Syringe
100) Medication Administration: Nasal Instillation

101) Medication Administration: Nebulized

45 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


APPENDICES

Competency List

102) Medication Administration: Oral


103) Medication Administration: Rectal Suppositories

104) Medication Administration: Subcutaneous Injection

105) Medication Administration: Topical


106) Midline Catheter: Maintenance and Dressing Change

107) Midline Catheter: Removal


108) Moist Heat: Compresses and Sitz Baths
109) Nasal Cannula or Oxygen Mask Application

110) Nasal Foreign Body Removal

111) Nasogastric Tube: Insertion, Irrigation, and Removal


112) Nasopharyngeal Airway Insertion

113) Nasopharyngeal Suctioning

114) Ophthalmic Foreign Body Immobilization

115) Oral Airway Insertion


116) Oxygen Therapy and Oxygen Delivery

117) Pain Relief

118) Paracentesis
119) Patient Positioning: Dyspnea

120) Patient Positioning: Hypotension

121) Patient Positioning: Increased Intracranial Pressure


122) Patient Positioning: Lateral, Sims (Semiprone), and Log Rolling
123) Patient Positioning: Moving Up in Bed

124) Patient Positioning: Supine or Prone


125) Patient Positioning: Supported Fowler
126) Peak Expiratory Flow Measurement

127) Pelvic Examination


128) Peritoneal Lavage: Diagnostic: Advanced Practice
129) Pneumatic Antishock Garment

130) Preoperative Care

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 46


APPENDICES

Competency List

131) Pressure Dressing


132) Pulmonary Artery Catheter Insertion (Assisting) and Monitoring

133) Pulmonary Artery Catheter: Mixed Venous Oxygen Saturation Sample

134) Pulse Oximetry


135) Pulsus Paradoxus Assessment

136) Radial Pulse


137) Restraint Application and Monitoring
138) Resuscitation Bag: Manual Self-Inflating in Mechanically Ventilated Patients

139) Right Atrial and Central Venous Pressure Monitoring

140) Seizure Precautions


141) Skin Traction

142) Specimen Collection: Capillary Blood Gases

143) Specimen Collection: Midstream (Clean-Voided) Urine

144) Specimen Collection: Nose and Throat Specimens for Culture


145) Specimen Collection: Sputum

146) Specimen Collection: Stool

147) Specimen Collection: Timed Urine Specimen


148) Specimen Collection: Urine from Indwelling Catheter

149) Specimen Collection: Urine Screening for Glucose, Ketones, Protein, Blood, pH, and Specific Gravity

150) Specimen Collection: Wound Drainage


151) Spinal Immobilization: Cervical Collar, Backboard, and Vacuum Mattress
152) Splinting: General Principles

153) Splinting: Traction Splints


154) Splinting: Vacuum Splints
155) Staple and Suture Removal

156) Streptokinase for Acute Myocardial Infarction


157) Suctioning: Endotracheal and Tracheostomy Tube
158) Suctioning: Nasotracheal

159) Suctioning: Oropharyngeal

47 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM


APPENDICES

Competency List

160) Symptom Management at End of Life


161) Thoracentesis

162) Tracheostomy Tube: Care and Suctioning

163) Transfer Technique: Assisting Patients from Bed to Chair


164) Transfer Technique: Assisting Patients to Sitting Position

165) Transfer Technique: Horizontal Transfer of Patients from Bed to Stretcher (Slide Board or Friction-
Reducing Board)
166) Transfer Technique: Using Mechanical Lifting Device
167) Transfusion Reaction

168) Urinary Catheter: Closed Continuous Irrigation


169) Urinary Catheter: Indwelling Catheter Care

170) Urinary Catheter: Indwelling Catheter Removal

171) Urinary Catheter: Straight and Indwelling Catheter Insertion (Female)

172) Urinary Catheter: Straight and Indwelling Catheter Insertion (Male)

173) Urinary Catheter: Suprapubic Catheter Care


174) Venous Cut down
175) Ventilation: Bag Mask

176) Ventilation: Mouth to Mask

177) Whole Bowel Irrigation


178) Wound Care: Amputation

179) Wound Cleansing and Irrigation of Traumatic Wounds


180) Wound Closure: Advanced Practice
181) Wound Drainage Evacuation

182) Wound Irrigation

SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM 48


APPENDICES

49 SAUDI EMERGENCY NURSING DIPLOMA CURRICULUM

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